What’s new in vascular access device care and management from the Infusion Therapy Standards of Practice?

KARI ERTMER, RN, BSN, PHN, VA-BC

If you prepare and secure IV lines, you’ll want to review the new and expanded global standards in infusion therapy from the 2021 Infusion Therapy Standards of Practice1, released every five years by the Infusion Nurses Society (INS).

Our 3M application engineers, registered nurses with vascular access or wound care board certification, partnered with Lisa Gorski, chairperson of the INS Standards Committee to develop a two-part webinar series that outlines new and notable practice recommendations, and a newly available on-demand discussion about vascular access device (VAD) care and maintenance.

Putting best practices into action

The goal of VAD care and maintenance is to reduce the risk of VAD-related complications and ensure that the VAD remains in place for the duration of the intended therapy. The 2021 standards span several topics, including some directly related to VAD insertion and maintenance and others addressing clinician and site preparation to help minimize infection risk:

  • Standard 16: Hand Hygiene – Reviews recommendations for handwashing practices and includes considerations for which hand hygiene method to use depending on the clinical scenario such as alcohol-based hand rub (ABHR) and soap and water. View pg. S53 for complete guidance.
  • Standard 17: Standard Precautions – Addresses precautions for personal protective equipment (PPE), respiratory hygiene and cleaning and disinfecting durable medical equipment (DME). View pg. S54 for complete guidance.
  • Standard 36: Needleless Connectors – Reviews four categories of needleless connectors as defined by the 2021 glossary and provides a practice recommendation to standardize the type of needleless connector within the organization. It also provides guidance regarding needleless connector disinfection including using active or passive disinfection methods. View pg. S104 for complete guidance.
  • Standard 38: VAD Securement – Addresses the importance of securement to prevent complications associated with VAD motion at the insertion site and unintentional loss of access. Provides direction to secure the VAD, ensuring the methods to secure the VAD do not interfere with the ability to assess and monitor the access site. View pg. S108 for complete guidance.
  • Standard 42: VAD Assessment, Care and Dressing Changes – Includes standards that promote dressing and skin integrity, and considerations when selecting the appropriate type of dressing based on the patient’s condition and risk factors with the goal of selecting a dressing that will have minimal dressing disruptions. View pg. S119 for complete guidance. The use of chlorhexidine-impregnated dressings for all patients 18 years and older with short-term nontunneled central vascular access devices (CVADs), as well as for use with implanted vascular access ports ( 28, S86), Hemodialysis VADs (Std. 29, S89), and epidural access devices (Std. 56, S171).
  • 55: *New* Catheter-Associated Skin Injury – This new standard gives guidance on routinely assessing the VAD site for signs and symptoms of skin injury. It also discusses some of the interventions that should be implemented to reduce the risk of, and manage, skin injury, including the use of a sterile, alcohol-free skin barrier product to protect at-risk skin.

Looking for more information about what’s new?

Read more about specific product considerations and terminology changes and find a summary of our first webinar with Lisa Gorski that provides an overview of some of the 2021 changes.

Download the eBook

We’ve selected a few 2021 standards that we believe can help you prevent infection, reduce complications, and ultimately deliver better patient outcomes. Download the eBook for a quick look at topics including hand hygiene, dressings and securement and IV access point disinfection.

1 Gorski LA, Hadaway L, Hagle ME, et al. Infusion therapy standards of practice. J Infus Nurs. 2021;44(suppl 1): S1-S224. doi:10.1097/NAN.0000000000000396

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