Innovative approaches to teaching vascular access to nursing students in the COVID-19 era
For the student nurse, peripheral venous cannulation is one of the most stressful skills to be learned. Although some healthcare employers/establishments offer courses on vascular access and infusion nursing as part of their onboarding programs, ultimately educational institutions should share the responsibility to ensure that graduating nurses can provide safe infusion therapies.
An innovative vascular access and infusion nursing (VAIN) curriculum was created and mapped onto the entry to practice undergraduate nursing program at McGill University in Montréal, Québec, Canada. This presented an opportunity to implement new teaching approaches.
Students experienced multiple new teaching approaches including multimedia and experiential learning and live simulation to ensure acquisition of knowledge and psychomotor skills. The teaching approaches had to be rapidly modified with the advent of the COVID-19 pandemic.
The VAIN curriculum emphasizes simulation and directed practice, seeking to increase competence, confidence, and knowledge. The pandemic underscored the need for flexibility and creativity in content delivery.
Canadian undergraduate nursing education programs are designed to prepare nurses for entry to practice. These education programs aim to reflect excellence and achieve clear educational outcomes, all aligned with provincial regulatory and national accrediting bodies (Canadian Association of Schools of Nursing [CASN], 2014). While nursing programs in Canada are accredited based on a standardized framework established by CASN, school curricula are not uniform across the country (CASN, 2014). With respect to the body of knowledge and competencies surrounding vascular access and infusion nursing (VAIN) in particular, neither national nor provincial standards clearly define the requisite educational preparation for entry to practice. Rather, it is the responsibility of the educational institution to ensure that their graduates are competent in this domain of nursing.
However, VAIN content is often scattered inconsistently in undergraduate programs and sometimes overlooked. This oversight highlights a significant educational need. More than one study has shown that structured VAIN education is often not included in pre-licensure university programs (Alexandrou et al., 2012; Hunter et al., 2018). In fact, when surveyed, many registered nurses reported that they had not been taught how to insert a peripheral intravenous (PIV) catheter in nursing school and relied on in-service training, if available, and practice opportunities with unsuspecting patients (Aloush, 2018; Engum et al., 2003; Vizcarra et al., 2014). Unfortunately, inadequately trained nurses may contribute to intravenous catheter-related complications (Hunter et al., 2018; Keleekai et al., 2016; Raynak et al., 2020). Outcomes of failed PIV catheterizations or PIV-associated complications include pain, patient dissatisfaction, increased length of stay, prolongation of care, venous depletion, and the need to treat minor or more severe complications (Romeo et al., 2020). Conversely, nurses who have the proper skills in vascular access device insertion, maintenance, and post-insertion care can significantly and positively impact outcomes such as patient satisfaction, healthcare costs, and length of stay (Dychter et al., 2012; Vizcarra et al., 2014; Woody & Davis, 2013).
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