3 Areas Where Vascular Access Must Improve

By Ramzy Nasrallah | October 17, 2017

Central line-associated bloodstream infections can cost healthcare providers more than $35,000 extra per patient. Infections are not normal. Pain resulting from a vascular catheter is also not normal. We have to do better.

At the Association for Vascular Access (AVA) we’re seeing the industry moving more toward customer needs, at the bedside. Clinicians are also looking more closely at what’s missing from reducing complications as we make vascular access safer and easier. We have come a long way in upgrading central access, but there are challenges that our industry still faces in elevating both central-line and peripheral IV care, maintenance and research.

1. Reimbursement reform means covering the basics.

It’s very difficult for patients to get basic components of their necessary vascular access procedure covered. For example, transparent film dressings, a necessary component that protects patients and lines, are rarely reimbursed. If we can get basic items like these universally covered it would improve vascular access care tremendously. The cost savings would be very difficult to even quantify because those numbers are so large and spread across a wide range. CLABSIs result in $1.7 billion to $21.4 billion in avoidable costs.¹ Peripheral IV infections, long overlooked, could potentially cost even more. A modest reduction in catheter complications would produce enormous savings while saving lives.

2. We need a dedicated vascular access team in every acute care facility.

Ten years ago there was some ambiguity around what a facility’s true infection rate was. Readmissions due to line complications and infections were accepted as normal. We’re getting a better sense that hospitals understand these issues are happening within and outside of their walls, and they’re taking precise action to prevent infections and reduce readmissions. That’s great progress, but hospitals need to go one step further. They all need to staff a dedicated vascular access team. Just by having experts wherever there are patients and lines will have a significant impact on reducing complications and increasing favorable outcomes.

3. Education must be stronger and start sooner.

Often times peripheral IV competence is a see one, do one exercise. They don’t teach it adequately in medical schools. They don’t have enough time in nursing school. They tell you once you get hired you’re going to be on the job and you’ll see someone do a peripheral IV insertion and then you’ll be able to do one too. That’s how most peripheral IVs are inserted today. You’ve got to think the person you saw do one, probably saw someone else do one, who probably saw someone else do one. Peripheral IV insertion, care and maintenance should be a part of every core curriculum.

Vascular access is an integral part of healthcare delivery. It shouldn’t be something clinicians learn on the fly.

AVA and the AVA Foundation are committed to protecting patients, educating clinicians and saving lines. Our mission is significantly aided through the addition of Medline as a new strategic industry partner. Medline has demonstrated a strong commitment to elevating the standard of catheter care both through its products and practice. Working together, as we did at our Annual Scientific Meeting, we’ll open the door to new ideas to have a greater impact in vascular access by fusing innovation with action to drive greater standardization, education and safety.

Medline can help you implement and standardize best practices for vascular access to improve clinical outcomes.


1. HAI Data and Statistics. Centers for Disease Control and Prevention.

Categories: Expert Views, Infection Prevention, Patient Experience

Ramzy Nasrallah

Chief Executive Officer, AVA

Ramzy Nasrallah joined the Association for Vascular Access (AVA) in 2017 as chief executive officer. Prior to joining AVA, he spent 14 years at Johnson & Johnson in both its pharmaceutical and medical device businesses. Nasrallah has extensive experience and understanding of the critical issues and opportunities surrounding vascular access and healthcare delivery in America and abroad. Nasrallah leads the mission and strategic plan for both AVA as well as the AVA Foundation.

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