Abstract

Vascular access in burn patients is a challenging aspect of care that affects the healthcare team and patients daily. The goal in this evidence-based practice project at a southern United States burn center was to improve the quality of the vascular access process by reducing the use of Central Venous Lines (CVL) and unsuccessful venipuncture attempts. The following practice question was formed: In hospitalized burn patients (P), how does a vascular access team with ultrasound-guided peripheral IV capability (I) compared with no vascular access team and standard IV insertion (C) affect central line days (O1) or patient experience (O2) during patient hospitalization (T)? Based on systematic review of the literature and evidence appraisal, the recommendation was made to implement an early Vascular Access Team (VAT) consult for burn patients. A 45% reduction in CVL device days (DD) and a 35% improvement in patient experience were anticipated with implementation based on the evidence. The project was implemented in January through March 2022. The results included that there was a 12.8% reduction in CVL DD, an 89% reduction in the number of times more than two vascular access attempts was required, and a 138% improvement in patient experience. Although the CVL DD decreased, the evidence based anticipated outcome was not reached, most likely due to the specialized population of burn patients; however, the improvement in patient experiences far exceeded the evidence-based expectation. Early vascular access consult was successfully implemented in this burn center.

Date of publication

2023

Document Type

DNP Scholarly Project

Language

english

Persistent identifier

http://hdl.handle.net/10950/4176

Committee members

Lauri D. John PhD, Cheryl Parker PhD

Degree

Doctor of Nursing Practice

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