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Care and Maintenance to Reduce Vascular …

Nursing Best Practice GuidelineShaping the future of NursingApril 2005 care and Maintenance to ReduceVascular AccessComplications2008 Greetings fromDoris Grinspun Executive DirectorRegistered Nurses Association of Ontario It is with great excitement that the Registered Nurses Association of Ontario (RNAO)disseminates this nursing best practice guideline to you. Evidence-based practice supportsthe excellence in service that nurses are committed to deliver in our day-to-day offer our endless thanks to the many institutions and individuals that are makingRNAO s vision for Nursing Best Practice Guidelines (NBPGs) a reality. The Governmentof Ontario recognized RNAO s ability to lead this program and is providing multi-year funding. TazimVirani NBPG program director with her fearless determination and skills, is moving the programforward faster and stronger than ever imagined.

Nursing Best Practice Guideline Shaping the future of Nursing April 2005 Care and Maintenance to Reduce Vascular AccessComplications 2008

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1 Nursing Best Practice GuidelineShaping the future of NursingApril 2005 care and Maintenance to ReduceVascular AccessComplications2008 Greetings fromDoris Grinspun Executive DirectorRegistered Nurses Association of Ontario It is with great excitement that the Registered Nurses Association of Ontario (RNAO)disseminates this nursing best practice guideline to you. Evidence-based practice supportsthe excellence in service that nurses are committed to deliver in our day-to-day offer our endless thanks to the many institutions and individuals that are makingRNAO s vision for Nursing Best Practice Guidelines (NBPGs) a reality. The Governmentof Ontario recognized RNAO s ability to lead this program and is providing multi-year funding. TazimVirani NBPG program director with her fearless determination and skills, is moving the programforward faster and stronger than ever imagined.

2 The nursing community, with its commitment and passionfor excellence in nursing care , is providing the knowledge and countless hours essential to the creation andevaluation of each guideline. Employers have responded enthusiastically to the request for proposals(RFP), and are opening their organizations to pilot test the NBPGs. Now comes the true test in this phenomenal journey: Will nurses utilize the guidelines in their day-to-day practice? Successful uptake of these NBPGs requires a concerted effort of four groups: nurses themselves, otherhealthcare colleagues, nurse educators in academic and practice settings, and employers. After lodgingthese guidelines into their minds and hearts, knowledgeable and skillful nurses and nursing students needhealthy and supportive work environments to help bring these guidelines to life. We ask that you share this NBPG, and others, with members of the interdisciplinary team.

3 There is muchto learn from one another. Together, we can ensure that Ontarians receive the best possible care every timethey come in contact with us. Let s make them the real winners of this important effort!RNAO will continue to work hard at developing and evaluating future guidelines. We wish you the best fora successful implementation!Doris Grinspun, RN, MSN, PhD (cand), OOntExecutive DirectorRegistered Nurses Association of Ontario1 Nursing Best Practice GuidelineHow to Use this DocumentThis nursing best practice guidelineis a comprehensive document providing resources necessaryfor the support of evidence-based nursing practice. The document needs to be reviewed and applied,based on the specific needs of the organization or practice setting/environment, as well as the needs andwishes of the client. Guidelines should not be applied in a cookbook fashion but used as a tool to assist indecisionmaking for individualized client care , as well as ensuring that appropriate structures andsupports are in place to provide the best possible , other healthcare professionals and administrators who are leading and facilitating practice changeswill find this document valuable for the development of policies, procedures, protocols, educationalprograms, assessments and documentation tools.

4 It is recommended that the nursing best practiceguidelines be used as a resource tool. Nurses providing direct client care will benefit from reviewing therecommendations, the evidence in support of the recommendations and the process that was used todevelop the guidelines. However, it is highly recommended that practice settings/environments adaptthese guidelines in formats that would be user-friendly for daily use. This guideline has some suggestedformats for such local adaptation and wishing to use the guideline may decide to do so in a number of ways: Assess current nursing and healthcare practices using the recommendations in the guideline. Identify recommendations that will address identified needs or gaps in services. Systematically develop a plan to implement the recommendations using associated tools and is interested in hearing how you have implemented this guideline. Please contact us to share yourstory.

5 Implementation resources will be made available through the RNAO website to assist individuals andorganizations to implement best practice Nurses Association of OntarioNursing Best Practice Guidelines Program111 Richmond Street West, Suite 1100 Toronto, Ontario M5H 2G4 Website: and Maintenance to Reduce Vascular Access Complications2 Program Team:Tazim Virani,RN, MScN, PhD(candidate)Program DirectorJane M. Schouten,RN, BScN, MBAP rogram CoordinatorHeather McConnell,RN, BScN, MA(Ed)Program ManagerStephanie Lappan-Gracon,RN, MNProgram Coordinator Best Practice Champions NetworkJosephine Santos,RN, MNProgram CoordinatorBonnie Russell,BJProgram AssistantCarrie ScottAdministrative AssistantJulie BurrisAdministrative AssistantKeith Powell,BA, AITWeb EditorCare and Maintenance to ReduceVascular AccessComplications3 Nursing Best Practice GuidelineDevelopment Panel MembersSusanne Nelson, RN, BScN, MN (C), CINA(C)Team Leader Nurse Coordinator Vascular AccessUniversity Health NetworkToronto, Ontario Lisa Valentine, RN, BScN, MNTeam FacilitatorPractice Consultant College of Nurses of OntarioToronto, Ontario Sharon Armes, RN, CINA(C)Clinical Education CoordinatorBard Canada , Ontario Adrienne Austin, RN, BScN, CINA(C)Clinical Manger, Vascular Access Therapy Hamilton Health Sciences CentreHamilton, OntarioNan Cleator, RN, CINA(C)

6 National Clinical ConsultantVictorian Order of Nurses Canada Huntsville, OntarioLina D Onofrio, RN, MNClinical Nurse SpecialistTransfusion Services University Health NetworkToronto, OntarioCynthia Giff, RNNursing Director Medical/Surgical UnitsBrockville General HospitalBrockville, OntarioSusanne Gomes, RN, BScN,Oncology NurseThunder Bay Regional Health Sciences CentreThunder Bay, OntarioGlenda Hicks, RN, BScNNurse Educator/ClinicianCritical care ProgramSt. Joseph s Heath CentreSudbury, OntarioKris Paton, RN, CINA(C)Clinical Leader, Vascular Access TherapyHamilton Health Sciences CentreHamilton, Ontario Sharon Rodkin, RN, CINA(C)Manager, Clinical Consulting Baxter CorporationMississauga, Ontario Jane M. Schouten, RN, BScN, MBAP rogram Staff FacilitatorNursing Best Practice Guidelines ProgramRegistered Nurses Association of OntarioToronto, OntarioRNAO also wishes to acknowledge the following: Diane Legere, RN, APCCN, BScN, MScN(C)for herwork as a Research Assistant in conducting thequality appraisal of the literature and preparationof evidence tables for the development of thisguideline; andTeresa Harper, RN, MSN (Patient EducationSpecialist)for her expertise on client education andher contribution to the development of the clienteducation recommendation of this of interest and confidentiality were made by all members of the guideline development panel.

7 Further details areavailable from the Registered Nurses Association of and Maintenance to Reduce Vascular Access Complications4 AcknowledgementStakeholders representing diverse perspectives were solicited for their feedback and the Registered Nurses Association of Ontario wishes to acknowledge the following for their contribution in reviewing this Nursing Best Practice Allin, RN, BA, CNCC(C) Charge Nurse ICU/Telemetry, Leamington District Memorial Hospital,Leamington, OntarioGina Bagger, RN, BScNFormer Vascular Access Resource Nurse, The Hospital for Sick Children, Toronto, OntarioNancy A. Bauer, , Professional Practice Leader, Leamington District Memorial Hospital, Admin., RN, ETLeamington, OntarioMichele Bellows, RN, CINA(C)Director of care and Emergency Room, Stoneridge Manor/Carleton Place andDistrict Memorial, Carleton Place, OntarioJoan Bennett, RN, CINA(C)RN Surgical Day care , Peri-operative Services, St. Michael s Hospital, Toronto, OntarioSuzanne Benoit, BScN, RN, CINA(C)Nurse Clinician, Systemic Treatment Program, Northeastern Ontario RegionalCancer Centre of the Sudbury Regional Hospital, Sudbury, OntarioIsobelle Blake, RN, BScN, CINA(C)Director of Clinical Management, Bayshore Home Health, St.

8 Catharines, OntarioRosemary Bland, RN, BSN, Nurse Manager, Palliative care , Oncology, and Ambulatory care , CON(C), CINA(C), OCNJ oseph Brant Memorial Hospital, Burlington, OntarioRebecca Brock, RNProgram Manager, Victorian Order of Nurses, North Bay, OntarioLinda Brown, RN, BScN, CINA(C)Nurse Clinician, Chatham-Kent Health Alliance, Chatham, OntarioDonna Burkart, RN, BNClinical Educator, Lake of the Woods District Hospital, Kenora, OntarioPat Carlson, RN, CINA(C)Senior Skin Health Representative, 3M Canada Company, Health care Division,London, OntarioRisa Cashmore, RN, BSc, CIC, CINA(C)Infection Control Specialist, Peel Region Public Health, Brampton, OntarioKathleen Cranston, RN, CON(C), CCRPI nfection Control Practitioner, Thunder Bay Regional Health Sciences Centre,Thunder Bay, OntarioKimberly Dalla Bona, RN, BScN, CINA(C) Clinical Resource Nurse, Saint Elizabeth Health care , Windsor, OntarioCatherine Davilmar, BScN, MBAC linical Consultant, Baxter Corporation, Mount Royal, QuebecSusanne Dodman, RN, BAClinical Education Specialist, Baxter Corporation, Mississauga, OntarioLinda Giesler, RN, BScNNurse Clinician, North Bay General Hospital, North Bay, OntarioJocelyn Grecia Hill, RN, BSN, ONCC linical Nurse Educator/Clinical Nurse Leader IV Therapy & Home Infusion, St.

9 Paul s Hospital-Providence Health care , Vancouver, British ColumbiaElizabeth Hummel, RN, BScNNurse Clinician CCU/ER, North Bay General Hospital, North Bay, Ontario5 Nursing Best Practice GuidelineDianne Husbands, RN, BA, Acting Nurse Manager, IV Therapy, 5 Chest, 2 Uro/Gyne, BScN, ENC(C), MN(C)St. Joseph s Healthcare, Hamilton, OntarioDiana Iaquinto, RN, BScN, CPN(C)Registered Perioperative Nurse, St. Joseph s Healthcare, Hamilton, OntarioTami Jemson, RNPatient care Coordinator IV Program, Kelowna General Hospital, Kelowna,British ColumbiaElsabeth Jensen, RN, PhDResearch Coordinator/Scientist, University of Western Ontario/Lawson HealthResearch Institute, London, Ontario Sherri Keller, RN, CINA(C)Clinical Education Specialist, Becton Dickinson, and Company, Oakville, OntarioTrinet Landry, RN, BScN, CINAM adeleine Larson, RNNurse Educator, Family Child Program, Sudbury Regional Hospital, Sudbury, OntarioMark C. Lepinsky, HBScN, CETNS urgical Services Clinical Educator, Thunder Bay Regional Health SciencesCentre, Thunder Bay, OntarioJune MacDonald-Jenkins, RN, BScN, MN(C)Professor Health Studies Durham/UOIT Collaborative Nursing Program, DurhamCollege and the University of Ontario Institute of Technology, Oshawa, OntarioLorraine Mackett, RN, HBScN, CETNM anager 2B (Medical Unit), Thunder Bay Regional Health Sciences Centre,Thunder Bay, OntarioJoan Maguire, RN, CINA(C)IV Therapy Resource Nurse, Southlake Regional Health Centre, Newmarket, OntarioTerry Major, RN, BScN, CON(C)Thunder Bay Regional Health Sciences Centre, Thunder Bay, OntarioSue Masoorli, RNPresident/CEO, Perivascular Nurse Consultants, Philadelphia, PennsylvaniaSherry McKnight, RN, BScN, CINA(C)

10 Nurse Clinician, Brant Community Healthcare System, Brantford, OntarioJo-Ann Murphy, RNTeam Manager, Near North Community care Access Centre, North Bay, OntarioSuzanne Nagy, RN, CINA(C)Director, Pharmaceutical Services, Bayshore Home Health, Mississauga, OntarioKylie Nowak, RN, MN Nurse Clinician, Infusion Therapy, Mount Sinai Hospital, Toronto, OntarioLouise Oak, RNPICC Nurse Insertionist, Sault Area Hospital, Sault Ste. Marie, OntarioCherie Pinkerton, RN, BNNurse Educator, Health Sciences Centre, Winnipeg, ManitobaSusan Pitalzke, RN, BScN, MPHD irector of Clinical Oncology Systems, Thunder Bay Regional Health SciencesCentre, Regional Cancer Program, Thunder Bay, OntarioMarg Poling, RN, BScN, PHCNPP alliative care Nurse Practitioner, Palliative care Advisor, Victorian Order ofNurses, Thunder Bay and District, Thunder Bay, OntarioWendy L. Pomponio, RN, BScNNurse Clinician, Medical & Rehabilitation Services, Brant Community HealthcareSystem, Brantford, OntarioDonna Prenger, RN, ONAR egistered Nurse (Oncology), Thunder Bay Regional Health Science Centre,Thunder Bay, OntarioChristina Purdon, RN, BScNClinical Educator, Thunder Bay Regional Health Sciences Centre, Thunder Bay, OntarioMary Runde, RN, MN-ACNP, Educator ICU/Critical care , Sault Area Hospital, CNCC (C), CCN(C), CINAS ault Ste.


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