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Evidence-Based Care in Pediatrics and Obstetrics - Professional Day 2019

Join us for a day of evidence-based approaches to care in pediatrics and obstetrics, provided by Texas Children's Hospital. Earn up to 8.0 contact hours and enhance patient outcomes through inter-professional practice.

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Evidence-Based Care in Pediatrics and Obstetrics - Professional Day 2019

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  1. Professional Day 2019: Evidence-Based Approaches to Care in Pediatrics and Obstetrics Provided by Texas Children’s Hospital September 19th, 2019 | Houston, TX | 8:00 CONTINUING NURSING PROFESSIONAL DEV ELOPMENT Texas Children's Hospital is an approved provider with commendation of continuing nursing education by the Texas Nurses Association - Approver, an accredited approver with distinction, by the American Nurses Credentialing Center’s Commission on Accreditation. REQUIREMENTS FOR SUCCESSFUL COMPLETION To receive contact hours for this continuing education activity, the participant must: • Sign in to the activity • Attend at least one session (contact hours awarded based on attendance) • Complete the post evaluation Once successful completion has been verified, a “Certificate of Successful Completion” will be awarded for up to 8.0 contact hours. For web link issues, email cne@texaschildrens.org CONTINUING MEDICAL EDUCATION (CME) ACCREDITATION Texas Children’s Hospital (TCH) is accredited by the Texas Medical Association to provide continuing medical education for physicians. CREDIT DESIGNATION Texas Children’s Hospital designates this live activity for a maximum of 8.0 AMA PRA Category 1 Credits TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity. CME transcripts available upon request via email: cme@texaschildrens.org LEARNING OUTCOME: At the completion of this activity the learner will be able to enhance quality care and patient outcomes through evidence-based inter-professional practice in the area of pediatrics and obstetrics. CONFLICTS OF INTEREST The planning committee members/content reviewers and/or presenters of this CME/CNE activity have disclosed NO relevant financial relationships related to the planning or implementation of this CME/CNE activity: Eric Williams, MD, Amanda Garey, Angie Rangel, Deborah Lee, Jessica Ramirez, Jill Stonesifer, Kathryn Holl, Lauren Ivanhoe, and Lindsey Zaremba The following speakers of this CME/CNE activity have disclosed the following relevant financial relationships related to this CME/CNE activity. Those conflicts of interest have been appropriately resolved: • Carla Giannoni, MD – Formal Advisor, EPIC Pediatric Otolaryngology Steer Board • Jeff Wagner – Formal Advisor, Omnicell Advisory Board The activity’s director/Nurse Planner has determined that no one who has the ability to control the content of this CME/CNE activity – planning committee members and presenters/authors/content reviewers – has a conflict of interest.

  2. The Superheroes of IV Access Lindsey Zaremba BSN, RN, CPN, CPHON Imelda Mercado-Nuda BSN, RN, VA-BC

  3. Vascular Access

  4. Failed IV attempts

  5. Ultrasound Guided Peripheral (USG) IV

  6. Pre-considerations Technical Considerations Optimal USG peripheral IV site is in a vein 2-4 mm in diameter or larger and 0.3-1.5 cm in depth Vein size determining catheter size. Bigger not always better. Goal is smallest catheter! Recommended USG catheter length 2-6 cm Vessel Assessment • Past surgeries • Comorbid conditions • Thrombosis • Anatomy (tortuous veins, bifurcations)

  7. Vessel Assessment

  8. Picture of U/S image

  9. Site Selection

  10. Challenges

  11. Is it the right line?

  12. What the highest concentration of Dextrose for Peripheral IV? 12.5%

  13. Complications: Insertion is only the beginning of the journey

  14. Bedside staff Infiltrations can be more severe. MEASURE PIVIE and refer to Extravasation/Infiltration Table for further management

  15. Training

  16. Clinical staff had first time success rate of 18-86% but VAT can achieve 98-99% first time success.

  17. MetricsSince October 2018

  18. Metrics Over 3,010 Patient Encounters

  19. VAT team has an average 1.09 attempts success rate Saved attempts

  20. Metrics

  21. Metrics

  22. Moureau. (2019). Vessel Health and Preservation: The Right Approach for Vascular Access. Springer International Publishing • Edwards, C., & Jones, J. (2018). Development and Implementation of an Ultrasound-Guided Peripheral Intravenous Catheter Program for Emergency Nurses. JEN: Journal of Emergency Nursing, 44(1), 33–36. https://doi.org/10.1016/j.jen.2017.07.009 References

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