Vascular Access for End of Life Care describes how a Vascular Wellness Vascular Access Expert provided an alternative vascular access solution for a critically ill patient by using clinical expertise and compassionate care to balance the patient’s needs and the family’s treatment requests. 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. 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 End of Life Care
– Clinical Case
This Vascular Access for End of Life Care case occurred in a long-term care facility (LTC) with a critically ill patient whose family was faced with making decisions on the patient’s behalf during an end of life situation. The patient was in severe decline and was unable to eat or drink. The family’s preference was to continue administering fluids and monitor their loved one, hoping for improvement. Prior to Vascular Wellness being consulted, the patient’s nurse practitioner ordered a PICC line to avoid repeated needle sticks which would have been necessary to accommodate the family’s request for continued monitoring. Unfortunately, the staff was unable to find acceptable veins and place the PICC, and at that point, our Vascular Access Expert was contacted to remedy the situation and gain vascular access.
Vascular Access for End of Life Care
– Diagnosis and Treatment
Upon arrival, the Vascular Wellness clinician thoroughly reviewed the patient’s condition and conversed with the nurse practitioner. During the review, it was disclosed that the family’s request for additional monitoring could not be accommodated due to failed attempts at the PICC line placement. It was also disclosed that the family had refused Hospice end of life care, although the patient could not eat or drink and was quickly declining. The Vascular Wellness clinician, practiced in holistic care, acknowledged the family’s hope for improvement and the practitioner’s desire to keep the patient comfortable by avoiding numerous needle sticks. Together, the Vascular Wellness clinician and the nurse practitioner went to the patient’s bedside, where the Vascular Wellness clinician performed an Ultrasound assessment of the patient’s veins. While a patient’s veins can be challenging for a central line at an end of life situation, it was determined that the patient’s veins could accommodate a midline catheter. This was good news for the practitioner, patient, and the patient’s family because a midline catheter is less invasive, less expensive, and can monitor and hydrate the patient without inserting the more invasive PICC line. The nurse practitioner agreed with the plan, and the Vascular Wellness clinician placed the midline catheter without difficulty.
Vascular Access Experts
– Key Points
As Vascular Access Experts, our clinicians bring the knowledge and expertise learned over many years of practice to every clinical case. We have earned the trust of Nurse Practitioners, Physician Assistants, and Medical Doctors who regularly reach out to the Vascular Wellness team for consultations and device placement. Our clinicians operate in a wide range of healthcare settings and have diagnosed and treated hundreds of thousands of patients across diverse healthcare settings. Our clinicians are skilled in using the latest technology, such as Ultrasound, for vein visualization. We don’t just place a device, we place the right device at the right time, as demonstrated in this case. We are confident in our vascular access device recommendation because we spend time with the treating physician, patient, and family and thoroughly review the patient’s medical record to fully understand the patient’s history and the purpose and use of the non-central or central line. Our clinicians prioritize this comprehensive assessment and are not evaluated or motivated by how fast they can place the line and leave the patient. Selecting the midline catheter was the correct solution for balancing patient comfort and family requests in this Vascular Access for End of Life Care situation.
Vascular Wellness cares deeply about the patient, their families, and our healthcare partners. Our clinicians know how to combine compassionate care and clinical expertise, especially in situations like End of Life Care. They understand the importance of both with respect to all stakeholders. Finding a solution that works for all parties is part of our mission, and we are empowered to recommend changes for the treating physician’s evaluation that either help optimize the patient’s outcome or, in this situation, provide a level of comfort. In addition, our employee model (W2 Employees) allows our clinicians to provide patient-centered holistic care, even when such care extends the time at the bedside or results in a less expensive clinical service for the patient. This Vascular Access for End of Life Care case is an excellent example of how our Vascular Access Expert found a solution that addressed the patient’s clinical needs, the practitioner’s goals, and the family’s personal desires.
If you require Vascular Access or want to learn more, speak to the team at Vascular Wellness today. For the latest articles and insights, follow us on LinkedIn, Facebook, Twitter, YouTube, and Instagram.
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.