KerryTaliaferroCNC

IntravenousAccessTeam

CanberraHospitalACT

AVASASM2017

DEVELOPMENT OF AN INTRAVENOUS ACCESS TEAM CREDENTIALING PACKAGE

Financial Disclosures

1.DisclosureofRelevantFinancialRelationships

Ihavenofinancialrelationshipstodisclose

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Canberra Hospital & Health Services

Acutecareteachinghospital

600inpatientbeds

ServicesACT&SouthernNSW

Providesspecialistandacutecaretomorethan500,000people

IVATestablished2014

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IVAT AIM

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Recruitandtrainnewstaff

Qualifiedcompetentpractitioners

Developacredentialingpackage

What we had...

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5

How to go from here....

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To finding a plan

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Australian credentialing programs

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International Programs

PICCACADEMYNETWORK(PAN)• TraintheTrainer• 40• Expense• RecognitioninAustralia

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International

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WoCOVA evidence based consensus

• StandardminimalrequirementsfortrainingonCVAD’s

• 16recommendationsaskeytoensuringsafeandcompetentpractice

• Standardiseeducation

• Simulationpractice

• Supervisedinsertions

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The Basics

• A&P• Ultrasound• CVADknowledge• Infectioncontrol&SurgicalANTT• Deviceselection• Insertionmethods• Troubleshooting• CareandMaintenance• Proficiencyandcredentialing

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Adult learning methods

• Experientiallearning• Integrationofknowledge,activityandreflection

• Experientialeducation• Takeintoaccountlearnersknowledgebase/experience

• Situatedlearning• Active/guidedparticipationthroughapprenticeship• Communityofpractice• Student– Mentor

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Situational Learning

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Offer Variety

• Facetoface

• Elearning

• External

• Internal

• Simulation

• Handsonsupervised

• Formalobjectivecredentialing

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The Learner

• Gainknowledge,skills,competency

• Establishedrequiredstandards

• Achieveidentifiedoutcomes

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The Trainer

• Defineneeds

• Setobjectives

• Communicate

• Monitorprogress

• Feedback

• Encourage

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CredentialingCriteriaforPICCInsertionsforIVATmembers

PreRequisites

CompetencyAchievedin

SuccessfulapplicationtoIVATRN2role

Venepuncture andbloodcollection

Intravenouscannulation

TrainingduringIVATRN2roletoachievePICCinsertioncompetency

AttendonedayUltrasoundguidedPICCinsertionworkshop

Completethesee-learningprograms

Consent

Aseptictechnique

CVADCareandmaintenance

PatientidentificationandProcedurematching

Scrubbinggowningandgloving

OneononelectureonCVAD’sandUltrasoundguidedaccesswithIVATCNCandStaffspecialistICU

SupervisedPICCinsertionswithIVATCNC– until

PassIVATCVADinsertionandcareexam

FormalClinicalCompetencyofprocessfromreferraltocompletedinsertionandfollowup

OrientationtotheIVATRN2role

VascularAccessDeviceSelection,InsertionandManagementOnlineCourse(CourseCost:$50.00- optional)

UltrasoundforPeripheralAccessTrainingCourse

Sherlock3CG*TipConfirmationSystem(TCS)TrainingCourseandcompetency

Completeelearning programsathttps://www.bardaccess.com/clinical_training/login.php

MaintainInsertionSkillsReassessmentEvery3years

DIVISIONOFMEDICINEExecutiveDirectorofMedicine

DirectorofNursing

AmbulatoryServicesAssistantDirectorofNursing

INTRAVENOUSACCESSTEAM

IVATCNC

NHSQSTANDARD3.9.1:INVASIVEDEVICES STANDARD3COMMITTEE

Scrubbinggowningandgloving/SurgicalANTT/ECGTCSPracticalassessment Obtain

Ultrasoundguidedaccesstrainingandcompetency

TraininginECGTCS

IVATRN2

Pre requisites

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elearningInternal External

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Training for IVAT RN 2 role

• OrientationtoIVATRN2role• AttendexternalonedayUltrasoundguidedPICCinsertionworkshop

• OneononelecturesonCVAD’sandUltrasoundwithCNCandStaffspecialistICU

• S,G&G/SurgicalAseptictechniquetraining

• SupervisedPICCinsertionswithCNC

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Assessments

• S,G&G/Aseptictechnique>Practicalassessment• FormalClinicalCompetencyofprocessfromreferraltocompletedinsertionandfollowup• PassIVATCVADinsertionandcareexam

• MaintainInsertionSkills

• Reassessmentannually

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Competency

• Skills• Knowledge• Attitude

• Valid• Reliable• Fair

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Competency based assessment

Fourdomains• ProfessionalPractice

• CriticalThinkingandAnalysis

• ProvisionandCoordinationofCare

• CollaborativeandTherapeuticPractice

ArandaS,YatesP.Competencyassessmenttoolformanagementofcentralvenousaccessdevices(CVADs).Canberra:TheNationalCancerNursingEducationProject(EdCaN),CancerAustralia;2009.

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CATEGORY / LEVEL

• Knowledge• Comprehension• Application• Analysis• Synthesis• Evaluation

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PERFORMANCE LEVEL

COMPETENTEstablishedcompetenceasaspecialistwithintheirclinicalfieldofpracticeCOMPETENTBeginningcompetenceasaspecialistwithintheirclinicalfieldofpracticeNOTYETCOMPETENT

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Written exam topics

• Anatomy&Physiology• Patientassessment&deviceselection• Insertion• Documentation• Complications• Management• Scenarios

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Competency

• Certificate• Capabiliti record• 40hrsCPD

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Participants Perceptions

Did you attend an Outside (Industry) PICC study day prior to starting with IVAT

•Yes=3

•No=1

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Responses

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CVAD SKILLS

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0123456789

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RankedEasiest(1)toHardest(10)

Averagerank

Lowestranked

HighestRanked

Ultrasound Skills

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0

0.5

1

1.5

2

2.5

3

3.5

4

4.5

5

HoldingtheProbeSteady

Identifyingvessels/nerves/structures

AccessingveinsforPICCinsertion

AccessingveinsforPIVC

(cannula) insertion

Identifyingtheneedletip

RankedEasiest(1)toHardest(5)

AverageRank

LowestRanked

HighestRanked

Did you undertake independent research for the exam?

Yes=3No=1• Hospitallibrary• Generalanatomyfromtestbooks• Hospitalpolicy• Intravenousaccessjournals• BARDonlinearticles

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Time to confident insertion

• 5weeks

• 6weeks

• 8weeks*

*parttime

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Confidence level

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Knowledge level

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0

10

20

30

40

50

60

70

80

90

100

Lowestranking Highestranking Averageranking

HowwouldyourateyourknowledgeofCVAD'sonascaleof1to100(100=expert)

BeforeTraining Aftertraining

Validation

• NHSQSAccreditation2105• Standard3HAICommittee• SDU- Capabiliti• EducationActivityReport• RegisteredVET

• ValidationbyexternalPICCCNC

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Future directions

• PAN??• Collaboration!

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I acknowledge the support of an ACT Health Nursing and Midwifery Travel Scholarship to attend this conference and present to you today

Thank you!