Supporting clinical competency in managing peripherally inserted central catheters during the COVID-19 pandemic: an education evaluation
Hospitals had to create new practices and training due to the severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) pandemic. An increase in patient acuity and the need for peripherally inserted central catheters (PICC) across the hospital required an urban community hospital to educate and support in-patient nurses to manage PICCs in acute and complex care units. Traditionally, these skills were performed by specialized registered nurses (RNs) from the Vascular Access Team (VAT). This paper highlights the education plan, implementation, and evaluation of a hospital-wide training for RNs and registered practical nurses (RPNs) in in-patient units during the SARS-CoV-2 pandemic.
Clinical Resource Leaders (CRLs) created a modular approach to upskill existing nurses and train new hires. Various education strategies, such as the use of competency assessments, creating practice supports, and incorporating specialists as a resource, were utilized to ensure knowledge transfer, application, and guidance of evidence-informed clinical practices. Vascular Access Team documentation was utilized to obtain Kirkpatrick's (2021) level 4 evaluation.
This training program was implemented after the second wave of the pandemic and was also embedded into nursing orientation. This structured approach ensured that nurses were competent to support the increased acuity and needs of patients. Eighty percent of full-time and part-time nurses were trained to manage PICC lines.
Education evaluation results show a decrease in PICC-related VAT assistance requests with a baseline of 570 calls down to 149 six months after education was implemented. Leaders are encouraged to ensure teams have role clarity, policies, and practice supports to be successful.
Hospitals had to create new practices and training due to the severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) pandemic. During the second wave of the pandemic (at the end of 2020), there was an increase in patient acuity and the need for peripherally inserted central catheters (PICCs), a central vascular access device (CVAD), across Michael Garron Hospital (MGH). This required Clinical Resource Leaders (CRLs), who are similar to advanced practice nurse educators, to create a training program to support in-patient nurses in acute and complex care units to manage PICCs. Traditionally, these skills were performed by the specialized registered nurses (RNs) from the Vascular Access Team (VAT), Intensive Care Unit (ICU), Cardiac Integrated Units (CIU), and Emergency Room (ER) nurses. Rapid Response Nurses usually supported clinical units when VAT was not available, however, their focus shifted to supporting deteriorating patients during this pandemic.
Michael Garron Hospital provides services to 400,000 patients a year. This hospital is committed to improvement and to adapting to the needs of a diverse community. With an aging population and being in the middle of a pandemic, the complexity of the patients cared for by interprofessional teams is increasing.
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