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The 7 rights approach – vascular access management plan – VAMP
Managing VA in neonates is challenging due to their unique physiological characteristics and the potential for serious complications.
In this presentation, you will find how a structured approach (the 7 Rights Framework) within a Vascular Access Management Plan (VAMP) improve patient safety and outcome.Author
Roland van Rens, Clinical Nurse Specialist and Researcher, member of the board
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A narrative review on tip navigation and tip location of central venous access devices in the neonate: Intracavitary ECG or real time ultrasound?
The proper location of the tip of a central venous access device plays a crucial role in minimizing the risks potentially associated with its use. Recent guidelines strongly recommend preferring real-time, intra-procedural methods of tip location since they are more accurate, more reliable and more cost-effective than post-procedural methods. Intracavitary electrocardiography and real time ultrasound can both be applied in the neonatal setting, but they offer different advantages or disadvantages depending on the type of central venous access device. Reviewing the evidence currently available about the use of these two methods in neonates, in terms of applicability, feasibility and accuracy, it can be concluded that (a) real time ultrasound is the only acceptable methodology for tip navigation for any central venous access device in neonates, (b) intracavitary electrocardiography is the preferred method of tip location for central catheters inserted by ultrasound-guided cannulation of the internal jugular vein or the brachiocephalic vein, and (c) real time ultrasound is the preferred method of tip location for umbilical venous catheters, epicutaneo-cava catheters, and central catheters inserted by ultrasound-guided cannulation of the common femoral vein.
natile-et-al-2024-a-narrative-review-on-tip-navigation-and-tip-location-of-central-venous-access-devices-in-the-neonateDownloadAuthors
Miria Natile1, Gina Ancora1, Vito D’Andrea2 , Mauro Pittiruti3 and Giovanni Barone1
1Neonatal Intensive Care Unit, Infermi Hospital, AUSL della Romagna, Rimini, Italy
2Neonatal Intensive Care Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
3Department of Surgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
Corresponding author:
Giovanni Barone, Neonatal Intensive Care Unit, Infermi Hospital Rimini, Via Settembrini 2, Rimini, Romagna 47923, Italy.
Email: gbarone85@yahoo.it -
Bundles for Vascular Access in a Neonatal Population
During the 8th WoCoVA, MaANP, NNP PhD student Radboudumc Nijmegen the Netherlands, Roland van Rens, gave an interesting session on care bundles for vascular access in a neonatal population. What are the efforts and the challenges?
He also presented the 7 rights framework, 7 rights of Vascular Access.
Authors
Roland van Rens, MaANP, NNP PhD student Radboudumc Nijmegen the Netherlands
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Prevention of primary malposition in neonates: the Neo-ECHOTIP protocol
During the 8th WoCoVA, Dr. G. Barone, Consultant NeonatologistNeonatal Intensive Care Unit, Infermi Hospital – Rimini, Italy, presented us : Prevention of primary malposition in neonates: the Neo-ECHOTIP protocol
You can find the presentation here:
Authors
Dr. G. Barone, Consultant Neonatologist
Neonatal Intensive Care Unit, Infermi Hospital – Rimini, Italy -
Technologies for Diagnosis of Infiltration/Extravasation
During the 8th WoCoVA, Roland van Rens, MaANP, NNP PhD student Radboudumc Nijmegen the Netherlands gave a presentation about technologies for diagnosis of infiltration/extravasation. This topic is dedicated to improve the safety and reliability of Neonatal Vascular Access.
You can find the presentation here:
Authors
Roland van Rens, MaANP, NNP PhD student Radboudumc Nijmegen the Netherlands
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Peripheral arterial catheters in neonates: risks and possibilities
During the 8th WoCoVA, some of our members were presenting interesting insights about vascular access in neonates.
The first presentation that we post is from Dr. Robin van der Lee, pediatrician-neonatologist, Radboud University Medical Center Amalia Children’s Hospital, Nijmegen, The Netherlands about Peripheral arterial catheters in neonates: risks and possibilities
You can find the full presentation here:
Authors:
Dr. Robin van der Lee, pediatrician-neonatologist, Radboud University Medical Center Amalia Children’s Hospital, Nijmegen, The Netherlands
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The future of neonatal care – Neonatal Vascular Access
During the 99nicu congress, 2 of our NEVAT members: Dr. Christian Breschan and MD Roland van Rens, RN NNP, gave a very interesting session with many valuable insights that we should take into account for the future
We started with a theoretical part and then also hands-on.
In the presentation you can discover everything we as NEVAT stand for:Authors:
Dr. Christian Breschan and MD Roland van Rens, RN NNP
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Central-line-associated bloodstream infection burden among Dutch neonatal intensive care units
The aim of this study is to describe the nationwide epidemiology of central-line-associated bloodstream infections (CLABSI) among Dutch Neonatal Intensive Care Units (NICUs).
Methods: Data from 2935 neonates born at <32 weeks’ gestation and/or with a birth weight <1500 g admitted to all nine Dutch NICUs over a two-year surveillance period (2019e2020) were analysed. Variations in baseline characteristics, CLABSI incidence per 1000 central-line days, pathogen distribution and CLABSI care bundles were evaluated. Multi-variable logistic mixed-modelling was used to identify significant predictors for CLABSI.
The conclusion of the study is that CLABSI remains a common problem in preterm infants in The Netherlands, with substantial variation in incidence between centres. Being the largest collection of data on the burden of neonatal CLABSI in The Netherlands, this epidemiological overview provides a solid foundation for the development of a collaborative platform for continuous surveillance, ideally leading to refinement of national evidence-based guidelines. Future efforts should focus on ensuring availability and extraction of routine patient data in aggregated formats.
Authors :
S.J. Jansen a, *, y, S.D.L. Broer a, y, M.A.C. Hemels b, D.H. Visser c, T.A.J. Antonius d, I.E. Heijting d, K.A. Bergman e, J.U.M. Termote f, M.C. Hu ̈tten g, J.P.F. van der Sluijs h, E.J. d’Haens b, R.F. Kornelisse j, E. Lopriore a, V. Bekker a
a Willem-Alexander Children’s Hospital, Department of Paediatrics, Division of Neonatology, Leiden University Medical Centre, The Netherlands
b Department of Neonatology, Isala, Zwolle, The Netherlands
c Emma Children’s Hospital, Department of Paediatrics, Division of Neonatology, Amsterdam University Medical Centre (AUMC), Location AMC, Amsterdam, The Netherlandsd Amalia Children’s Hospital, Department of Paediatrics, Division of Neonatology, Radboud University Medical Centre (Radboud UMC), Nijmegen, The Netherlands
e Beatrix Children’s Hospital, Department of Paediatrics, Division of Neonatology, University Medical Centre Groningen (UMCG), Groningen, The Netherlandsf Wilhelmina Children’s Hospital, Department of Neonatology, Division of Mother and Child, University Medical Centre Utrecht (UMCU), Utrecht, The Netherlands
g Department of Paediatrics, Division of Neonatology, Maastricht University Medical Centre (MUMC), Maastricht, The Netherlands h Department Paediatrics, Division of Neonatology, Ma ́xima Medical Centre (MMC), Veldhoven, The Netherlandsj Erasmus MC e Sophia Children’s Hospital, Department of Neonatal and Pediatric Intensive Care, Division of Neonatology, University Medical Centre Rotterdam, Rotterdam, The Netherlands
* Corresponding author. Address: Leiden University Medical Centre, Department of Neonatology, PO Box 9600, 2300 RC Leiden, The Netherlands. Tel.: +31 0715269111.
E-mail address: s.j.jansen@lumc.nl (S.J. Jansen).
https://doi.org/10.1016/j.jhin.2023.11.020
0195-6701/@ 2023 The Authors. Published by Elsevier Ltd on behalf of The Healthcare Infection Society. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)
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Introduction Maintaining parent-infant skin-to-skin contact during peripheral intravenous catheter insertion in a Dutch neonatal unit
Peripheral intravenous cannulation is a widespread and often repeated experience for infants nursed in a neonatal unit. The procedure, involving pain and discomfort for the infant and anxiety for the parents, is associated with increased exposure to physiological and emotional stress. These stresses can adversely affect parent satisfaction, emotional well-being, and infant neurodevelopmental outcomes.
Interventions such as kangaroo mother care and skin-to-skin contact reduce overall stress experiences for parents and their infants and improve long-term outcomes. The practice challenge is ensuring the continuity of these supportive interventions during medical procedures that have traditionally interrupted parent-infant contact.
This article provides a comprehensive overview of one Dutch neonatal unit’s approach toward maintaining parent-infant skin-to-skin care during routine peripheral intravenous catheter insertion.
Authors
Petra Sipkemaa, Matheus (Roland) van Rensb*, Kevin Hugillc
a Neonatal Unit, Rijnstate Hospital, Arnhem, the Netherlands
b Radboud University, Nijmegen, the Netherlands
c Neonatal Nurse Educationalist, Freelance. formerly Director of Nursing (Education), Qatar* Corresponding author: e-mail address: Roland.vanRens@radboudumc.nl (M.(R. van Rens).
Petra Sipkema et al., Journal of Neonatal Nursing, https://doi.org/10.1016/j.jnn.2024.01.004
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Point‐of‐care ultrasound for vascular access in neonates and children
Ultrasound plays a major role in neonatal/pediatric vascular access, both for venous access and for arterial access, not only just for the insertion of intravascular catheters, but also for many other issues related to this type of maneuver. This “global use of ultrasound” includes a systematic and consistent adoption of this technology for several steps of vascular access:
- the pre-procedural assessment/evaluation of the vessels,
- the ultrasound-guided puncture and cannulation of arteries and veins,
- the real-time diagnosis of immediate, puncture-related complications,
- the so-called “tip navigation” (i.e., real- time intra-procedural assessment of the direction and trajectory of the guidewire and/or of the catheter inside the vasculature),
- the so-called “tip location” (i.e., intra-procedural or post-procedural assessment of the proper position of the tip of the catheter), and (f) the early diagnosis and/or management of most non-infective late complications.
What is Known:
- Ultrasound is obviously useful for vascular access procedures in neonates and children.
What is New:
- Recent evidence suggests that ultrasound is useful for many purposes in the field of vascular access (preprocedural scan, ultrasound-guided puncture, tip navigation, tip location, diagnosis of most non-infective complications).
- Recent evidence also suggests that radiological methods no longer play any role in the insertion of vascular accesses in neonates and children.
The conclusion of this study is that, any vascular access expert (nurse or physicians) should have documented competency in the use of ultrasound. This knowledge should include the use of ultrasound for assessment of vessels, for catheter insertion, for proper placement of the tip, and for real-time detection of complications.
Mauro Pittiruti1 · Maria Giuseppina Annetta2 · Vito D’andrea3
* Mauro Pittiruti mauropittiruti@me.com
- Dept. of Surgery, Policlinico Universitario ‘A.Gemelli’, Largo Gemelli 8, 00168 Rome, Italy
- Dept. of Anesthesia and Intensive Care, Policlinico Universitario ‘A.Gemelli’, Rome, Italy
- Neonatal Intensive Care Unit, Policlinico Universitario ‘A.Gemelli’, Rome, Italy
European Journal of Pediatrics
