THE CVAA
Newsletter of the Canadian Vascular Access Association
Fall 2022
A return to in-person CVAA Learning Events! The North Eastern Ontario (NEO), Greater Hamilton, and PEI CVAA chapters held full-day education events this fall.
North Eastern Ontario CVAA (NEOCVAA) Chapter Event Update On September 26, 2022, the NEOCVAA chapter held our annual CVAA Learning Event (CLE) in Sudbury, Ontario. We were happy to have had a great turnout of 62 participants back in person and the ability to do some face-to-face networking. This year’s theme was “Partners in Vascular Access 10+ Years” in which four keynote speakers, as well as nine Skills Lab presenters, addressed the changes and
advances over the past ten years and how far we have come. Daphne Broadhurst (CardioMed/ NIPRO) presented “The Perils of Dislodgement,” taking a look at causes of malposition and how we can prevent these events from occurring. She provided insight into new technologies in securement and reviewed some clinical pearls to help decrease these incidents. Sara-Claude Gilbert (Teleflex) discussed “Why the Cavoatrial Junction?” for central venous catheter (CVC) placement and
the most current guideline recommendations to optimally decrease rates of malposition, thrombosis, and infection. Utilizing some of the newer technologies and changes in practice can reduce risk and improve patient outcomes. Michelle DaGloria (Baxter) discussed “Aseptic No Touch Technique (ANTT) Principles for Vascular Access and Beyond” and highlighted the purpose, principle, and practice and how they fit into current clinical practice for infusion therapy continued on page 3…
Studies using the Curos™ Disinfecting Cap for Needleless Connectors have shown a reduction in Central Line-Assoociated Bloodstream Infections (CLABSIs) from 40% - 87% 1
There’s safety in numbers. Now you can protect ALL IV access points. Needleless connectors. Stopcocks. Catheter hubs. Male luers. Hemodialysis connectors. If your patients have an IV access point, there is a 3M™ Curos™ Disinfecting Port Protector to disinfect and protect it. These alcohol-containing caps twist onto access points, helping reduce the risk of intraluminal contamination. Learn more:
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Infection reduction in 30 Long-Term Acute Care Hospitals (LTACHs) was projected to be an annual savings of approximately $3.7 million2
1. 3M™ Curos™ Disinfecting Port Protectors Clinical Evidence Summary 2. Grigonis, PhD Antony M., PhD Amanda M. Dawson, Mary Burkett DNP CNS, Arthur Dylag MA MBA, BS Matthew Sears, and Betty Helber, RN, MS, ANE-BC and. “Antony M. Grigonis.” American Journal of Critical Care. March 01, 2016. http://ajcc.aacnjournals.org/ content/25/2/165.full.
© 3M 2017. All rights reserved. 3M and Curos are trademarks of 3M Company.
and standardizing practice for improving patient safety and clinical outcomes. Dr. Renée Gauthier (NEOCVAA) discussed Medical Assistance in Dying (MAiD), taking a look at the historical landscape and its current processes including Ontario statistics and personal perspective as a provider of MAiD services since 2016. This included insight into the importance of vascular access, as it is a critical piece in the process. Dr. Gauthier also was speaking to the Hamilton CVAA chapter group the same week.
Greater Hamilton CVAA Chapter Event Update On Thursday September 29, clinicians from around southwestern Ontario gathered in Burlington for the Greater Hamilton Chapter’s full-day education CVAA Learning Event. It was a great day with several speakers and hands-on
Three very deserving members were presented with NEOCVAA Lifetime Memberships – Daphne Broadhurst, Bonnie Onyschuk, and Karen Mallet – in recognition of their ongoing support, guidance, and commitment to the chapter. On a special note, Karen Mallet, who has been a dedicated member as well as executive founding chapter member for more than ten years, has stepped down from her position. She will be greatly missed in this role, as she has been a driving force over the years to Skills Labs. Our speakers were: Sara-Claude Gilbert speaking on Device Selection in the Acute Care Setting and sponsored by Teleflex Medical; Mary Lou Chaulk, discussing Vascular Access: Care and Maintenance and sponsored by AngioDynamics; and Dr. Renée Gauthier, bringing her expertise continued on page 5…
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provide up-to-date information and she shares her passion and experience to bring education events such as this to our communities. Thank you again to Karen for all your hard work over the years. As we begin the 2022–2023 NEOCVAA chapter year, we would like to welcome our new executive team members – Caroline Kovacs as Administrative Assistant and Milly Thomson as Treasurer. Our team of five look forward to working together for and with NEOCVAA members.
Preserving sites and protecting veins BD Nexiva™ Closed IV Catheter System BD understands that complications of peripheral intravenous catheters (PIVCs) are not only common in the hospital setting— they are costly.1,2 The BD Nexiva™ Closed IV Catheter System is the only all-in-one PIVC shown to preserve sites for longer and it supports industry guidelines, making treating patients safer.1-4 Selecting the right PIVC the first time may help minimize costs associated with restarts and preserve sites.1-3
Discover the BD Nexiva™ Closed IV Catheter System today go.bd.com/Nexiva-safety References: 1. González López J, Arribi Vilela A, Fernández Del Palacio E, et al. Indwell times, complications and costs of open vs closed safety peripheral intravenous catheters: a randomized study. J Hosp Infect. 2014;86(2):117-126. 2. Gorski LA, Hadaway L, Hagle ME, et al. Infusion therapy standards of practice. J Infus Nurs. 2021;44(suppl 1):S1-S224. 3. Maki DG, Ringer M. Risk factors for infusion-related phlebitis with small peripheral venous catheters. Ann Intern Med. 1991;114(10):845-854. 4. Canadian Vascular Access Association.(2019). Canadian Vascular Access and Infusion Therapy Guidelines. Pembroke, ON: Pappin Communications. BD, the BD Logo, and Nexiva are trademarks of Becton, Dickinson and Company or its affiliates. © 2022 BD. All rights reserved. BD-74046 (10/22)
on the Medical Assistance in Dying (MAiD) process in Ontario. The Skills Lab demonstrations included: Extended Dwell Peripheral Catheters: Assessment and Insertion (Teleflex); Port Access: It Matters to Your Patient (AngioDynamics); VAD Dressing Changes: Tips and Tricks (3M); PIV Insertion using ANTT (BD); and Peripheral IV Infiltration & Extravasation (CHS). Thank you for attending! Charlie Byer and Connie Wootten Greater Hamilton CVAA Chapter Executive
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New Member Spotlight Get to know one of the 150+ new CVAA members who have joined this year so far!
Jennifer Reguindin, MScN, RN, GNC(C), CCNE What is your current role/institution? Formerly Clinical Resource Leader for Nursing Practice and Education for Michael Garron Hospital Where are you located in Canada? Toronto, Ontario Why did you join CVAA? I was fortunate to win my first membership through the 2022 CVAA virtual conference. When we revised PVAD and CVAD policies during the pandemic, it was evident to me that we needed to be more current and employ best practices. I learned about CVAA in researching for new policies. What features of membership are you looking forward to utilizing? I look forward to regular webinars and the recorded series. The VA journal is a wonderful resource. My team at MGH was able to submit an article for the journal as well. How did you find the virtual conference this year and do you plan to attend the 2023 one in Toronto? We are already planning our work to submit to this conference. We can’t wait to join and meet everyone in person.
Why are you passionate about vascular access/ infusion therapy? As a Clinical Resource Leader in acute care, I know that vascular access is common practice. I want to ensure that the nurses I work with have access to the best practices, policies, procedures, and resources to provide quality care in our hospital.
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2023 CVAA & WoCoVA Special Event Are you planning to join us IN PERSON in 2023? We are SO excited to be coming together again in person April 26–28, 2023 in Toronto, Ontario, for the 2023 CVAA & World Congress on Vascular Access (WoCoVA) Special Event. What is the 2023 CVAA & WoCoVA Special Event? CVAA holds our national conference each year in different locations across Canada and in 2023, we will be partnering with WoCoVA for a Special Event as part of our conference. In the offyears, WoCoVA partners with countries on Special Events. CVAA will be hosting our three-day conference (Wednesday April 26– Friday April 28, 2023) and the first day (Wednesday April 26, 2023) will be the CVAA & WoCoVA Special Event.
Vascular Access Student Club (VASC) event: September 29, 2022 Better Your Blood Draw: On September 29th, the Vascular Access Student Club (VASC) of McGill University held their first “Better Your Blood Draw” event. With the aim of enhancing students’ confidence and competence in blood draw skills, the event drew in a crowd of first-year BNI students, direct-entry masters students, and Nurse Practitioner candidates. Of the 20 students who registered for the event, all reported a lack of confidence in successfully completing a blood draw following best practice. Those who attended were paired
with a peer to practice blood draw techniques on wet arms, generously donated by BD Canada, while receiving individualized help from VASC executives and ISoN faculty. Following the event, attendees were sent a post-event survey, and 100% of students reported that following the event, they “strongly agree” that they are more confident in their ability to perform a blood draw successfully, following best practice. VASC looks forward to hosting more drop in blood draw help for McGill ISON students as the academic year progresses!
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Have you considered putting your name forth for a Board of Directors position? We encourage you to think about it for 2023. There several positions available at this time and all CVAA members are invited to apply. Board of Directors positions each carry a two (2)-year term unless otherwise listed. Applications are due November 4, 2022. The available positions for 2023–2024 are: • 1 Treasurer-Elect • 3 Directors-At-Large • Student Ambassador (non-voting).
Apply here In the meantime, hear from current Board members about how they came to the role and get to know them a bit. Here are the first available installments of the CVAA Meet the Board series: Nathan Best
Sara-Claude Gilbert
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CVAA Board Get Together After several years only meeting over Zoom and some new Board Members having never met each other in person, (most of) the CVAA Board spent a great weekend together this past summer. We were able to get to know each other, talk about our plans for CVAA, and connect in ways that Zoom just can’t provide – you can’t beat an Escape Room for strategic bonding! We look forward to the 2023 Board being able to meet together in January and again at the April conference – why don’t you join us? Put your name forth to be a Board Member!
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This website and the videos presented here are intended for the exclusive use of licensed healthcare professionals involved with I.V. Therapy. The information and images shown in the videos are also intended for the exclusive use of licensed healthcare professionals only and must not be relied upon or interpreted to be in any manner medical or clinical advice. Baxter is a trademark of Baxter International Inc. Baxter is registered in the U.S. Patent and Trademark Office. Copyright 2020, Baxter Corporation. All rights reserved.
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Fall 2022 | Page 11
Monthly Messages Melissa Stark, CVAA Executive Director, has started making quick videos each month to give a short update on what’s new in CVAA’s world. Check them out here: Watch here:
Watch here:
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CVAA at the Critical Care Nurses Associations National (CACCN) Dynamics of Critical Care Conference From September 19 to 21, I had the privilege of representing CVAA at the Critical Care Nurses Associations National (CACCN) Dynamics of Critical Care Conference “Extraordinary Every Day” in Windsor, Ontario. I met critical care nurses from all over Canada, even a CVAA member from William Osler Health Centre, and a nurse I knew in 1998 from the Intensive Care Unit at the Kingston Health Sciences Centre. I also had the opportunity to meet some of the faculty from my Specialty Nursing, Critical Care BScN program. I was able to attend four seminars with a vascular access and infusion therapy focus: “Sometimes it’s up to US: Ultrasound guided peripheral intravenous (IV) insertion for difficult vascular access” with Ryan Chan, a RN from the Ottawa Hospital ICU (Ontario), “Exploring diabetes insipidus (DI) versus syndrome of inappropriate antidiuretic hormone (SIADH)”, “Intravenous (IV) fluids: Routine care or important medical therapy?” and “It’s a bloody
mess: Massive transfusion protocol”. These three were presented by the president of CACCN and one of my BScN instructors, Sarah Crowe. Sarah Crowe is a Nurse Practitioner in Critical Care with the Fraser Health Authority in British Columbia. There was also a session on infusion pump safety and a poster presentation on the nurse management of radial arterial lines. I made time to connect with some of the speakers to share how CVAA is a complementary organization
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to their practice and discuss opportunities for publication, speaking and of course, membership! I met with many of industry partners, including B. Braun and Nipro/CardioMed, who were displaying vascular access products. An unexpected surprise was being able to attend with my close friend and colleague, who attended as a CACCN local board member from the Ottawa region. There was a great evening of music
and dancing. A draw was held for a complimentary 2023 membership and a clinician from Quinte Health was the lucky winner! Critical care and vascular access and infusion nursing (VAIN) are two specialties that have much in common. As both a critical care nurse and a specialist in VAIN, this was a great opportunity to promote CVAA to our colleagues in critical care. Partnering our specialties can help improve safety and outcomes for our patients. Kerry McDonald
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Perspective from a CVAA(c) Certified Naturopathic Physician Healthcare in Canada is in a period of unprecedented challenge. Staffing shortages, burnout, and insufficient nursing graduates entering practice are straining the system like never before. At the same time, patient acuity has been rising steadily, and an aging demographic is projected to overwhelm the ability of younger generations to support it. The stress on healthcare professionals, as well as on patients facing crowded emergency rooms and lengthy surgical wait times is extreme. I began my healthcare career in nursing as an RN. For 15 years, I worked in acute medicine, critical care, IV therapy/PICC teams, and nursing education. I became CVAA certified during my PICC training at Royal Inland Hospital, and this proved to be an invaluable part of my professional development as a nurse. I then returned to school to become a naturopathic physician, graduating from the Canadian College of Naturopathic Medicine – Boucher Campus, in 2010. Throughout my initial time in practice, I was seeing an increasing number of patients with cancer and other serious illnesses, with particularly marked growth in the last few years. I realized that my lifelong education journey was about to take another turn. In June of this year, I began a two-year program as Resident in Naturopathic Oncology & Complex Chronic Disease at Port Moody Health – Integrative Medicine & Cancer Care, in collaboration with Bastyr University in Seattle, WA. The World Health Organization has identified integrative healthcare as vital to achievement of better public health outcomes worldwide. The term “integrative” means: to bring
together or unify separate things; “integrative medicine” means combining conventional and complimentary medicine. There is perhaps no better example of the value of integrative medicine than in the realm of oncology. Cancer patients undergo, arguably, the most difficult treatments in medicine: chemotherapy, radiation, and surgery. There is clinical and empirical evidence of the consequences of these treatments, including pain, nausea, macro- and micronutrient depletion, fatigue, and overall decreased quality of life. There is vast potential for enhanced patient care in integrative oncology. IV therapy can help replace micronutrients depleted by chemotherapy, support patients unable to tolerate
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continued on page 16…
a regular diet, and complement the effects of medical treatments. Loco-regional hyperthermia is a potent, Health Canada-approved radiosensitization modality aimed at providing therapeutic advantage to those undergoing chemotherapy and radiation with minimal healthy tissue toxicity. Medicinal plants, in both dietary and supplemental forms, can be used in support of conventional treatments and promote better quality of life. My nursing education and experience, along with CVAA certification, are a perfect fit in this type of specialized practice. IV therapy plays an integral role in adjunctive cancer care, as an increasing number of patients are receiving IVADs and PICCs for their outpatient treatments. Awareness of the value of integrative medicine is growing, and the available treatment options enable patients to choose to support their health in ways that extend beyond the boundaries of pharmaceuticalbased medicine. I would like to deeply thank my CVAA nurse mentors and the CVAA for their vital contributions to my career development and ongoing, lifelong learning. As the first CVAAcertified naturopathic physician, I continue to promote the high standards of practice I learned as a nurse, and look forward to a future of truly integrative medicine in Canada. Dr. Jennifer Cham
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Tip Tuesdays Are you following along? We are launching a new weekly social media feature to remind you of best practice snippets from the CVAA Guidelines. Follow along on Facebook, Instagram, and Twitter below or follow #TipTuesday
Recent tips include: Don’t crush it! Attach needle-free connectors without overtightening (Add on devices – pg. 32) Scrub the hub and threads when changing and connecting new add-on devices (Add on devices – pg. 32) Documentation for insertion of a VAD should include: (VAD insertion – pg. 23). • Size, gauge, and length • VAD type, and number of lumens • Insertion site using anatomical descriptors • Site assessment and size.
PVAD catheter versus vein size – Think about vein size when choosing your insertion site. While there are no specific numbers given for ratio, the larger the vein, the better dilution and longevity of your catheter (Venous site selection – pg. 22). Need to disconnect? Don’t get all loopy about it! Remember that when disconnecting an administration set, the male luer end of the set should be covered by a sterile cover at all times—do not connect (“loop”) the exposed male end of the administration set into the injection port or use syringe cap over it (Administration sets – pg. 53).
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Fall Webinars Join us on November 2 and November 9 for virtual education!
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