24-Hour Vascular Access Consult and Coordination describes a patient who came to an Emergency Department on a weekend with a suspected infection in her PICC line, which she had in place for long-term outpatient antibiotic therapy, and the ED wasn’t sure of the best course of action.
24-Hour Vascular Access Consult and Coordination
– Clinical Case
A patient who had been discharged some time ago with a PICC line in place for long-term outpatient antibiotics came to the Emergency Department during a weekend with worries of a possible infection at the insertion site. The care team performed a visual assessment of the line and talked with the patient to learn more about what was causing the issues, and to consider if the PICC line needed to be replaced.
The patient explained that she works in a job that causes her to sweat a lot, and upon assessment, it was evident that her dressings were saturated due to her job and lifestyle. In addition, the dressings weren’t being cared for properly, nor were they changed routinely. Both situations led to what looked to be an infection at the insertion site under the dressing.
24-Hour Vascular Access Consult and Coordination
– Diagnosis and Treatment
The Emergency Department contacted Vascular Wellness after hours on this weekend evening, as they were unsure of the best course of action and asked for a consult. The Vascular Wellness 24-hour client support team connected the provider with our AOC (Administrator On-Call).
At no extra charge to any client under our standard no-cost, no-commitment contract, Vascular Wellness staffs and provides an advanced vascular access clinician on-call who is available to clients 24/7 by phone for questions, consults, and troubleshooting.
The AOC reviewed the case and patient record and spoke with the care team. She recommended the patient have a “Line Holiday,” and then afterwards, the PICC line could be replaced.
A Line Holiday is when a central venous catheter is purposefully removed for a 24-48 hour period to allow time for a suspected bloodstream infection to clear.
The Emergency Department care team agreed with the plan for the PICC line to be removed and a new PICC line to be placed after the Line Holiday. However, they were uncertain how to arrange for the PICC replacement. The Vascular Wellness clinician explained that we could place the new line in an outpatient setting after the Line Holiday, and that we have done this for clients in the past, and it works well. The facility liked the idea, but they thought the patient needed to be admitted so she would be there when it was time to place the new line. The patient, however, did not want to stay in the hospital overnight or be admitted while she waited for the suspected infection to clear, nor did she want to return to the Emergency Department.
The Emergency Department was then informed by someone in the facility that the PICC line replacement would need to be scheduled with their Interventional Radiology department, rather than admitting the patient or scheduling it as an outpatient procedure. The Vascular Wellness clinician knew that this was not necessary, as we help facilities establish and implement outpatient procedures all the time. Additionally, performing this procedure in an outpatient clinical setting is much faster and less expensive for all parties, requires far less coordination, and is much more convenient, comfortable, and less stressful for the patient. As an added benefit, it requires far fewer resources, including providers and staff.
More phone calls back and forth ensued, and eventually, the Vascular Wellness AOC was able to connect with the house supervisor, who agreed that the line replacement could be performed on an outpatient basis and assisted in setting it up. With this agreed upon, things moved along smoothly and Vascular Wellness prescheduled the procedure for 48 hours later as an outpatient procedure.
The care team was thankful for the AOC clinician’s patience and assistance with the patient case, as the phone calls were numerous and went well into the evening. With a resolution and plan in place, the care team was freed up to continue to care for other patients in need. The patient was thrilled to be able to go home in the interim and eliminate the need for a return to the Emergency Department. The replacement PICC was placed about 48 hours later in an outpatient room without any complications or delays.
With the new PICC line in place, the Vascular Wellness clinician showed the patient how to properly care for her dressing at home and encouraged her to keep a better eye on it. She also explained that limiting the level of activity where possible while the PICC line was in place would help prevent this from happening again.
24-Hour Vascular Access Consult and Coordination
– Key Points Vascular Access Experts
It is extremely important to properly care for vascular access devices while they are in place, and, as Vascular Access Experts, Vascular Wellness clinicians educate facilities and patients regularly on how to properly handle and care for any vascular access device to ensure they are kept clean and working properly. Helpful information on proper care and maintenance of vascular access devices – including a printable Care Guide – can be found on our Vascular Access Patient Education page.
Collaborative Approach
Vascular Wellness promotes teamwork, internally and externally, by either becoming an extension of a client’s in-house team or operating as a client’s dependable outsourced provider. Our deep expertise and collaborative approach have earned us the role as a trusted part of the care team, and with respect to vascular access, we function as a bridge among all stakeholders, such as the patient, their family members, and the providers and staff.
Outpatient Services have many potential benefits as compared to Inpatient, including community outreach, additional clinical services, and the ability to drive down costs, primarily due to the elimination of a hospital room that can be around $10,000 per night. Additionally, outpatient services provide a lower risk of hospital-acquired infections (HAIs) and other complications. Faster treatment, more personalized care, and improved continuity of care all contribute to overall better patient satisfaction scores, as outpatient procedures are more convenient and enable easier recoveries due to the patient being in the comfort of their own home.
If you’re interested in learning more about how to easily set up outpatient services at your facility at no cost, call us at 877-284-4435 or reach out via our contact form.
If you require Vascular Access or want to learn more, speak to the team at Vascular Wellness today.
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Vascular Wellness provides:
(1) Comprehensive vascular access services to North Carolina, Oklahoma, South Carolina, and Virginia; and
(2) Customized vascular access services to Arkansas, Delaware, Georgia, Mississippi, Pennsylvania, Tennessee, and West Virginia; and
(3) Support vascular access services to Ohio and Kentucky.
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