Access Device Guidelines

More than forty years ago, healthcare professionals were limited to administering IV drugs through short-term peripheral or subclavian access devices. The practice of administering drugs to other areas of the body such as the epidural or peritoneal spaces existed in theory only. Flash forward forty years, and youll see how the healthcare landscape has changed. Today, you have at your disposal, a variety of both short-term and long-term access devices with new devices and improvements being continuously added to the mix. Healthcare professionals can now develop complex plans of treatment, and the quality of life and safety of patients has also improved. Although procedures for managing both the routine care and the complications that can arise in patients are common for most access devices, maintaining extensive knowledge on each device can be a challenge. The latest edition of Access Device Guidelines: Recommendations for Nursing Practice and Education will help you develop the expertise you need in this climate of perpetual change. For this third edition, an extensive literature search was conducted for each type of access device available. Youll also explore the latest technologies, management procedures, and the controversies that still exist in the field. With little evidence-based knowledge to guide nursing practice in the use of access devices, these guidelines have instead focused information culled from the available literature on such procedures as strict hand washing, strict aseptic technique, and a consistent approach to maintenance care. Developed to provide recommendations for application of access device technology within nursing practice, these guidelines provide the foundation for evidence-based practice and a means to evaluate your own procedures and practices.

"In a dynamic and intricate healthcare system, the Oncology Nursing Society (ONS) understands the need to provide access device resources supported by best practice and available literature, research, guidelines, and expert opinion. It is with both pride and gratitude that we present the fourth edition of Access Device Guidelines: Recommendations for Nursing Practice and Education. The intent of these guidelines is to provide the foundation for evidence-based practice and support oncology nurses in their day-to-day care of patients. This publication marks the fourth edition of Access Device Guidelines, a slight departure from the previous publication in 2017 titled Access Device Standards of Practice. After considerable thought and discussion, this decision to return to Guidelines was made based on the current evidence available surrounding access device practice and the process utilized to update and develop the text"--

"The use of venous access devices (VADs) is central to the care that nurses provide to patients with cancer. Oncology nurses must base their practice on evidence-based research when available, but a lack of evidence has been a professional challenge for decades. With limited research to guide practice, ongoing controversies remain regarding optimal device management. Since 1989, the Oncology Nursing Society (ONS) has provided guidelines to establish a foundation for access device management. With this new text, ONS has identified practice standards, developed from a synthesis of evidence, critical review, and analysis of aspects of access device management for which nursing is accountable. Access Device Standards of Practice for Oncology Nursing reviews the controversies in access device care, explores the range of devices currently available, details the advantages and disadvantages of each device to ensure optimal selection based on patient needs, and discusses the key legal ramifications concerning access devices and their management. With access device technology becoming more complex, this text is an essential resource for nurses practicing in a wide range of settings to ensure safe, effective care of patients with VADs."--Publisher's description.

"In a dynamic and intricate healthcare system, the Oncology Nursing Society (ONS) understands the need to provide access device resources supported by best practice and available literature, research, guidelines, and expert opinion. It is with both pride and gratitude that we present the fourth edition of Access Device Guidelines: Recommendations for Nursing Practice and Education. The intent of these guidelines is to provide the foundation for evidence-based practice and support oncology nurses in their day-to-day care of patients. This publication marks the fourth edition of Access Device Guidelines, a slight departure from the previous publication in 2017 titled Access Device Standards of Practice. After considerable thought and discussion, this decision to return to Guidelines was made based on the current evidence available surrounding access device practice and the process utilized to update and develop the text"--

This Open access book offers updated and revised information on vessel health and preservation (VHP), a model concept first published in poster form in 2008 and in JVA in 2012, which has received a great deal of attention, especially in the US, UK and Australia. The book presents a model and a new way of thinking applied to vascular access and administration of intravenous treatment, and shows how establishing and maintaining a route of access to the bloodstream is essential for patients in acute care today. Until now, little thought has been given to an intentional process to guide selection, insertion and management of vascular access devices (VADs) and by default actions are based on crisis management when a quickly selected VAD fails. The book details how VHP establishes a framework or pathway model for each step of the patient experience, intentionally guiding, improving and eliminating risk when possible. The evidence points to the fact that reducing fragmentation, establishing a pathway, and teaching the process to all stakeholders reduces complications with intravenous therapy, improves efficiency and diminishes cost. As such this book appeals to bedside nurses, physicians and other health professionals.

Since their first application in 1982, Totally Implantable Venous Access Devices (TIVADs) have become increasingly important in the clinical practice, as more intensive chemotherapy and parenteral treatments have come into use. At this time, there is objective evidence that TIVADs are a safe, effective strategy for long-term venous access; they play a significant role throughout the management of the oncology patient, as they are needed in the initial phases for active treatments as well as in the last stages for palliative measures, making possible repeated administration of chemotherapeutic vesicant agents, nutrients, antibiotics, analgesics, and blood products. According to a number of prospective studies, use of TIVADs is associated with a significant complication rate (10% to 25% of all patients). Evidence-based data support that most complications are directly related to inappropriate technique of placement and/or nursing care, sometimes leading to TIVAD loss, significant morbidity, increased duration of hospitalization, and additional medical cost. A group of world-renowned experts - both in the clinical and research fields – contributed to this volume, whose aim is to provide clinicians, nurses and medical students with a multidisciplinary, full update on these devices, as long term central venous access can no be longer considered a routine matter, and serious complications can be maintained at a very low level only if strict adherence to a well-defined protocol of surgical technique and of catheter care is maintained.

Central venous access devices (CVADs) are used within a variety of areas in both hospital and community health care settings to administer blood or fluids, to provide long term access for repeat transfusion of blood or blood products, chemotherapy, parenteral nutrition and antibiotic therapy, and to provide immediate access in emergency situations. Central venous access devices is a practical guide to the care and management of CVADs aimed at student nurses, newly qualified nurses and more experienced nurses who are unfamiliar in dealing with these devices. Central venous access devices addresses patient assessment and education, relevant anatomy and physiology, appropriate device selection, and guidelines on insertion, follow-up care and management of CVADs. Each category of CVAD - including peripherally inserted central catheters, non tunnelled central venous catheters, skin tunnelled catheters and implanted ports - is explored in turn. Concluding chapters explore hazards of insertion, prevention and management of complications, and patient perspectives on living with a CVAD

Volume numbers determined from Scope of the guidelines, p. 12-13.