This best practice guideline focuses on assisting all nurses providing care to clients requiring infusion therapy in diverse practice settings, both institutional and community. It covers client assessment and appropriate device selection, which is applicable to all clients requiring vascular access. Nurses working in specialty areas such as paediatrics, gerontology, oncology and dialysis will require further practice direction from guidelines in their unique area of practice.
This best practice guideline focuses on assisting all nurses providing care to clients requiring infusion therapy in diverse practice settings, both institutional and community. It covers client assessment and appropriate device selection, which is applicable to all clients requiring vascular access. Nurses working in specialty areas such as paediatrics, gerontology, oncology and dialysis will require further practice direction from guidelines in their unique area of practice.
As an introduction, we’ve provided summaries of the practice recommendations from the BPG document — but we strongly encourage downloading RNAO’s official PDF.
All clients requiring vascular access, regardless of duration of therapy, require the use of a structured approach such as an algorithm to facilitate a comprehensive client assessment and the development of a vascular access care plan prior to the initiation of therapy.
To determine the most appropriate type of vascular access device, the nurse needs to consider the following factors:
Nurses will discuss the options for vascular access devices with the client and family caregivers. Device selection is a collaborative process between the nurse, client, physician and other members of the health care team, however, the nurse has a role to educate and advocate for clients in relation to the selection of appropriate devices.
Nurses will document comprehensive information regarding assessment of infusion therapy and device recommendations. This documentation should include, as a minimum:
The principles and practice of infusion therapy should be included in the basic education of nurses in their core curriculum, be available as continuing education, be provided in orientation to new organizations and be made available through continuing professional development opportunities.
Health care organizations should have access to infusion therapy nursing expertise to support optimal vascular access outcomes.
Health care organizations must have quality improvement systems in place to monitor client outcomes. This should include an interdisciplinary process that will monitor quality indicators related to vascular access and infusion therapy, the provision of timely feedback for improved client outcomes, and systems for reporting and capturing data to support practice improvements.
In order to support continuity of client care within and between organizations, all clients with a vascular access device and/or their caregivers need to have available comprehensive information about the device, which should include, as a minimum:
Nursing best practice guidelines can be successfully implemented only where there are adequate planning, resources, organizational and administrative support, as well as the appropriate facilitation. Organizations may wish to develop a plan for implementation that includes:
