Enhancing neonatal vascular access: proposing a patient-centered framework based on 7-Rights

Neonatal vascular access (VA) is a critical component of neonatal intensive care. However, VA remains a high-risk procedure associated with pain and serious complications. Despite the availability of evidence-based guidelines, variability in practice persists, leading to inconsistent patient outcomes. A standardized, patient-centered approach could enhance patient safety, experience, and outcomes. The '7-Rights Framework for Neonatal VA' emerged through international expert consensus. This framework uses the concept of patient rights, the '7-Rights' - Right Patient, Right Care Team, Right Comfort Measures, Right VA Device, Right Blood Vessel, Right Care of the Infusion and Device, and Right Therapy Duration and Device Removal to integrate best evidence-based practice, ethical considerations, and family involvement. Recognizing the need for a standardized approach to VA and simultaneously considering individual needs, the framework readily provides guiding principles for developing individualized Vascular Access Management Plans (VAMP). In addition to proposing the 7-Rights framework, this article advocates for its operationalization in a VAMP that encompasses the entire VA process, from planning, device selection, insertion, maintenance, monitoring, and quality control. A VAMP based on the 7-Rights framework has the potential to individualize VA care, improve consistency, enhance patient safety, and facilitate quality improvement initiatives. IMPACT: Key message Introduces the 7-Rights Framework as a structured, patient-centered model to guide neonatal vascular access (VA) decisions. What it adds Translates human rights principles into clinical VA practice, integrating ethical standards and family involvement. Proposes the use of individualized Vascular Access Management Plans (VAMPs) to operationalize the framework. Impact Addresses current gaps in standardization, safety, and consistency across NICUs. Provides a universal guide to support clinicians in reducing complications and improving neonatal outcomes.