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THE CVAA

Newsletter of the Canadian Vascular Access Association

WINTER/SPRING 2018

Meet the Board: Adriana Congi Each CVAA Link issue features short interviews with members of the CVAA Board. Why did you put your name forth for the Student Ambassador position on the CVAA Board? After starting my nursing degree, I wanted to put myself out there and seize any opportunity that could help me learn more about the nursing profession and about patient care. When I came across the posting for the Student Ambassador position with CVAA, I thought that this would be a great opportunity to network, learn, teach, advocate and expand my skills. Not knowing anything about CVAA, I went onto the organization’s website and read the mission and vision statement and even the Constitution. In only a year of being on the Board, I’ve gained an abundant amount of knowledge and developed new skills that could have never been taught in a classroom or in a clinical placement. This opportunity has been the start in shaping me into the nurse I hope to be when I graduate. What are you most excited about with CVAA in 2018? I am excited to get more involved with CVAA in my Student Ambassador role. I hope to really encourage and prompt curiosity in my peers to want to learn more about CVAA. I hope to brainstorm ideas with my peers on what we can do at the nursing student level to advocate for vascular access and infusion therapy. Currently, our curriculum only teaches the basic information and I strongly believe that in order to provide safer patient care, nursing students need more knowledge and learning opportunities before they graduate.

What do you enjoy about the conference? 2017 was my first attendance at a professional nursing conference and I enjoyed every moment. I was extremely grateful to have had the opportunity to network with so many amazing healthcare professionals. When you are in nursing school, you are very limited in learning about what options you have after graduating. The conference helped me expand my understanding of the various paths I can take when I enter the workforce. In addition, going into the conference, I knew very little about vascular access and infusion therapy. I came back home with a new appreciation and comprehension and I could not stop talking about it with my peers, my family and my professors. Tell us something interesting about yourself (personal, not professional) When I was younger, figure skating played a big role in my life. I had a private coach and participated in competitions. I still have my favourite purple sparkly dress from my very first competition. Eventually, I made the decision to stop figure skating in order to focus on my education. Every winter season, I go to the Windsor outdoor public skating rink to enjoy a cup of hot chocolate and skating with my friends and family.


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43RD ANNUAL CVAA CONFERENCE

EDUCATE, ENGAGE & EMPOWER: ADVANCING A BROADER VISION FOR CANADIAN INFUSION THERAPY APRIL 25-27, 2018 | TORONTO, ON

PRELIMINARY PROGRAM

WW W. C V A A . I N F O

CONFERENCE-AT-A-GLANCE Please note that the schedules below are subject to change.

DAY ONE: WEDNESDAY APRIL 25, 2018 09:00 – 12:00

Pre-Conference Workshops (TBC) (separate registration will be required)

09:00 – 10:30

Focus Group (TBC) (separate registration will be required)

11:45 – 13:00

Registration / Refreshments / Chapter Council Meeting (for Chapter Executives)

13:00 – 13:30

Opening Remarks / CVAA Awards/Prizes

13:30 – 14:30

Opening Keynote PLENARY SPEAKER #1 Jack LeDonne, Quality Improvement in Vascular Access: Standardizing Practice at the Highest Level, Sponsored by Eloquest

14:30 – 15:30

Exhibitor Hall / Refresh Break

15:30 – 17:30

Skills Lab Stations (hands-on demonstrations)

18:00 – 22:00

Dinner & Social Event (TBC)

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DAY TWO: THURSDAY APRIL 26, 2018 07:00 – 08:00

Morning Exercise

07:00 – 08:30

Registration / BD Breakfast Symposium

08:30 – 08:45

Morning Welcome / CVAA Awards/Prizes

08:45 – 09:45

PLENARY SPEAKER #2 Jocelyn Hill, For Better or For Worse? Harm Reduction, Ethics and Patients who use Substances with Vascular Access / Infusion Therapy Challenges

09:45 – 11:00

Exhibitor Hall / Refresh Break / Poster Presentations

11:00 – 11:30

Concurrent Sessions (select one) Clinical Pearls for the Management of Challenging Skin Issues Karen Laforet

11:45 – 12:15

Are we listening? IV Competence; More Than Just a Successful First Stick Sponsored by BD Patty Hignell, Joy Dacquisto & Yunn Adam

Did You See That Tip Moving? France Paquet

VAIN: A Vascular Access and Infusion Nursing Curriculum for Bachelor of Science in Nursing (BScN) students at McGill University Caroline Marchionni & Mélanie Gauthier

Did You See That Tip Moving? France Paquet

VAIN: A Vascular Access and Infusion Nursing Curriculum for Bachelor of Science in Nursing (BScN) students at McGill University Caroline Marchionni & Mélanie Gauthier

Concurrent Sessions (select one) Clinical Pearls for the Management of Challenging Skin Issues Karen Laforet

Are we listening? IV Competence; More Than Just a Successful First Stick Sponsored by BD Patty Hignell, Joy Dacquisto & Yunn Adam

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12:15 – 14:00

Exhibit Hall / Lunch

14:00 – 14:30

Concurrent Sessions (select one) Educate, Engage and Empower the Patient to SelfAdminister Their Own IV Antibiotics Daphne Broadhurst

14:45 – 15:15

Nurses Leading the Way—Empowering Change Sponsored by BD Martha Polovich

Return of the Midline Sponsored by Bard Julie Bilbrey

Vascular Access Mindfulness: A Critical Component of Successful Apheresis Martha Mitchell

Return of the Midline Sponsored by Bard Julie Bilbrey

Vascular Access Mindfulness: A Critical Component of Successful Apheresis Martha Mitchell

Concurrent Sessions (select one) Educate, Engage and Empower the Patient to SelfAdminister Their Own IV Antibiotics Daphne Broadhurst

Nurses Leading the Way—Empowering Change Sponsored by BD Martha Polovich

15:15 – 15:45

Refresh Break

15:45 – 16:45

PLENARY SPEAKER #3 Karen Laforet, IV Push Medications: Increasing Safety and Choosing Best Practice

13:00 – 18:15

Annual General Meeting (for CVAA Members only)

19:00

Supper Club (optional)

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DAY THREE: FRIDAY APRIL 27, 2018 07:00 – 08:00

Morning Exercise

07:00 – 08:30

Registration / AngioDynamics Breakfast Symposium

08:30 – 09:00

Morning Welcome / CVAA Awards/Prizes

09:00 – 10:00

PLENARY SPEAKER #4 Amy Rissler, Catheter-Associated Venous Thrombosis in the Oncology/Hematology Patient: A Review of Current Practice Guidelines in Prevention and Management

10:15 – 10:45

Concurrent Sessions (select one) Ultrasound for Intravenous Access: Technology Aids in Advancing your Skills Sponsored by Bard Adam Wires

11:00 – 11:30

Personal, Social and Structural Factors Influencing CVAD Care and Maintenance and Outcomes in Patients on Home Parenteral Nutrition (HPN) Jocelyn Hill & Jennifer Lanuza

Project to Reduce Errors and Hemolysis in Blood Sampling: From Observation to Education Leyla Teymouri & Susan Csatari

Designing a System to Reduce Infusion Pump Errors Daphne Broadhurst

Project to Reduce Errors and Hemolysis in Blood Sampling: From Observation to Education Leyla Teymouri & Susan Csatari

Designing a System to Reduce Infusion Pump Errors Daphne Broadhurst

Concurrent Sessions (select one) Ultrasound for Intravenous Access: Technology Aids in Advancing your Skills Sponsored by Bard Adam Wires

Personal, Social and Structural Factors Influencing CVAD Care and Maintenance and Outcomes in Patients on Home Parenteral Nutrition (HPN) Jocelyn Hill & Jennifer Lanuza

11:45 – 12:45

Closing Keynote PLENARY SPEAKER #5 Andrea Raynak & France Paquet, The Current State of Central Venous Access Device Knowledge Among Nurses

12:45 – 1:00

Closing Remarks

1:00

To Go Lunch available

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2017 Chapter Highlights CVAA has 15 thriving chapters across Canada and in Bermuda that host excellent education and networking events throughout the year—have you attended one yet? Here are some chapter highlights from 2017:

Calgary We, the Calgary CVAA Chapter, would like to share with you an accomplishment that we have achieved and are very proud of for 2017. We applied to our professional association—College and Association of Registered Nurses AB (CARNA)—to be recognized as a Specialty Practice Group. We achieved this goal in March of this year. We are extremely delighted to share with CVAA National that the Calgary CVAA Chapter is now recognized by CARNA as a Specialty Practice Group!

Greater Hamilton As for a chapter highlight, it’s difficult to select just one! We had great attendance at our March event with the support of Hamilton Health Sciences and SterileCare/CHS. It was very rewarding to have multidisciplinary attendees participating in this vascular access education event. Additionally, our CVAA Learning Event (CLE) was very successful and the participant feedback was very positive. And of course, welcoming a new president to our executive was a highlight and we look forward to great collaboration moving forward.

Fraser Valley Our chapter highlight was the response from our first newsletter—people loved it!

NEO (North Eastern Ontario) Once again, we had the pleasure of finishing our CLE by taking part in skills stations allowing us to interact with experts and apply hands-on techniques. It was difficult for many to choose only four skills lab stations since the various topics were current, interesting and practice related. Subjects covered included no-touch PICC dressing technique; documentation of peripheral IV and best practice; pH and risk of tissue damage from commonly given medications; troubleshooting central lines; port accessing/ flushing; distinguishing between positive, negative and neutral displacement devices; best practice techniques for blood collection; and CVAD dressing application. Congratulations to our NEOCVAA executive for once again organizing an amazing education day, providing us with new information to share with colleagues, and a great opportunity to network with peers and experts alike.

Nova Scotia Our executive chose our CLE to be the highlight for our chapter this year. We had 11 members actively involved in the planning committee and helping out during the event, had an increase in the number of company sponsorships, and are in a positive financial position for 2018 activities. Despite fiscal restraint in the Health Authority, there was a small increase in attendance from the previous years. However, it was indeed an honour to receive the Achievement Award for 2016 at National Conference, so that is a highlight as well!

PEI

Ottawa We had huge commitment and engagement from our members in taking part in preparation for the national conference held in Ottawa in 2017.

Our annual CLE at The PEI Brewing Company was a great success. The CLE was titled Choose Wisely: Care, Maintenance and Preservation of our Veins

continued… Winter/Spring 2018 | Page 7


and Lines”. We had four speakers: Susan Csatari, “From the Line to the Lab”, sponsored by BD, Michelle DaGloria, “Optimizing Patient Safety in Infusion Therapy”, sponsored by Baxter, Daphne Broadhurst, “Dress for Success: Securing our Patient’s Catheter, and “Skin Integrity”, sponsored by 3M. We had eight hands-on skill stations including: Blood withdrawal and blood cultures, What is

proper documentation?, Dialysis lines, Peripheral IV starts with ultrasound and vein lights, Germ jeopardy, and Securement devices. There were 10 booths for information sharing and lots of networking. Our evaluations were excellent. Everyone had a great day with good food, great presentations, lots of networking and expanding their knowledge and skill in vascular access!

CVAA/BD Award Winners • First Place and National Winner – Tannia AgnotJohnston, Victoria General Hospital, Winnipeg, MB

Congratulations!

• Second Place and Regional Winner – Janice Buttle, Aberdeen Hospital, New Glasgow, NS

The CVAA Board of Directors is pleased to announce the winners of the 2018 CVAA/BD Excellence in Vascular Access Management & Infusion Therapy Award! The award recognizes the important contributions made in vascular access management and infusion therapy practice with a focus on peripheral IV therapy. The Call for Nominations went out in November 2017. Purpose of the award • Promote safety and quality improvement in peripheral IV vascular access management and infusion practices for optimal patient outcomes  • Recognize champions and trailblazers in Canadian vascular access management and infusion therapy practice • Raise the awareness of the impact of individual contributions to system-wide results. We had a great number of deserving applicants and the submissions were blindly reviewed by a committee of Board members. We are very pleased to announce the following recipients:

• Third Place and Regional Winner – Nancy Friesen, Winnipeg Regional Health Authority, Winnipeg, MB

The regional and national recipient(s) will receive an education grant of $500 and $1,000 respectively, to be used for educational pursuits and a registration for the upcoming CVAA conference where they will be presented with the award. CVAA is appreciative of the initiative and support of BD Canada, one of our 2018 Platinum Corporate Members, and wishes to thank them for funding this award.

Winter/Spring 2018 | Page 8


AND A SOLUTION FOR HIGH IV FAILURE RATES. IV therapy is one of the most common, invasive procedures conducted today. Yet complications cause up to 50% of all IVs to be replaced before therapy is completed.1 That can result in delayed treatment, unnecessary restarts, pain and discomfort for your patients and stress for you. Enter BD Vascular Access Management—a new, integrated solution for reducing peripheral IV complications. It’s an approach that can help you achieve improved outcomes for your patients by combining evidence-based clinical training and education with a comprehensive portfolio of products—all working together to raise the quality of vascular access care. Discover the difference one company can make. Discover the new BD.

Visit the BD booth at CVAA Conference 2018 or bd.com/vam-ca to learn more about the Difference of One. 1 Helm RE, Klausner JD, Klemperer JD, Flint LM, Huang E. Accepted but unacceptable: peripheral IV catheter failure. J Infus Nurs. 2015;38(3):189–203. © 2018 BD. BD and the BD Logo are trademarks of Becton, Dickinson and Company. MC9194 (0218)


Q TIP What is a Q-Tip? Quality tips are drawn from the most available evidence and this information is summarized to support your clinical practice. In each newsletter, the authors will address a burning question from the CVAA community. Q: Lately we’ve been noticing a lot of our PICC patients are developing skin reactions under their IV dressing. Could they be developing an allergy to CHG? Answer: Before getting to the heart of your question, it is important to step back and refresh our understanding of skin antiseptics. Antiseptics are antimicrobial substances that are applied to living tissue/skin to reduce the possibility of infection, sepsis, or putrefaction. Antiseptics are generally distinguished from antibiotics by the latter›s ability to be transported through the lymphatic system to destroy bacteria within the body, and from disinfectants, which destroy microorganisms found on non-living objects.1 Chlorohexidine gluconate (CHG), with or without 70% alcohol,

Welcome to Q-Tip: Quality Tips for Improving Practice is the most commonly used antiseptic for VAD insertion and dressing changes, having gaining popularity since its introduction in the 1950s.2 It is a widely-used antiseptic agent in medical practice, cosmetics, and dentistry with low risk of adverse events.3 Skin antisepsis prepares the skin for the sterile procedure that is to follow, whether it is a surgical procedure or VAD insertion. The commensal and transient microbes on and within the epidermis are the reason why a skin antiseptic is used. Skin antiseptics destroy these microbes. There are no shortcuts to properly preparing the skin for VAD insertion or dressing changes. Using aseptic technique and following the “four rights of skin antisepsis©” will reduce risk of infection and skin damage. The four rights of skin antisepsis are the: 1. Right volume to cover the area slightly larger than the dressing—anything less than that increases risk of infection;

Winter/Spring 2018 | Page 10

2. Right applicator: A swab stick or swab applicator provides adequate coverage over the surface of the skin and reduces risk of contamination; 3. Right application: Scrub moving back and forth horizontally for 15 seconds then flip the swab stick and repeat in the opposite or vertical direction for another 15 seconds. A 30-second scrub is required. The rationale: skin surface is not flat; the scrubbing motion disrupts the commensal and transient microbes lifting them to the surface and exposing them to the antiseptic4; 4. Right dry time: Dry time depends on a number of factors: condition of the patient’s skin, the ambient environment and how much CHG (or other antiseptic) was applied to the skin. Bottom line: there isn’t a definitive dry time. The critical point, however, is the skin must be completely dry prior to the insertion of the device or, in the case of site maintenance, the application of the dressing. The drying time is the kill time. If the skin is damp, the surface


microbes are not destroyed, increasing the patient’s risk of contamination. If one applies a dressing prior to the skin being completely dry, the result may be skin damage that mimics an allergic reaction or skin breakdown. In order to determine the cause of the skin reactions you are seeing, consider the following: If your patient has an allergy to CHG, the skin reactions will be demonstrated wherever the CHG was used. Therefore, if the skin reactions are limited to, or under the dressing area, it is highly

unlikely CHG is the culprit. In these incidences, consider the skin was not completely dry prior to applying a dressing. The corollary that it then must be the dressing is not necessarily true. If the situation is still unclear, it is recommended to conduct a separate patch test for the CHG product and IV dressing being used.

2

3

Karen Laforet, MClSc, RN, CCHN(c), CVAA(C), VA-BC™ (Endnotes) 1 McDonnell G, Russell AD. Antiseptics and Disinfectants: Activity,

Winter/Spring 2018 | Page 11

4

Action, and Resistance. Clinical Microbiology Reviews. 12:147–9. Lim KS, Lam PCA. Chlorhexidine— pharmacology and clinical applications. Anaesth & Intensive Care. 2009 (Jul); 36(4):502-12. Garvey LH, Kroigaard M, Poulsen LK, Skov PS, Mosbech H., … Husum B. IgE-mediated allergy to chlorehexidine. J Allergy Clin Immunol. 2007(Aug);120(2):409-415. Crosby CT, Mares AK. Skin Antisepsis: past, present and future. JVAD. 2001 Spring;6(1):26-31.


2nd Annual Canadian Vascular Access & Infusion Therapy Day January 25, 2018 marked the 2nd Annual Canadian Vascular Access & Infusion Therapy Day that was celebrated across the country. We encouraged our members to Be The One:

• TO ADVOCATE FOR YOUR PATIENT • TO KNOW BEST PRACTICES • TO BE EDUCATED AND CVAA(C) CERTIFIED • TO PREVENT COMPLICATIONS • TO SPREAD THE WORD

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Thank you to our committee members for your hard work, to all of our chapters for celebrating in your region, and to all of you who strive to Be The One every day in your practice!


Winter/Spring 2018 | Page 13


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The CVAA Link: Winter/Spring 2018  

Newsletter of the Canadian Vascular Access Association

The CVAA Link: Winter/Spring 2018  

Newsletter of the Canadian Vascular Access Association

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