Guideline: Peripherally inserted central venous catheters (PICC)
Pediatric: Nurse-Placed Peripherally Inserted Central Catheters in an Interventional Radiology...
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in interventional radiology, such as transcatheter chemoem- bolization and tumor ablation, allow direct delivery of che- motherapeutic and radiotherapy agents to malignancies. These procedures tend to be less invasive, less expensive, and frequently are associated with less morbidity. The Evolution of Site Verification in Interventional Radiology Floreen Knight, BSN, RN Children’s Hospital Boston, Walpole, MA Caring for patients in interventional radiology (IR) presents unique challenges in procedural site verification. At Child- ren’s Hospital Boston, we have developed a site verification process that addresses the issues that differentiate IR from the operating room environment. Our IR site verification pro- cess evolved as a result of an incident in which, despite adher- ence to existing policies, the contralateral site was accessed. As a team, we responded by analyzing and identifying the contributing risk factors specific to IR and incorporating them into a revised site verification checklist that meets JCA- HO standards. This poster will follow the evolution of this site verification tool. Kyphoplasty in the Radiology Suite Mary Kramer, MSN, RN, CCRN, CRN Community Hospital of the Monterey Peninsula, Marina, CA This is a poster representing the evolution of performing kyphoplasties in a nonprofit community hospital. Implemen- tation of the service contributed to revisions in the hospital’s physician privileging process and the policy for sedation monitoring. The presentation will review the procedure, the demographics of cases, the introduction of the procedure, how it influenced hospital policies, the types of sedation used, the process devel- oped for selecting type of sedation, and how that has changed hospital policy. Lights, Camera, Action! Video ConsentdTake Two! Pamela Marron, BSN, RN, CPN, Sarah Moyer, RN Columbus Children’s Hospital, Columbus, OH To meet the needs of the 21st century, radiology nursing will rise to new levels. With the growth of technology, new crea- tive strategies need to be developed to enhance physician/ patient communication. In our Pediatric Radiology Department, we have instituted an innovative concept of video consenting for procedural seda- tions. Legality issues were investigated by our department ra- diologist through the Procedural Sedation Board and legal services. A survey was instituted. The purpose of our survey is to analyze parental satisfaction in using video vs. personal physician consent. Completed surveys have indicated that video consents have improved the quality of service for our pediatric patients and families. Pediatric: Nurse-Placed Peripherally Inserted Central Catheters in an Interventional Radiology Setting Improves Outcomes Beverly Paul, RN, Carol Czajka, RN Children’s Hospital of Philadelphia, Philadelphia, PA Pioneering quality performance management for the vascular access needs in children is of critical importance. Specifically, appropriate assessment and timely intervention of central line access are priorities. Santolucito (2001) indicates that im- proved triage of appropriate vascular access intervention, for example Peripherally Inserted Central Catheters (PICC) placement, could reduce the trauma and costs of multiple con- ventional short peripheral IV catheter insertions, as well as po- tentially reducing length of hospital stay. ‘‘Failure to establish a reliable vascular access prior to discharge often results in postponed discharge dates, prolonged hospitalization and in- creased cost.’’ A proactive approach to known barriers related to catheter selection and care will be pivotal to the success of the Pediatric-placed PICC. We embarked on a unique ap- proach to improve outcomes in children. As a result Vascular Access Nurses currently place PICCs in the Interventional Ra- diology setting. The team consists of a Radiology Nurse, a Vascular Access Nurse, a Radiology Technologist, and an Interventional Radiology Attending Physician. In this model patients are evaluated for appropriateness of a nurse-placed PICC, sedation, urgency, and scheduled accordingly. In the Interventional Radiology setting the patient receives IV seda- tion, PICC lines are placed using maximum sterile barrier technique, ultrasound and fluoroscopy capability. This is made possible only with the expertise of all team members. Significant results of this patient care model include efficiency, patient safety, and cost effectiveness. Sedation and MRI Safety: Experiences at the Children’s Hospital of Philadelphia Lorie Reilly, MSN, CRNP, Elicia Parave, MSN, CPNP, CEN The Children’s Hospital of Philadelphia, Philadelphia, PA Annually, approximately 8,000 patients receive an MRI scan at The Children’s Hospital of Philadelphia. About 50% of these children require sedation to maintain immobility throughout the scan. Our multidisciplinary team of physicians, nurse practitioners, nurses, technologists, and child life specialists contribute their expertise to phone triage, screening, and presedation assess- ment/planning, medication administration, management of complications, and safe recovery from sedation. This poster outlines the roles of team members and follows the child from MRI scheduling, sedation, recovery, and sub- sequent discharge to home. Technical and Clinical Perspectives on Uterine Artery Embolization: What Nurses Need to Know Kenneth Rempher, PhD, MBA, RN, APRN, Celia Dokas, RN, Kris Prentice, RN, Denise Ercole, RN Sinai Hospital of Baltimore, Baltimore, MD Session Abstracts JOURNAL OF RADIOLOGY NURSING 94 SEPTEMBER 2006 www.radiologynursing.org
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Transcript of Pediatric: Nurse-Placed Peripherally Inserted Central Catheters in an Interventional Radiology...
in interventional radiology, such as transcatheter chemoem-bolization and tumor ablation, allow direct delivery of che-motherapeutic and radiotherapy agents to malignancies.These procedures tend to be less invasive, less expensive,and frequently are associated with less morbidity.
The Evolution of Site Verification in InterventionalRadiology
Floreen Knight, BSN, RN
Children’s Hospital Boston, Walpole, MA
Caring for patients in interventional radiology (IR) presentsunique challenges in procedural site verification. At Child-ren’s Hospital Boston, we have developed a site verificationprocess that addresses the issues that differentiate IR fromthe operating room environment. Our IR site verification pro-cess evolved as a result of an incident in which, despite adher-ence to existing policies, the contralateral site was accessed.As a team, we responded by analyzing and identifying thecontributing risk factors specific to IR and incorporatingthem into a revised site verification checklist that meets JCA-HO standards. This poster will follow the evolution of thissite verification tool.
Kyphoplasty in the Radiology Suite
Mary Kramer, MSN, RN, CCRN, CRN
Community Hospital of the Monterey Peninsula, Marina, CA
This is a poster representing the evolution of performingkyphoplasties in a nonprofit community hospital. Implemen-tation of the service contributed to revisions in the hospital’sphysician privileging process and the policy for sedationmonitoring.
The presentation will review the procedure, the demographicsof cases, the introduction of the procedure, how it influencedhospital policies, the types of sedation used, the process devel-oped for selecting type of sedation, and how that has changedhospital policy.
Lights, Camera, Action! Video ConsentdTake Two!
Pamela Marron, BSN, RN, CPN, Sarah Moyer, RN
Columbus Children’s Hospital, Columbus, OH
To meet the needs of the 21st century, radiology nursing willrise to new levels. With the growth of technology, new crea-tive strategies need to be developed to enhance physician/patient communication.
In our Pediatric Radiology Department, we have instituted aninnovative concept of video consenting for procedural seda-tions. Legality issues were investigated by our department ra-diologist through the Procedural Sedation Board and legalservices. A survey was instituted. The purpose of our surveyis to analyze parental satisfaction in using video vs. personalphysician consent. Completed surveys have indicated thatvideo consents have improved the quality of service for ourpediatric patients and families.
Pediatric: Nurse-Placed Peripherally Inserted CentralCatheters in an Interventional Radiology SettingImproves Outcomes
Beverly Paul, RN, Carol Czajka, RN
Children’s Hospital of Philadelphia, Philadelphia, PA
Pioneering quality performance management for the vascularaccess needs in children is of critical importance. Specifically,appropriate assessment and timely intervention of central lineaccess are priorities. Santolucito (2001) indicates that im-proved triage of appropriate vascular access intervention,for example Peripherally Inserted Central Catheters (PICC)placement, could reduce the trauma and costs of multiple con-ventional short peripheral IV catheter insertions, as well as po-tentially reducing length of hospital stay. ‘‘Failure to establisha reliable vascular access prior to discharge often results inpostponed discharge dates, prolonged hospitalization and in-creased cost.’’ A proactive approach to known barriers relatedto catheter selection and care will be pivotal to the success ofthe Pediatric-placed PICC. We embarked on a unique ap-proach to improve outcomes in children. As a result VascularAccess Nurses currently place PICCs in the Interventional Ra-diology setting. The team consists of a Radiology Nurse,a Vascular Access Nurse, a Radiology Technologist, and anInterventional Radiology Attending Physician. In this modelpatients are evaluated for appropriateness of a nurse-placedPICC, sedation, urgency, and scheduled accordingly. In theInterventional Radiology setting the patient receives IV seda-tion, PICC lines are placed using maximum sterile barriertechnique, ultrasound and fluoroscopy capability. This ismade possible only with the expertise of all team members.Significant results of this patient care model include efficiency,patient safety, and cost effectiveness.
Sedation and MRI Safety: Experiences at the Children’sHospital of Philadelphia
Lorie Reilly, MSN, CRNP, Elicia Parave, MSN, CPNP, CEN
The Children’s Hospital of Philadelphia, Philadelphia, PA
Annually, approximately 8,000 patients receive an MRI scanat The Children’s Hospital of Philadelphia. About 50% ofthese children require sedation to maintain immobilitythroughout the scan.
Our multidisciplinary team of physicians, nurse practitioners,nurses, technologists, and child life specialists contribute theirexpertise to phone triage, screening, and presedation assess-ment/planning, medication administration, management ofcomplications, and safe recovery from sedation.
This poster outlines the roles of team members and followsthe child from MRI scheduling, sedation, recovery, and sub-sequent discharge to home.
Technical and Clinical Perspectives on Uterine ArteryEmbolization: What Nurses Need to Know
Kenneth Rempher, PhD, MBA, RN, APRN, Celia Dokas, RN,Kris Prentice, RN, Denise Ercole, RN
Sinai Hospital of Baltimore, Baltimore, MD
Session Abstracts JOURNAL OF RADIOLOGY NURSING
94 SEPTEMBER 2006www.radiologynursing.org
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