The majority of hospitalized patients can expect to receive an IV catheter during their hospital stay. In fact, peripheral IV placement is the most common invasive procedure performed worldwide. Yet, it is well documented that IV failures and complications remain unacceptably high.¹
Facilities must address these issues to improve patient quality of care. Observation through bedside rounding is an effective strategy to highlight these issues and brainstorm solutions to both improve patient outcomes and reduce costs.
One large, urban community hospital has been successful in bringing together unit-based staff, nursing leadership, nursing professional development, clinical nurse specialists, infection prevention – the Jamboree team – all with the shared goal of improving vascular access outcomes through routine monthly rounding.²
Michelle DeVries, MPH, CIC, VA‐BC, shares her facility’s collaborative process, dubbed a ‘Vascular Access Jamboree’, in a three‐part workshop series. These recorded workshops can be viewed HERE and contain actionable take‐aways.
What is a Vascular Access Jamboree?
A Vascular Access Jamboree is a large, festive gathering of nursing unit leadership, infection prevention, professional development and industry partners collectively performing routine bedside rounding and documenting observations with the goal of improving patient care. This quality improvement audit is treated as a monthly opportunity to partner around best practice for patients.
Step One: Getting Started
Establishing clear goals and definitions is done to understand what the team aims to accomplish, what data needs to be collected and analyzed, and to designate a uniform way to record the data. Consistency in all these areas is important so everyone is on the same page.
Gathering the Team
The next step is building the Vascular Access Jamboree. This team is generally composed of both a Hospital Team and Industry Partners, as seen in the table below.
It is important to note that selling/upselling products is not done during a Vascular Access Jamboree. All team members from across the hospital team and industry partners must be focused on improving patient quality of care through respectful collaboration.
Step 2: Collecting Data and Implementing Change
Before collecting data, both a purpose and an end goal to measure success must be defined. An example from a Vascular Access Jamboree was a quality improvement project to decrease premature dressing changes to reduce infection risk. The end goal was for 80% dressings to remain fully intact without reinforcement for up to 7 days, or when the dressing had to be changed due to other reasons.
This pilot project found that while education alone failed to achieve desired outcome, two types of dressings, when paired with gum mastic adhesive, were successful in keeping dressings intact more than 80% of the time. While increasing adhesion is important to keep dressings intact, higher risk of skin‐tear injuries can be a concern while doing so. However, no skin‐related injuries were reported from any patients who received the gum mastic adhesive, dressing, and education combination.³
Access the full study HERE. [Devries‐JWOCN]
Opportunities for Improvement at Interfaces
Routine observation will highlight trends and uncover issues. However, often such issues are at the intersection of several different products. Addressing these problems can be done with multifaceted approaches that include:
- Leveraging expertise between various devices
- Direct observation rather than chart review
- Reviewing practice rather than policy
Step 3: Post‐Implementation Monitoring
The basic components of creating a Vascular Access Jamboree are:.
- Plan: Let’s have a jamboree!
- Do: Gather the team and round patient bedsides
- Check: Come back and do it again
- Act: What do we need to do differently?
Trends are then examined by device, by unit, and by quarter in reaching the defined improvement. Jamborees that are unannounced ensure units are observed as they routinely operate.
The 2021 INS Standards recommend using audits and feedback when implementing changes in practice.⁴ Jamboree‐associated audits have:
- Changed policies
- Improved practices
- Increased collaboration
- Strengthened understanding
- Optimized product use
FloMedical can partner with your institution to facilitate a Vascular Access Device Site Assessment to determine the state of both dressing and skin integrity for patients in your facility, while providing you and your team with information on your facility’s infection risk, nurse efficiency, and product waste. Click HERE to request a Point Prevalence Assessment today!
References
1. Helm RE, et al. Accepted but Unacceptable: Peripheral IV Catheter Failure. J Infus Nurs. 2015;38:189‐202.
2. DeVries, M. Scott, N. (February 2020). Jamboree: Bringing It All Together. Intravascular Quarterly, X(1), 3‐4. Retrieved from ********issuu.com/avainfo/docs/iq_‐_february_2020?fr=sODMwZjE0Mjc5Mw.
3. Devries M, et al. Improving Vascular Access Dressing Integrity in the Acute Care Setting: A Quality Improvement Project. J Wound Ostomy Continence Nurs. 2021;48(5)383‐388.
4. Gorski LA, Hadaway L, Hagle ME, et al. Infusion Therapy Standards of Practice. J Infus Nurs. Revised 2021.