Association of Vascular Access 31st Annual Scientific Meeting, Phoenix, Arizona, USA, September
2017
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With the
theme of this year's AVA ASM being 'Capture your Spirit!' a bunch of enthusiastic AVATARians jetted off
to Phoenix in September to embrace the spirit of the Southwest with vascular access colleagues from across
the United States and further afield. Held at the Phoenix Convention Center in the heart of Phoenix, the
ASM featured a pre-conference workshop day and four full days of stimulating presentations. Pre-conference
workshops on offer included paediatrics, care across the continuum, best practice in dressings, research
skills, health worker wellbeing, and cadaver lab. Something for everyone!
The AVA ASM is
always a special event, and this year was attended by 1500 passionate VA clinicians, experts and industry
partners keen to share recent innovations and research findings, and reconnect with old friends and make
new ones. Kudos to Amy Stone and the AVA D-team (event organisers) for another superbly organised program,
with all sessions and presentations fully accessible on the conference app. Well done!
This
year, AVATAR members presented more than 20 invited speaker sessions, showcase events, power hour breakouts,
oral abstracts and poster presentations. Highlights included the hot-off-the-press findings of the RSVP
trial, XLabS vascular access lab research, as well as a host of engaging presentations from the PIVC Consumer
survey, PICC registry, Flushing studies, and the CASCADE, PICC COMPARE, SMILE, SAVE, REPLACE, and OMG
studies (We love our acronyms!).
Congratulations to all AVATAR presenters (seasoned and novice).
Everyone did a fantastic job to showcase the hard work put in by all the team, at home and abroad. It's
always rewarding to see how our research is much appreciated by our colleagues across the seas.
The AVA ASM is a great chance to network with like-minded VA folks and build new research partnerships.
Next year's AVA ASM will be in Columbus, Ohio (15-18 September) and the Call for Topics and Presentations
is open now (Call for Abstracts coming next year). I encourage you to consider presenting your research
at the 2018 conference, which is sure to be amazing! http://www.avainfo.org/
Travel to this year's AVA was partly funded by Medline, Angiodynamics
and BD. We would like to thank them, alongside Griffith University, Queensland University of Technology
and Queensland Health for their ongoing support.
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AVATAR visit to University of Michigan
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Two of the world's leading research centres
in vascular access came together in Ann Arbor, Michigan prior to AVA. Hosted by Dr Vineet Chopra, a productive
and enjoyable time was had by Marie Cooke, Nicole Marsh, Claire Rickard and Amanda Ullman. Highlights
included tours of the UM and VA Hospitals and being the vascular access 'cart' (to us 'the trolley'),
and meeting Safety legends Dr Sanjay Saint, Dr Scott Flanders and Dr Valerie Vaughn. Thank you Vineet
and University of Michigan!
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Congratulations, Dr Nancy Moureau!
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Over the past three years I have had the extreme pleasure and honor of working with a very talented
group of individuals, notably the AVATAR group and specifically Drs. Claire Rickard, Marie Cooke, Vineet
Chopra, Li Zhang, Amanda Ullman, Gillian Ray-Barruel, Samantha Keogh and the most efficient Nicole
Marsh and Emily Larsen.
From what started as sponsored research of skin colonization ended in the
completion of a dream and Doctorate of Philosophy (PhD through Prior Publication). This PhD by prior publication
was new to all, but through much kindness and patience, we walked the path to success and I am forever
grateful for the degree, the research experience and most of all for the addition of new friendships in
a new continent.
As an American viewing the processes and educational system of Australia I was
pleasantly amazed to find that the system supported research, encouraged motivated investigators, and
focused on scholastic achievement rather than strictly completion of courses. I applaud each of you working
together to provide answers to questions that help to make patient care and outcomes better.
I am
honored to be considered part of this AVATAR group.
I am also very grateful to my sponsors 3M, Entrotech
and Cook.
Thanks to all.
Nancy Moureau
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AVATAR- Victorian Education Event
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'Patency, flushing, locking, occlusions.
Evidence and practice recommendations for PIVs and CVADs' was the 'hot topic' for Victorian clinicians
on August, 24th 2017 attracting over 80 clinicians from all over Melbourne and regional Victorian. Interestingly
there were over 20 sites with multiple participants at each site who joined the event via teleconference
from Queensland, NSW, ACT and regional Victoria. A fabulous result with technology enabling our regional
colleagues to participate; an area we are striving to improve each time too! A fabulous result for the
3rd Vic forum!
Speakers represented three streams; research, pharmaceutical and clinical. Speakers
included the inspiring Prof. Sam Keogh who enlightened us about the current evidence surrounding flushing
for both peripheral and central lines and the future direction of patency research. Shevon Fernando (Pharmacy,
Alfred Health) session was immensely informative about current and emerging thrombolytics to restore patency.
Kerrie Curtis spoke about other factors that impact device patency and demonstrated the procedure of restoring
patency for a complete occlusion.
A discussion finished a dynamic and informative evening.
This event was kindly supported by nine industry representative companies. Thank you to Teleflex,
ICU Medical, Medical Specialities Australia, BD, Bard, 3M, B Braun, Cardinal Health and Smith & Nephew.
Kerrie Curtis
Victorian Chapter Lead
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Clinical Research Award for Emily Larsen
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The Royal Brisbane and Women's Hospital
recently held their 26th Annual Healthcare Symposium (12-14 September 2017). The theme of the symposium
was '150 years: where to next?'
The Nursing and Midwifery session 'At the
Cutting Edge' was well attended, bringing in clinicians, researchers, educators and managers alike.
Several members of the AVATAR team were there to support the event, including Professor Joan
Webster, Ms Julie Flynn, Ms Emily Larsen and Ms Sarah Northfield.
Congratulations to Emily
who (presenting on behalf of Professor Claire Rickard) was awarded the 'Clinical Research Award' for the
poster presentation 'RSVP Trial'.
Emily Larsen
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ACIPC 2017 ECR grant: I-DECIDED study
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| Ray-Barruel G, Rickard CM, Cooke M, Mitchell
M. "I-DECIDED: a clinical decision-making tool for improving peripheral intravenous catheter
assessment and safe removal in hospitals". Australian College for Infection Prevention and
Control 2017 Early Career Research Grant. $12,000.
Information about the I-DECIDED study can be
found on the AVATAR webpage: http://www.avatargroup.org.au/i-decided.html
ACIPC Research grants page: http://www.acipc.org.au/research/
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NHMRC Project Funding Success
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Our warm congratulations to Dr Amanda Ullman from Menzies Health Institute Queensland and the
AVATAR group who has been awarded $318,768 from the National Health and Medical Research Council 2018
for the project titled, "Innovation to improve the experience and outcomes of paediatric central venous
access devices: the e-Vascular Access Passport" (APP1138634). Fantastic outcome and very well deserved!
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PISCES Trial Poster at the Translational Research Institute Poster Symposium July 31, Princess
Alexandra Hospital
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PISCES Trial Poster at the Translational Research Institute Poster
Symposium July 31, Princess Alexandra Hospital
Left to right: Prof
Claire Rickard, Joanne Taylor and Kerrie Doupain
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AVATAR Presentation & Webinar sponsored by Centurion
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A "Research to Practice Symposium on Vascular
Access" was hosted by Centurion Medical Products in September 2017. This was presented to both a
live audience in Michigan and via Webinar to nurses across the USA.
Dr Amanda Ullman and Dr Claire
Rickard presented their ongoing program of research and summarised existing evidence in two presentations:
"Solving the CVAD security puzzle: Promoting performance and preventing harm" and "Stick
'em up and don't move!! Keeping PIVs in their place and free of complications".
The webinar
will soon be available to watch on the AVATAR and Centurion websites.
Thank you Centurion for sponsoring
this educational event. |
Achieving optimal vascular access - thinking outside the central line-CLABSI box
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| On October 11 the AVATAR team were delighted
to present a pre ASM workshop to support of the important wok of the Intensive Care Foundation. 'Achieving
optimal vascular access - thinking outside the central line-CLABSI box' attracted over $40000 in sponsorship
from BARD, ICUMedical, MSA (Medical Specialities Australia), Teleflex and support from Armstrongs Insurance
Brokers, Baxter, BD, Device Technologies, Tuta. The free workshop was attended by over 40 clinicians
who enjoyed an innovative program presented by foremost Australian clinicians and researchers, led by
Professor Claire Rickard, Dr Evan Alexandrou, Tricia Kleidon, Dr Amanda Ullman and Dr Kaye Rolls. The
AVATAR team were delighted that Dr Tim Jackson, consultant Anaesthetist & Intensivist from Calderdale
& Huddersfield NHS Foundation Trust (UK) was able to join us for the Panel discussion (courtesy of
Teleflex). The workshop was highly rated by participants, who also indicated they would attend more AVATAR
workshops. We hear you and are working on this as the newsletter goes live. |
From the Infection Prevention &
Control Consortium Australia Blog
https://ipcca.com.au/pps/
The Australian National Healthcare Associated Infection Point Prevalence Survey
For the first time in over 30 years, a healthcare associated infection (HAI) point prevalence
survey is to be conducted in Australia.
As you may know, researchers blogging on this website
have been long time supporters of national HAI surveillance, highlighting the gaps in our knowledge on
the burden of healthcare associated infections in Australia. We are one of the few OECD countries that
does not have a national HAI surveillance program. This severely limits our ability to implement evidence
based national infection prevention interventions and improve the safety and quality of patient care across
Australia.
Led by Dr
Philip Russo (Deakin University), with Chief Investigators Professor
Brett Mitchell (Avondale College), Professor
Allen Cheng and Dr
Andrew Stewardson (Monash University) and Professor
Tracey Bucknall (Deakin University), the project will commence recruiting hospitals towards the end
of 2017 for the survey to be undertaken in 2018.
The primary aims of the research are:
To
estimate the total burden of HAIs in acute care hospitals in Australia
To describe the HAIs by site,
type of patient, specialty, type of facility and geographical location
Data will also be collected
on patients with multi-resistant organisms, urinary and vascular devices, and those requiring single room
placement.
Findings from this research will inform future national HAI prevention initiatives,
as well as developing a model for future national HAI surveillance.
The survey, based on methods
developed by the European Centre for Disease Control
and Prevention (ECDC) has been graciously funded by a charity that has donated over $1 million to
nursing research over the last decade.
We will post further details on this site. In the meantime,
if you would like further information, please contact either Dr
Philip Russo (Twitter @PLR_aus) or Professor
Brett Mitchell (Twitter @1healthau)
Read the press release here
Interested in participating?
During 2017, we will start to recruit hospitals. If you are
potentially interested in being part of this project and are a public principal referral or Group A hospital
(AIHW peer group), we would love to hear from you. Please indicate your interest using the form below.
We can then contact you again in late 2017 with more details and information for you to consider. |
Call for Abstracts- IVNNZ
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IVNNZ Inc. is calling for groups and individuals
who wish to submit an oral presentation or poster display at our conference, in Rotorua, New Zealand
on 16th-17th March 2018. The closing date for submissions is 22nd January 2018. All abstracts will be
peer reviewed, and you will be advised regarding the outcome by 31st January, 2018. Here is your chance
to share your work.
https://www.ivnnz.co.nz/conference-2018/call-for-abstracts/
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You can read our publications at http://www.avatargroup.org.au/our-publications.html
Rickard
CM, Ray-Barruel G. Peripheral intravenous catheter assessment: beyond phlebitis. The Lancet Haematology.
Vol 4 September 2017
A useful and safe PVC is one that the patient still needs, is
tolerated (not painful), is free of all complications (not just phlebitis), is well dressed and secured,
and still works when treatment is due. A useful monitoring instrument is one that captures all
of these concepts validly and reliably, is user-friendly, prompts appropriate clinical decision
making and action, and enables
institutional and health system benchmarking and improvement.
Absence of such a quality measure no doubt drives the health system's ongoing inaction to address
the staggeringly high prevalence of PVC complications and failure.
Kleidon
TM, Ullman AJ, Gibson V, Chaseling B, Schoutrop J, Mihala G, Rickard CM. A Pilot Randomized Controlled
Trial of Novel Dressing and Securement Techniques in 101 Pediatric Patients. J Vasc Interv Radiol. 2017
Sep 18.
The results suggest trials of innovative PICC securement are feasible. Innovative
PICC securement techniques are as safe as, and might be more effective than, standard care; are acceptable
to health care staff and parents; and may reduce the need for dressing change after insertion. Further
research is required to definitively identify clinical, cost-effective methods to prevent PICC failure
and improve reliability.
Ullman
AJ, Kleidon T, Gibson V, McBride CA, Mihala G, Cooke M, Rickard CM. Innovative dressing and securement
of tunneled central venous access devices in pediatrics: a pilot randomized controlled trial. BMC Cancer
(2017) 17:595
High-quality research involving children with tunneled, cuffed CVADs
is feasible, and CVAD securement can play an important role in the prevention of CVADassociated
complications . Careful consideration should be given by interdisciplinary clinicians
when choosing CVAD securement, to ensure it is the most appropriate device for the individual needs
of their
patient. Further research is necessary to examine the effectiveness of novel securement
and dressing products for CVADs in pediatrics.
Choudhury
Md A, Sidjabat HE, Rathnayake IU, Gavin N, Chan RJ, Marsh N, Banu S, Huygens F, Paterson DL, Rickard CM,
McMillan DJ. Culture-independent detection of chlorhexidine resistance genes qacA/B and smr in bacterial
DNA recovered from body sites treated with chlorhexidine-containing dressings. Journal of Medical Microbiology
2017;66:447453
Supplementary Materials to Study
This study has revealed that qacA/B
and smr are frequently recovered from skin sites where CHG dressings are used, as well as body
sites not exposed to CGH dressings. There is no evidence that CHG dressings increase the frequency
of bacteria harbouring CGH tolerance genes at catheter insertion sites. However, the high rates
of recovery of CGH tolerance
genes at body sites suggest that surveillance of CHG tolerance
in hospitals may be warranted.
Ullman
AJ, Kleidon T, Cooke M, Rickard CM. Substantial harm associated with failure of chronic paediatric central
venous access devices. BMJ Case Rep. 2017 Jul 6;2017
Central venous access devices
(CVADs) form an important component of modern paediatric healthcare, especially for children
with chronic health conditions such as cancer or gastrointestinal disorders. However device
failure and complications rates are high. Over 2½ years, a child requiring parenteral nutrition
and associated vascular access dependency due to 'short gut syndrome' (intestinal failure secondary
to gastroschisis and resultant significant bowel resection) had ten CVADs inserted, with ninesubsequently
failing. This resulted in multiple anaesthetics, invasive procedures, injuries, vascular depletion,
interrupted nutrition, delayed treatment and substantial healthcare costs.A conservative estimate
of the institutional costs for each insertion, or rewiring, of her tunnelled CVAD was $A10 253
(2016 Australian dollars). These complications and device failures had significant negative
impact on the child and her family. Considering the commonality of conditions requiring prolonged
vascular access, these failures also have a significant impact on international health service costs.
Ullman
A, Marsh N, Rickard CM. Securement for vascular access devices: looking to the future. British Journal
of Nursing 2017 (IV Therapy Supplement) Vol 26, No 8
Re-establishing the fundamentals,
reconsidering old, and implementing new technologies will likely result in improved VAD security,
and outcomes for patients. With the range of innovations in development, it will be a significant
advantage to have an assortment of effective VAD securement products available for different, sometimes
difficult, clinical situations. However clinical decision making regarding different VAD security
products must be supported by high-quality evidence (randomised trials and systematic reviews of
randomised trials), to ensure effective treatment and judicious use of healthcare resources.
Webster
J, Larsen E, Marsh N, Choudhury MA, Harris P, Rickard CM. Chlorhexidine gluconate or polyhexamethylene
biguanide disc dressing to reduce the incidence of Central-Line-Associated Blood Stream Infection: a feasibility
randomised controlled trial (the CLABSI trial) Journal of Hospital Infection (2017), doi: 10.1016/j.jhin.2017.04.009.
Disc dressings containg PHMB are safe to use for infection prevention at catheter insertion
sites. An adequately powered trial to compare PHMB and CHG discs is feasible.
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