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Advancing IV Therapy

News and presentations from today’s Advancing IV Therapy conference chaired by Jackie Nicholson Chair, National Infusion and Vascular Access Society (NIVAS).

Jackie a Vascular Access Nurse Consultant at St George’s Healthcare NHS Trust opened the conference with a presentation on IV therapy and the care of vascular access devices – a national and international perspective.
Jackie’s full PowerPoint presentation

Jackie comments: 

"Nursing Standards: We need these type of standards, nobody takes responsibility for IV quality

Tip location combination technology: There are a couple of companies offering positioning magnetic and ECG.  Positioning – ECG & Doppler ultrasound only currently available in the USA

Medical glue with a securement device helps prevent infection and no 24 hour dressing change

Andrew Barton has been trialing a new machine to aid peripheral cannulation.  It’s a bit like a TENs machine and the pulses make veins more palpable.  Cheaper than an ultrasound machine

NICE medical technology guidance, anyone putting in central lines should be following these standards

Integrated all in one placement device, couple of brands available in the UK.  Andrew Barton said that he had found one of these very successful and can last upto 4 weeks

The OMG PIVC study out of Australia is a really good study

If we use standards and guidelines we can improve patient outcomes"

NICE guideline and quality standards for IV fluid therapy in adults in hospital
Dr Mark Tomlin 
Critical Care Consultant Pharmacist, Southampton University Hospitals NHS Trust and member, Guideline Development Group, IV Fluid Therapy in Adults in Hospital, NICE

Mark comments:

"I have a long interest in the sort of fluids that are used

- First question should always be “Does the patient need IV fluids”, it has to be

- My organization spends over £1million on IV fluids.  If we were to introduce a new drug costing that much there would be questions asked

- Many staff who prescribe IV fluids don't know the likely fluid and electrolyte needs of individual patients

- IV fluid prescriptions should include the type of fluid to be administered, the volume and the duration

- This always causes a stir “what are we going to do over the next 24 hours, and write it down”, then everybody knows

- The knowledge out there is often deficient

- Don’t just copy the last bag! Should be a clear assessment and a decision made"

Meeting NMC requirements and competencies for IV Therapy: Supporting revalidation through developing and maintaining skills and competence
Jane Hodson 
Lead IV Practitioner, Guys and St Thomas NHS Foundation Trust

Jane comments:

"Get properly informed consent and document it before carrying out any action: Do we do this?  This is not often heard before putting in a peripheral line

The RCN standard on Infusion Therapy is coming out on Monday

In our trust the Code of Practice for administering medicine is hard to find

We are trying to get a guideline on competence

Engage in professional development

If we can do a competency assessment of managing the line we will see a difference in the trust"

Ensuring appropriate use of IV therapy in line with recent Guidance: Developing an IV fluid management plan for every patient
Andrew Barton 
Advanced Nurse Practitioner in Vascular Access and IV Therapy, Frimley Health NHS Foundation Trust

Andrew comments:

"We use plasma-lyte as is the only fluid comparable to plasma

As an organization we have adopted the NICE Quality Standards

We provide consistent education on our IV course

We inform the patient on their IV fluids"

Developing effective out patient access to intravenous therapy - OPAT
Dr Taran Saluja
 Consultant Micribiologist, Sandwell and Birmingham NHS Trust

Pre-Event Abstract 

Outpatient parenteral antibiotic therapy (OPAT) service provides an innovative way of delivering patient-centred care by treating medically stable patients with intravenous antibiotics in the community; in an ambulatory setting, their own home or on a day-case unit. OPAT service has enabled patients to be discharged from hospital and be managed in the community for completion of their intravenous therapy.
There is an increasing incidence of infections with antibiotic resistant organisms. Patients who could be medically treated in the community are often admitted to the hospital for intravenous antibiotics due to the lack of an appropriate oral agent. 
Receiving intravenous antibiotics at home improves the quality of life for patients. The service is effective with good clinical results and efficient as it has released numerous hospital beds for those in medical need. OPAT is in line with the Trusts ‘Right Care, Right Here’ philosophy and the UK healthcare-quality strategy. Patient feedback is overwhelmingly positive with 98% expressing a high level of satisfaction due to the flexibility of the service, great care, support and expertise of the staff.

Future events of interest:

Demonstrating & Improving Prescribing Competence & Practice
Tuesday 13 December 2016 
Asia House Conference Centre, London

Nurse Prescribing
Monday 30 January 2017 
De Vere West One, London

Nurse Prescribing for Pain
Friday 10 February 2017 
De Vere W1 Conference Centre, London

Effective Nurse Prescribing in End of Life Care
Friday 24 February 2017 
De Vere West One Conference Centre, London

Nurse Prescribing in Cardiology
Friday 31 March 2017 
De Vere West One Conference Centre, London

7 December 2016


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