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Downsizing. Use intravenous clinicians to maintain quality venous access care
1Department of Veterans Affairs Medical Center, San Francisco, California, USA.
Summary
Downsizing intravenous (IV) teams can maintain quality care by creating advanced practice roles. This strategy improved IV therapy outcomes, reducing line-associated bacteremia rates and enhancing compliance.
Area of Science:
- Healthcare Management
- Nursing Practice
- Infection Control
Background:
- Hospitals are dissolving intravenous (IV) teams to cut costs, despite evidence of their cost-effectiveness.
- This trend risks compromising the quality of intravenous therapy and patient safety.
- Maintaining high standards of care during downsizing requires strategic planning.
Purpose of the Study:
- To provide a guide for downsizing IV teams while preserving quality IV therapy.
- To demonstrate the impact of advanced practice roles in maintaining IV care standards.
- To analyze the effects of restructuring on line-associated bacteremia and compliance rates.
Main Methods:
- A case study of the San Francisco Veteran's Administration Medical Center's IV team disbandment.
- Implementing two advanced practice positions to manage IV therapy.
- Monitoring line-associated bacteremia rates (infections per 1000 line days) and compliance with IV care standards.
Main Results:
- Line-associated bacteremia rates significantly declined after the introduction of IV clinicians.
- Compliance rates with IV care standards remained unchanged or improved post-downsizing.
- The data support the crucial role of specialized IV nurses in maintaining care quality.
Conclusions:
- Advanced practice positions are instrumental in maintaining quality IV care during downsizing.
- IV nurse clinicians are essential for critical care coverage, education, auditing, and research.
- Strategic restructuring can lead to improved patient outcomes in vascular access and IV therapy.