Dear AVATAR clinicians, researchers, collaborators, colleagues and friends,

From here at AVATAR Central deep in the bunker, we write to wish you a very merry Christmas, some relaxing time with family and friends, and maybe just a little too much of good things to eat and drink

You guys have created a veritable fortress against vascular access complications.
We are proud to fight with you in this battle against our evil foes of catheter malfunction, pain, infection and wasted resources.

This year, we have had an astonishing 28 journal articles published or in press (see below). If you would like a copy of any of these please email Rita r.nemeth@griffith.edu.au This number is amazing, think about it. that has been a new publication on average every fortnight! It is also so pleasing to see that there were over 20 different people as first author on these publications, and numerous others as contributing co-authors the hard work as well as the glory are shared equally at AVATAR!

We know that these articles are not just put on a shelf, but actually directly impact on practice, policy and the industry who supply these vital products. We hear this constantly while networking at conferences, and from the nurses and doctors we work with at our collaborating hospitals who help us do this important research. We see our work referenced and shaping the important policy documents and practice guidelines that clinicians rely on to make practice decisions.

But we can't give up. Patting ourselves on the back for a moment feels good, but doesn't help the hundreds of millions of patients each year who need a vascular access device for their treatment. We must push on to build a strong body of research evidence that helps us to make the best clinical decisions possible. So relax, refresh, and then come back ready next year to rejoin the WAR on vascular access complications.

Healthy and happy wishes to you all from the AVATAR team,

Professor Claire Rickard (Director) and Dr Samantha Keogh (Deputy Director)

2014 PUBLICATIONS Accepted/in press

1. Webster J, McGrail M, Marsh N, Wallis M, Ray-Barruel G, Rickard CM. Post infusion phlebitis: Incidence and risk factors. Nursing Research and Practice. Accepted 17th December.

2. Reynolds H, Taraporewella K, Tower M, Mihala G, Tuffaha H, Fraser JF, Rickard CM. Novel Technologies Can Provide Effective Dressing and Securement for Peripheral Arterial Catheters: A Pilot Randomised Controlled Trial in the Operating Theatre and the Intensive Care Unit. Australian Critical Care. 2015. Accepted 11th Dec 2014.

3. Rickard CM, Marsh NM, Webster J, Gavin NC, McGrail MR, Larsen E. Corley A, Long D,  Gowardman JR, Murgo M, Fraser JF, Chan RJ, Wallis MC, Young J, McMillan D, Zhang L, Choudhury MA, Graves N, Playford EG. Intravascular device administration sets: Replacement after Standard Versus Prolonged use in hospitalised patients. The RSVP trial: study protocol for a randomised controlled trial. BMJ Open. 2015. Accepted 08 Dec 2014.

4. Higgins N, Keogh S, Rickard CM. Evaluation of a pilot educational program on safe and effective insertion and management of peripheral intravenous catheters. Journal of the Association of Vascular Access. 2015. Accepted 5th Dec 2014.

2014 PUBLICATIONS - Published

5. Carr P, Higgins N, Cooke M, Mihala G, Rickard CM. Vascular Access Specialist Teams for device insertion and prevention of failure. (Protocol). Cochrane Database of Systematic Reviews. 2014; 12:1-25. JIF=5.9.

6. Marsh N, Webster J, Flynn J, Mihala G, Fraser J, Rickard CM. Securement methods for peripheral venous catheters: A randomised controlled pilot trial. Journal of Vascular Access. JIF=1.2. Accepted 3rd November, 2014.

7. Malyon L, Ullman AJ, Philips N, Young J, Kleidon T, Murfield J, Rickard CM. Peripheral intravenous catheter duration and failure in paediatric acute care: a prospective cohort study. Emergency Medicine Australasia. Accepted 21 Aug 2014.

8. Edwards M, Rickard CM, Rapchuk I, Corley A, Marsh N, Spooner A, Mihala G, Fraser J. A novel approach to the securement of peripheral intra-arterial catheters in critically unwell patients:  A randomised controlled pilot study of 217 patients. Critical Care and Resuscitation. 2014. Sep;16(3):175-83. JIF=2.2

9. Inwood S. An exploration of the past, present and future of catheter securement. British Journal of Nursing. 2014; 8: S26-S27

10. Tuffaha H, Reynolds H, Gordon L, Rickard CM, Scuffham P. Value of information analysis informing future trial design from a pilot study on catheter securement devices. Clinical Trials. Published on-line early Aug 02, 2014. DOI: 10.1177/1740774514545634

11. Tuffaha H, Gordon L, Rickard C, Inwood S, Scuffham P. The epic3 recommendation that clinically-indicated replacement of peripheral venous catheters is safe and cost saving: How much would the NHS save? Journal of Hospital Infection. 2014. 87(3), 183-4. JIF=3.2

12. New K, Webster J, Marsh N, Hewer B. Intravascular device utilisation, management, documentation and complications: a point prevalence survey. Australian Health Review. 2014. 38(3) June 345-349.

13. Alexandrou E. The One Million Global Catheters PIVC worldwide prevalence study. Br J Nurs. 2014 Apr 24-May 7;23(8):S16-7.

14. Ullman AJ, Long DA, Rickard CM. Paediatric ICU nurses: preventing central venous device infections. British Journal of Nursing. 2014. 23(8):S14-5.

15. Russell E, Chan RJ, Marsh N, New K. A point prevalence study of cancer nursing practices for managing intravascular devices in an Australian tertiary cancer center. Eur J Oncol Nurs. 2014 Jun;18(3):231-5. doi: 10.1016/j.ejon.2013.11.010. Epub 2013 Dec 27.

16. Zhang L, Morrison M, Rickard CM. Draft genome sequence of strain Ralstonia Pickettii AU12-08, isolated from intravascular catheter in Australia. Genome Announcements. 2014. 2(1).

17. Alexandrou E. The One Million Global Catheters PIVC worldwide prevalence study. Br J Nurs. 2014 Apr 24-May 7;23(8):S16-7.

18. Marsh NM, Webster J, Rickard CM. Devices and dressings to secure peripheral venous catheters to prevent complications. (Protocol). Cochrane Database of Systematic Reviews. 2014. Issue 4, 12 April.

19. Zhang L, Gowardman JR, Krause L, Morrison M, Playford EG, Rickard CM. Molecular investigation of bacterial profiles on intravascular catheters. No longer just Staphylococcus. European Journal of Clinical Microbiology and Infectious Diseases. 2014. Epub Feb 06. JIF=3.0

20. Bradford NK, Edwards RM, Chan RJ. Heparin versus 0.9% sodium chloride intermittent flushing for the prevention of occlusion in long term central venous catheters in infants and children. Cochrane Database of Systematic Reviews 2014, Issue 2. Art. No.: CD010996. DOI: 10.1002/14651858.CD010996

21. Alexandrou E, Spencer TR, Frost SA, Mifflin N, Davidson PM, Hillman KM. Central venous catheter placement by advanced practice nurses demonstrates low procedural complication and infection rates-a report from 13 years of service. Critical Care Medicine. 2014 Mar;42(3):536-43.

22. Ray-Barruel G. Are infusion phlebitis assessment scales reliable and valid? British Journal of Nursing. 2014. 23(8): S15.

23. Keogh S, Marsh N, Davies K, Higgins N, Rickard CM. A time and motion study of peripheral venous catheter flushing practice using manually prepared and pre-filled flush syringes. Journal of Infusion Nursing. 2014. 37(2) 96-101. JIF=N/A.

24. Tuffaha HW, Rickard CM, Webster J, Marsh N, Gordon L, Wallis M, Scuffham P.  Cost-effectiveness analysis of clinically-indicated versus routine replacement of peripheral intravenous catheters. Applied Health Economics and Health Policy. 2014. 12 (1): 51-58. JIF= N/A

25. Ray-Barruel G, Polit D, Murfield J, Rickard CM. Infusion phlebitis assessment measures: A systematic review. Journal of Evaluation in Clinical Practice. 2014. 20(2) 191-202.JIF=1.5

26. Ullman A, Long D, Rickard CM. Prevention of central venous catheter infections: a survey of paediatric ICU nurses knowledge and practices. Nurse Education Today, 2014 34, 202-207 JIF=1.3

27. Wallis MC, McGrail MR, Webster J, Marsh N, Gowardman JR, Playford EG, Rickard CM. Risk factors for peripheral intravenous catheter failure: a multivariate analysis of data from a randomized controlled trial. Infection Control and Hospital Epidemiology. 2014; 35(1), 63-68. JIF= 4.0.


Nicole Marsh Masters of Applied Practice (Health Care Research) High Distinction

Dr Heather Reynolds, PhD, Griffith Uni

Julie Flynn, Masters of Applied Practice (Health Care Research) High Distinction

Dr Evan Alexandrou, PhD, Curtin Uni

Carr P, Higgins N, Cooke M, Rickard CM. Best Paper Runner Up Award. 12th International Conference for Emergency Nurses, Perth, October 2014.

Dr Evan Alexandrou. Runner Up. Best paper presentation. AVA Washington 2014.

Webster J, Marsh N, Rickard C. QuARRIES Awards 2014. Winner. Safe practice and Environment. For evidence based peripheral IV practice change

Kayla Chan. Congratulations to Ray and Nilla Chan on their new baby.

Dr Sam Keogh represented Australia at the World Championship triathlon in Edmonton, Canada. 

Amanda Corley, Masters of Applied Practice (Health Care Research) High Distinction

Dr Azlina Daud, PhD, Griffith Uni


BD European Meeting April 2014
Rickard CM (invited Speaker). Complications in PIVCs. Webinar, Istanbul Turkey.

Intravenous Nursing New Zealand Conference, Wellington, 28-29 March
Marsh, Nicole. A time and motion study of peripheral venous catheter flushing practice using manually prepared and pre-filled syringes
Keogh, Samantha.  Invited Speaker. True Blood: The Critical Care Story. An Audit of blood sampling practice across critical care settings
Marsh, Nicole. Invited Speaker. Peripheral intravenous catheters: The New World of Clinically Indicated Replacement.
Flynn, Julie. Sterile versus aseptic non touch technique when changing a connector on a central venous access device: a retrospective cohort study

J&J Forum, Las Vegas, Webinar.
Rickard CM (invited). An overview of AVATAR & the evidence it produces for policy and practice.

Mayo Healthcare Forum, March 12, Sydney.
Rickard CM. (Invited). Peripheral Intravenous Catheters: The New World of Clinically Indicated Replacement.

MEA/CEE Leadership Summit 2014. 3rd April
Rickard CM. Avoiding PIV Complications if routine replacement does not work, what will?  --   via webcast to Istanbul.  (Invited).

Canadian Vascular Access Association
Rickard CM. Peripheral IV Catheters Facing up to our Failures. (invited)

3M/BD Global I.V. Leadership Summit, Minneapolis, USA
Rickard CM. PIVC Complications. (Invited) Rickard CM. Using knowledge.

Infusion Nurses Society Annual Convention 3-8 May, Phoenix, Arizona
Rickard CM. PIVC Complications. (Invited) BD Satellite Event.

World Congress of Vascular Access (WoCoVA), 18-20 June, Berlin
1.  Alexandrou, A. A Global Prevalence Study on Peripheral Catheters (The OMG-PIVC Study)
2.  Alexandrou, A. Central Venous Catheter Placement by Advanced Practice Nurses Demonstrates Low Procedural Complication and Infection Rates -   A Report from 13 years of Service
3.  Butcher R. Lin F, Jones J, Rickard C.  The quality of published central venous catheter clinical practice guidelines: a systematic appraisal using the AGREE II instrument
4.  Higgins, N, Hewer B, Federi, R, Rickard C. Translating Vascular Access Research for Clinicians
5.  Reynolds, H. Securing arterial lines effectively in the operating theatre and the ICU: A pilot trial
6.  Marsh N, Webster J, Flynn J, Hewer, B, Mihala G, Rickard C.  Securing Peripheral Venous Catheters In Hospitals: can we do better at preventing catheter failure?
7.  Gavin NC, McMillan D, Keogh S, Rickard CM, Does parenteral nutrition promote microbial growth?  A review of clinical and laboratory findings.
8.  Gavin NC, Keogh S, McMillan  D, Rickard  CM. Does parenteral  nutrition  increase  the risk of catheter-related  infection?  Does the evidence  reflect current  practice guidelines?
9.  Flynn J. Keogh S, Gavin N. Sterile versus aseptic non-touch technique when changing the bung on a central venous access device: a retrospective cohort study (Oral)
10. S Keogh, J Flynn, N Marsh, N Higgins, K Davies, C Rickard. Nursing and Midwifery intravenous device flushing practice: A cross sectional survey. Free paper.
11. S Keogh, N Marsh, N Higgins, K Davies, C Rickard. A time and motion study of peripheral venous catheter flushing practice using manually prepared and pre-filled syringes. Poster.
12.  Carr P, Cochrane Protocol: Vascular access specialist teams for device insertion and prevention of failure (Oral)
13. Carr P, The VADER Study (Oral)
14.  Ray-Barruel G, Marsh N, Mihala G, Rickard CM. Inter-rater agreement of phlebitis assessment symptoms and scales
15.  Ullman AJ, Cooke ML, Mitchell M, Lin F, New K, Long DA, Mihala G, Rickard CM. Dressings and securement devices for central venous catheters (CVC): a systematic review. Poster.
16. Rickard CM.  Dressing and securement of PIVs. (Invited)
17. Spencer T. (AU): Expanding field of competence for clinicians from PIVs to CICCs, Malpositioned PICC tip repositioning using a high-flow flushing technique - a review of clinical practice, procedural outcomes and cost implications for clinicians
18.  Sheila Inwood (UK), How does a clinician choose needle free connectors: are there evidence based recommendations?
19.  Kleidon T. Taurolidine-Citrate line locks prevent recurrent catheter related bacteraemia - Evaluation of this novel therapy in a paediatric population. Poster
20.  Kleidon T. An intervention to reduce catheter related blood stream infections in paediatric patients - a bundle of care. Poster

Cancer Nurses Society of Australia, Melbourne July 2014.
Rickard CM. Keynote. CVAD Dressings & Securements: Do they work or are they just more work?

Association for Vascular Access, Washington, September 7-10
1. Ullman A, Marsh N, Rickard CM. Spoiled for Choice or Back to Basics? Dressing and securement devices for IV catheters (Invited).
2.  Keogh, S. Ullman, A. et al. What's the Current Practice? A Review of Blood Sampling (Invited)
3.  Rickard CM, Keogh S, Marsh N, Ullman A . So you think you can dance? The art and science of conducting randomised controlled trials in vascular access.
4.  S, Keogh, N Marsh, N Higgins, J Flynn, K Davies, C Rickard. Keeping IVs working: A review of research and practice on flushing to maintain peripheral intravenous catheter  patency. Poster.
5.  Spencer T. Gibson M. Non-invasive correction of malposition PICCs using a flushing technique: simple, successful and cost-effective.
6. Spencer T, Morris L. Obtaining and maintating vascular access in morbidly obese patients: challenges and strategies for success.
7. Alexandrou T. A global prevalence study on peripheral catheters The OMG PIVC study.

12th International Conference for Emergency Nurses, Perth, 8-10 Oct
Carr PJ, Rippey J, Budgeon CA, Higgins NS, Cooke ML, Rickard CM. Factors contributing to first time insertion success of peripheral intravenous cannula inserted in the emergency department. 

Australasian College of Infection Prevention and Control ASM. Adelaide, Nov 2014.
Rickard CM. Invited Speaker: Dressing and Securement of peripheral IV catheters: New solutions to an old problem. BBraun Educational Evening, Satellite Event of the ASM.
Rickard CM. Invited Plenary Speaker: Developing Clinical-Academic Research Partnerships for Vascular Access.

Gold Coast Health and Medical Research Conference, Dec 2014
Ullman A. Dressing and securement for vascular access devices. A Cochrane Review. 
OMG Study Update
We welcome Laura Alberto (in the middle) as our newest OMG study investigator. Laura is a Quality and Research Nurse at Sanatorio Sagrado Corazon, Buenos Aires, Argentina. Her work in spreading the word about the OMG study around the globe has been nothing short of amazing. We now have 567 hospitals in 50 countries signed up to participate. Excitement about the study is spreading around the globe. In the past 3 months, we have welcomed colleagues from Chile, Ecuador, Ireland, Japan, Malawi, Norway, Singapore and Venezuela. See the table over the page to find out how many hospitals in your country have signed up! The complete list of participating hospitals can be found on our website at http://www.omgpivc.org/hospital_sites/sites/ Many hospitals have obtained their approvals and have already collected the data. Nurses who have completed their data collection are reporting that participating in the study has really helped them to evaluate their practice and educate staff on PIVC management practice guidelines. The study is now available in the following language options: English, Spanish, French, Polish, Portuguese, Italian, Arabic, Chinese, Japanese, and Vietnamese. Huge thanks to everyone who has provided help with translations. Many OMG study teams around the globe have submitted photos of their data collection team, and we share these in this newsletter. Its wonderful to put faces to names. If you would like your team to appear in the next newsletter, do send us a photo!
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