The Right Bedside Systems Approach

The procedure of catheter placement is often performed without the application of an intentional assessment tool, as reflected by evidence-based interventions. Often, there is no consideration of the patients’ vessel quality or a plan for intravenous (IV) administration. Venipuncture attempts are repeated more than necessary at the bedside until valid venous access is obtained and/or the veins on both upper limbs are exhausted. Patients and clinicians are the two actors involved in the Vessel Health and Preservation (VHP) process at the bedside, who should collaborate and communicate with each other to choose and place the right vascular access device (VAD). For this collaboration to be consistently effective, it is essential to consider the systematic application of a framework at the bedside, i.e., a framework that represents the widely accepted best practice knowledge of VHP. The vascular access clinician should drive this framework and account for purpose, device, location, technique, and mitigating factors. Patients, clinicians, and vascular access devices are the three gears of a machine, influencing each other and oriented toward obtaining the same desired VAD results. Consistent application of agreed-upon knowledge at the bedside ensures the vascular access process runs smoothly and efficiently.