Training Nurses in the Cardiac Preparation and Recovery Unit to Insert Peripheral Intravascular Catheters Reduced Procedure Delays

Training Nurses in the Cardiac Preparation and Recovery Unit to Insert Peripheral Intravascular Catheters Reduced Procedure Delays

As a nurse, you’re often present in experiencing your patients most personal and intimate moments. While this can be confronting and challenging, making a positive difference to a patient at a time when they’re most vulnerable, is not only meaningful, but hugely rewarding.

My main objective as a Nurse Ambassador was to improve the information that cardiac patients received during their stay in hospital following a heart attack. Knowing that I could play a role in providing patients with the knowledge, skills and confidence to better manage their condition, aid their recovery and improve their quality of life, made this an exciting and challenging task

Pediatric cardiac patients admitted to CHOP's Cardiac Preparation and Recovery Unit (CPRU) require peripheral intravascular catheters (PIVs) prior to their procedure. However, historically only nurses in CHOP's Vascular Access Service (VAS) were the ones responsible for PIVs for all patients. The procedure monopolized VAS resources every morning and led to scheduling delays in services offered by the unit. To streamline the process and avoid delays in procedures, CPRU nurses developed a program to train their staff in PIV insertion in order to offload that responsibility from VAS nurses. In a two-phase project between 2017 and 2019, CPRU nurses received initial training by the VAS team and then underwent an immersion experience with the VAS team to practice PIV placement for a minimum of two hours. The two teams also developed a partnership so that in difficult cases, the VAS team could support the CPRU nurses. In addition, the team trained three unit-based "Qualified Observers" to help train and mentor other Cardiac Centres nurses in PIV placement. Using this two-phase process, the CPRU nursing team was able to increase rates of successful PIV placement by CPRU nurses from 83% success after phase one to 89% after phase two and decrease the number of delayed procedures from 4.6% after phase one to 1.8% after phase two. Overall PIV management and care also improved over the course of the project.