Vascular Access for Cardiac Rehabilitation Patient describes how a Vascular Wellness clinician notices an atrial fibrillation episode while placing a PICC line in an anxious quadruple bypass patient and promptly contacts the treating physician for additional medical attention, accelerating necessary therapy. Nurse Clinicians in Action is a spotlight series highlighting some of the interesting cases that Vascular Wellness clinicians have encountered and participated in treatment. These cases involve challenging situations or intriguing clinical presentations and may involve more than one Vascular Wellness clinician as our clinicians have the ability to consult each other while in the field, as well as an on-call Clinical Administrator via a HIPAA (Health Insurance Portability and Accountability) compliant communication app. In addition, our extensive training program and diverse client base, including Level 1 Trauma Centers, Short-Term Acute Care Hospitals, Long-Term Acute Care Hospitals, and Skilled Nursing Facilities, provide our clinicians with a wide array of clinical experience and why we believe our clinicians, as a group, are the most experienced and best trained and supported vascular access clinicians.
Vascular Access for Cardiac Rehabilitation Patient
– Clinical Case
This case follows an elderly man’s journey from a Short-Term Acute Care Hospital to a Cardiac Rehabilitation Hospital after the man received a successful quadruple bypass with a valve replacement procedure. While the man was recovering at the Short-Term Acute Care Hospital, he developed pneumonia, post-operative swelling, and atrial fibrillation. These untoward conditions contributed to the patient’s frustration, already having been through unexpected procedures. His frustration grew even more as his condition didn’t improve, and repeated labs were ordered, resulting in numerous painful blood draws. Although his cough persisted, it was eventually decided to remove his IVs and transfer him to an inpatient Cardiac Rehabilitation Hospital. While in the Cardiac Rehabilitation Hospital, an X-ray confirmed that the patient’s pneumonia was still present, and he would need new vascular access to treat the infection. The facility contacted Vascular Wellness and requested a nurse clinician to place a PICC line.
Vascular Access for Cardiac Rehabilitation Patient
– Diagnosis and Treatment
Shortly thereafter, the clinician arrived, reviewed his medical history, and learned from a conversation with the patient that he had several concerns, ranging from the level of procedural pain to the depth and breadth of the clinician’s experience. The patient had experienced numerous painful blood draws due to swelling in his hands and was apprehensive about another procedure. The clinician answered each question with patience and kindness, ensuring the patient was comfortable with how the vascular access would be performed, why it was necessary, and that his comfort level with her and the procedure was an integral part of his treatment. Once the patient was comfortable, the Vascular Wellness clinician began the process. Vascular Wellness clinicians use ultrasound guidance and other advanced technology and best practices, and because of this, in addition to the deep skill level of the clinician, she noticed an episode of atrial fibrillation during the procedure. The PICC was placed without incident, and the Vascular Wellness clinician notified the patient’s physician and care team of the Atrial Fibrillation. The medical team quickly ordered additional antibiotic therapy. The patient’s condition quickly improved, and he was discharged the following week.
Vascular Access Experts
– Key Points
As Vascular Access Experts, we take great pride in bringing the skills and experience distilled over many years to each case. The scope of our expertise enables us to manage each unique situation skillfully and to also serve as a client partner, promoting teamwork and collaboration both with the patient and the medical team. Our clinician’s expertise often gets utilized in unexpected ways as in this case. Our clinician was able to comfort an anxious patient to the point where he was casually conversing during the procedure and, further, was able to catch an Atrial Fibrillation episode and quickly notify the medical staff that the clinician had familiarity with due to the long history of serving this facility. A less experienced nurse clinician who doesn’t take the time to review the medical history and talk to the patient may not have had the knowledge and confidence to both comfort the patient and identify this AFib event.
Furthermore, Vascular Wellness expert clinicians are a team of W2 employees whose mission is to bring comprehensive vascular access, including holistic therapy, to the bedside, regardless of the location and the time needed to provide exceptional patient and client service. Our broad coverage area with redundancy and superior services are appreciated at every level of client and patient care we provide, from urban level 1 trauma centers requiring placement of dialysis catheters to rural skilled nursing facilities that may need assistance with a difficult peripheral IV or Midline placement. We have a greater than 98 percent success rate with a 0% insertion-related infection rate and a three-hour average response time, seven days a week, 365 days a year.
The patient reached out to Vascular Wellness to share his experience and gratitude…
“After so many painful procedures involving needles, and still having pneumonia after receiving antibiotics and having my IV lines removed, I was very apprehensive about another person coming in and starting over. The Vascular Wellness nurse was so patient and answered all my questions, including how many years she’s been doing these procedures and how many she has performed. I immediately felt comfortable that she was truly an expert and passionate about her field, and she talked me through the whole procedure. Afterwards, we chatted like old friends about common interests; I only wish I was feeling better at the time and had more energy, as I would have really enjoyed talking with her longer. Before she left, I asked her to take a picture of the two of us so I could show my family who took such great care of me. The nurses at Vascular Wellness even checked in on me later to make sure I was feeling better. I truly cannot thank them enough or the Rehab Hospital for partnering with such a professional and knowledgeable group.”
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Vascular Wellness provides:
(1) Comprehensive vascular access services to North Carolina, South Carolina, Virginia, and West Virginia;
(2) Customized vascular access services to Tennessee and Georgia; and
(3) Support vascular access services to Pennsylvania, Ohio, and Kentucky