Pediatric

Power Hour Breakout

(M7) Better Together: Collaborative Efforts Between A Vascular Access Team and Dedicated Wound Care Team to Effectively Manage, Treat, and Prevent Serious Harm PIVIEs

Presenter(s)

• 

  Krystalynn Barre, RN, MBA, VA-BC™

  Vascular Access RN Manager
  Cook Children's Medical Center

  Nothing to Disclose

Co-Presenter(s)

• 

  Misty McCutchen, CWOCN, CFCNCWS

  RN CWOCN
  Cook Childrens Medical Center

  NO DISCLOSURE INFORMATION SUBMITTED
• LR

  Larry Reaves, MD, FACS

  Medical Director of Wound Care
  Cook Children's

  NO DISCLOSURE INFORMATION SUBMITTED

A trend was discovered through in-depth investigation of all serious harm PIVIEs occurring at a 432 bed pediatric medical center in 2018 that identified vesicant medications, specifically Calcium Chloride and Calcium Gluconate given in emergent situations, as the causality of these events. A dedicated, physician-led Wound Care Team collaborated with the Vascular Access Team in establishing protocols and quality initiatives through multiple channels that have led to the reduction and hopefully sustained elimination of these serious harm PIVIE events. Collective efforts of engaging front line nursing staff in early identification as well as standardized hand-off and documentation of vesicant medication administration and infiltrations have driven the organization-wide focus of harm reduction from the these events. Early recognition and aggressive intervention and treatment of Calcium and other vesicant infiltrations by the Vascular Access Team and the Wound Care Team have also played an instrumental role in driving down serious harm infiltration rates.

Learning Objectives:

• identify Calcium as a vesicant medication that can cause latent and permanent patient harm.
• identify early intervention and treatment options for managing vesicant medication extravasations.
• describe the mechanism of action and clinical presentation of Calcium Gluconate and Calcium Chloride extravasations.
• define serious harm infiltration.
• describe prevention methodology used to prevent serious harm infiltration's.