Credentialing for Insertion of Adult Peripheral Intravenous (IV) Cannula

Transcription

1 F Policy Compliance Procedure Credentialing for Insertion of Adult Peripheral Intravenous (IV) Cannula This PCP relates to HNEH Policy HNEH 07/XX: HNEH Adult Peripheral IV Cannulation PCP Number Sites where PCP applies Target audience Description Subject Keywords Replaces Existing PCP? HNEH PCP All HNE facilities All Medical Officers, Registered Nurses, Enrolled Nurses, Endorsed Enrolled Nurses, Nurse Managers, Midwives, Radiographers, Nuclear Medicine Technicians in HNE facilities Framework for credentialing of staff required to insert adult peripheral IV cannulae as part of their scope of practice. To ensure standardised education and assessment of staff to be credentialed in HNEH for insertion of adult peripheral IV cannula. This will prevent adverse events and ensure that these devices are utilised within the appropriate clinical context. Adult, Peripheral IV cannulation, Education and training, Credentialing Assessment, Documentation, Cannula site No Related Legislation (including OHS legislation), Australian Standards, NSW Health Policy or Circular, other HNEH Documents, Professional Guidelines, Codes of Practice or Ethics: NSW Health. Medication Handling in NSW Public Hospitals. PD2007_077 NSW Health. Consent to Medical Treatment. PD2005_406 Guidelines for the Hospitals seeking to extend the practice of health professionals 91/ NSW Health Department Circular PD2005_247 Infection Control Policy NSW Health Department Circular PD2005_343 The Administration of Medications by Endorsed Enrolled Nurses NSW OHS&R Act 1998 and Amendments 2001 Portfolio Executive Director Director Of Clinical Operations responsible for Policy and PCP Policy Contact Person Details Summary This PCP provides: Framework for the education and assessment of staff for credentialing to insert adult peripheral IV cannula. Utilises current evidence to guide practice for the insertion of adult peripheral IV cannula. Distribution: Date PCP authorised: General Managers, Clinical Managers, Directors of Nursing and Midwifery, Medical Officers, Directors of Medical Service, Nurse Unit Managers. Area Safety and Quality Committee - 1 -

2 PCP authorised by: Date of Issue: PCP Review Due Date: TRIM Number: 2 years Pending Credentialing for insertion of Adult Peripheral IV Cannula Compliance with this Policy Compliance Procedure (PCP) is Mandatory Peripheral IV cannulation is a common invasive procedure with a potential for morbidity. Aim of Policy Compliance Procedure HNEH aims to ensure that all clinician who are responsible for inserting peripheral IV cannulae have had training and assessment which is consistent and evidence based. It is acknowledged that there are many pathways for staff to utilise to become credentialed for inserting adult peripheral IV cannulae. These include the HNEH developed program, or other external programs that are facilitated by RTOs (Registered training organisation) or accrediting bodies. Additionally, many highly skilled clinicians demonstrate knowledge and skills in clinical practice. These people will be recognised through applying the principles of RPL (recognition of prior learning). Other clinicians must be able to demonstrate the minimum knowledge and practical training or programs that safe insertion of adult peripheral IV cannula prior to being credentialed. Overview of HNEH program The HNEH adult peripheral IV cannulation education consists of a three phase approach to the credentialing of clinicians. Phase 1 Online learning and assessment, which will include a variety of interactive learning activities. The assessment of this is a series of scenario-based activities to assess the clinicians knowledge and decision making abilities. Phase 2 Observation of the IV cannula being inserted. Use of simulation to reinforce practical skills and develop muscle memory (learn how to handle the equipment). This will involve practicing setting up the cannulation trolley and handling the required equipment. Use of a simulated arm or manikin may assist with this phase. The purpose of this phase is to link theory to practice and begin to apply knowledge within a clinical context. Phase 3 Supervised assessment of a minimum of 5 adult peripheral IV cannulations. Supervisor and clinician to conduct evaluation of the process after each IV cannulation (see appendix 1 for documentation). The framework for assessment is based on guiding principles for insertion of an IV cannula as in the clinical context each scenario presents a different set of variables. As the clinician progresses through the required 5 cannulations they will be required to critically reflect on their clinical practice

3 1. Knowledge Requirements Clinicians who wish to become credentialed for inserting adult peripheral IV cannula are required to undertake a knowledge assessment and observe the procedure prior to undertaking a practical assessment. The HNEH program requires that clinicians demonstrate knowledge of: 1.1 Anatomy and physiology of the veins and selection of correct vein for the clinical context. 1.2 Indications and contraindications for adult peripheral IV cannulation. 1.3 Understand the Infection control principles and PPE requirements for safe insertion of peripheral IV cannulation 1.4 Describe the procedure of adult peripheral IV cannulation. 1.5 Outline the process of securing the IV cannula 1.6 Identify the signs of adverse events for a peripheral IV cannulation. 1.7 Understand documentation requirements for an IV cannula. 2. Clinical requirements 2.1 Clinicians are required to observe the insertion of an IV cannula prior to undertaking the procedure for the purpose of assessment of the skill. 2.2 The clinician who is learning the procedure is required to insert a minimum of 5 procedures directly observed by a clinician who is experienced at cannulation. 2.3 Both the supervising clinician and supervisor are to complete the evaluation, which identifies both the learning and the learning needs. 3. Recognition of Prior Learning (RPL) Where a clinician can demonstrate prior experience and skills in adult peripheral IV cannulation, modification of the credentialing process can include the following Completion of online knowledge assessment and one observed insertion of an adult peripheral IV cannula only. OR Recognition of an alternate IV cannula program or course in its entirety. 4. Database of Credentialed staff A centralised database of successful completion of all phases of the program or RPL will be held using the HNEH LMS Pathlore. 5. Maintenance of Skills/ proficiency 5.1 Clinicians who have completed all phases of the adult IV cannula program or have gained RPL have a professional responsibility to maintain skills and seek learning opportunities when they ano longer feel confident or have identified learning needs. To enable this, the online knowledge assessment can be repeated as often as required. In addition use of the simulation labs and/ or simulated arms can be accessed

4 References Croskerry.P The theory and practice of clinical decision-making, Canadian Journal of Anesthesia, 52:6, ppr1-r8. Schank, R (1997) Virtual Learning: a revolutionary approach to building a highly skilled workforce. McGraw- Hill, New York Tegtmeyer,K, Ibsen L, Goldstein B Computer-assisted learning in critical Care: from ENIAC to HAL in Critical Care Medicine 2001; 29:

5 Appendix 1 Hunter New England Health Adult Peripheral IV Cannulation Record of Assessment This tool is to be utilised by clinicians undertaken the Adult Peripheral IV Cannulation Program. Completion of all sections is required to be credentialed in HNEH facilities. Participant Name: Role: Payroll: Summary of Completion and Sign Off Completion of Knowledge assessment date: Insertion of 5 cannulas under supervision completed on: Final sign off by Supervisor I have observed the participant safely insert an adult peripheral IV cannula consistent with HNEH policies and best practice, and believe they have met the minimum requirements for credentialing. Date: Name and Signature: Payroll Role: Observations Prior to undertaking the clinical procedure it is important that participants observe another clinician performing an adult peripheral IV cannulation. A minimum of one insertion is to be observed. Date Context Learning Supervisor Name Simulation Following completion of the observation phase it is important to practice handling the equipment required for inserting a cannula. This can be done in the clinical workplace. Simulated arms and manikins may also be used for the purpose of practising IV cannulation. Supervised Assessment The purpose of supervised clinical practice is to develop confidence and skills in the practice of adult peripheral IV cannulation. The observational tool assesses both the clinicians preparedness for IV cannulation including clinical decision making and implementing policies and procedures that relate to the procedure. This form is to be presented to the manager or educator who is able to document the achievement of competency in the Pathlore LMS database

6 Guiding Principles For Assessment of Adult Peripheral IV Cannulation For Supervisors and Participants Pre Procedure Preparation 1. Considers all vascular access options. Identifies indications for and risks of the procedure. 2. Provides appropriate information to the patient and obtains consent 3. Prepares patient for the procedure 4. Observes OH&S guidelines by adjusting the environment to reduce risk Procedure Preparation 5. Gathers and assembles the correct equipment 6. Utilises clinical decision making to determine IV cannula size and insertion site 7. Performs hygienic handwashing and DONs PPE according to organisational policy. Procedure Performance 8. Arranges equipment and describes usage 9. Ensures equipment is functioning 10. Utilises tourniquet to identify vein 11. Prepares skin for Cannulation 12. Considers use of local anaesthetic, and administers correctly 13 Performs cannulation in accordance with organisational policies and procedure. 14. Verifies patency of cannula 15. Attaches IV therapy or cannula cap to cannula 16. Ensures that IV cannula site is clean and covers IV cannula site with sterile transparent dressing. Ensures IV cannula is stable/ secured. 17. Completes the interaction by communicating with the patient include provision of education about management of the cannula and site, and when to notify the health care worker. Post IV -Cannula Procedures 18 Documents on dressing date, time, size IV of cannula and initials of clinician performing procedure 19. Disposes of contaminated and non-contaminated waste appropriately 20. Removes PPE and attends hygienic handwashing according to organisational policy. 21. Documents in patient medical record and HNEH IV Cannula Care Plan 22. Verbalises procedure when an adverse event occurs

7 Self- Evaluation/ Critical Reflection Supervised clinical practice is an opportunity to reflect to improve skills. This tool supports the learning of adult peripheral IV cannulation by providing the clinician with an environment to reflect on practice and secure honest immediate feedback. This document can be kept by the staff member for your clinical portfolio. The following questions can be used to guide the reflection on the procedure for both the participant and supervisor Which part of the procedure did you do well? What aspects of the procedure did you find challenging? How can this experience help you to improve your skills and the patient experience? Clinician Name: Payroll: Supervisor Name: Payroll Date IV Site Clinician Self- Evaluation Supervisor Comments Assessment Outcome - 7 -