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presented by Lisa A. Gorski, MS, RN, HHCNS-BC, CRNI, FAAN
Financial - Lisa Gorski receives compensation from MedBridge for the production of this course. She also receives compensation for Speaking honoraria from BD, 3M, Genentech, being an Advisory Board Member for Teleflex, ivWatch, Hospira/Pfizer, and employee of Wheaton Franciscan Home Health and Hospice, Part of Ascension at Home. She also receives book royalties from FA Davis.
Non-Financial - Lisa Gorski is an Editorial Board Member, Home Healthcare Now, Chairperson, Infusion Nurses Certification Corporation and Infusion Nurses Society Standards of Practice Committee.
Satisfactory completion requirements: All disciplines must complete learning assessments to be awarded credit, no minimum score required unless otherwise specified within the course.
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This course provides home care nurses with essential knowledge required to safely manage patients who require vascular access devices (VAD). This course begins with the presentation of a model for home infusion therapy, describing how vascular access device care fits into the larger picture for provision of safe home infusion therapy. Participants will learn about the importance of vascular access device selection and the main categories of central VADs (CVAD) and peripheral catheters placed for home infusion therapy. The required care and maintenance, including key areas for assessment and setting the stage for effective patient education, are addressed. This presentation is followed by Part II, where potential complications will be explored including signs and symptoms, preventative interventions, and management.
Lisa A. Gorski, MS, RN, HHCNS-BC, CRNI, FAAN
Lisa Gorski has worked for more than 30 years as a clinical nurse specialist (CNS) for Wheaton Franciscan Home Health & Hospice, now part of Ascension at Home, in Milwaukee, Wisconsin. As a CNS, she has developed and oversees the home infusion therapy program, provides staff education, and is involved in agency quality assessment, performance…
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1. A Model for Safe Home Infusion Therapy
The Gorski Model for Safe Home Infusion Therapy predicts that positive outcomes, which include the absence of infusion therapy–related complications, patient satisfaction, and health care provider satisfaction, are maximized when four aspects of care are addressed during the home care planning process and during the process of providing care. These include (a) appropriate patient selection; (b) effective patient education; (c) meticulous patient care, comprehensive assessment, and monitoring and; (d) interprofessional communication and collaboration.
2. Vascular Access Device Selection
Reliable vascular access is a major factor allowing for the success of home infusion therapy. Selecting the most appropriate vascular access device is a critical decision that impacts the clinical outcome as well as the patient experience and satisfaction with care, and this decision requires critical thinking and analysis of multiple factors.
3. Indications for and Major Categories of Central and Peripheral Vascular Access Devices
Categories of CVADs commonly placed for home infusion therapy include peripherally inserted central catheters (PICC), subcutaneously tunneled CVADs, and implanted vascular access ports. Peripheral catheters include the commonly placed “short” peripheral catheter and midline catheters which are an increasingly common VAD choice for patients who require home antimicrobial therapies. Case scenarios will be used to illustrate VAD selection.
4. Care and Management of Vascular Access Devices
Proper care and maintenance of any VAD is necessary to reduce the risk of catheter related complications. This includes ongoing assessment, site care/dressing changes, site rotation in the case of short peripheral catheters, implanted port access, maintaining catheter patency, and in some cases, withdrawal of blood for laboratory studies. Strategies for effective teaching of patients and family members about VAD care are emphasized.
5. Patient Education
Effective patient education is essential to the safe provision of infusion therapy and VAD management in a home care setting. Strategies for effective teaching of patients and family members about VAD care are addressed and presented in the context of a case scenario.
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