AVA DAY 2...THE party

[InfusionTx]

DAY 2   After having my REM sleep rudely interrupted by the alarm clock, I trudged off to the Network Breakfast. I got there on time at 06:30. The first thing I was treated to was teasing from Lois Davis, RN for my comments on having to waking up early in yesterday’s post. How rude! But then I remembered what my mom told me; if the little girls pick on you that means they like you. So I guess I can count Lois as a friend. The breakfast went well with all the networks sharing a bit about what they were doing to revive interest or keep it going as the case might be. One of the Belgium attendees was present and talked about their network. Like so many other networks the Belgium group was started with industry support. The motivating force for their network was to standardize the care of ports within the many organizations in their country. Wow, I guess we can truly say AVA is world wide! If you would like more information on joining or starting a network please contact Tanya Miller in the AVA office and she will help you.   We began the general sessions with Dr Baird Mallory on “Assessing Venous Access: From PICC Team to Vascular Access Team”. Here was another guy that would not stand at the podium. Did I miss a big sale on roller skates at Macy’s or something? At his institution they had gone through years of working with the entire health care delivery system and teams to maximize outcomes for patients needing vascular access. He discussed pitfalls and shared many hints from his experience for establishing and maintaining a collaborative environment within an institution on vascular access issues. It is good to hear about his and so many other institutions that are now embracing the importance of vascular access and moving to supporting standardized best practices.   Next Ruth Carrico, PhD, RN, CIC delighted me by standing at the podium. I am so easy to please. Her presentation was on “Preventing Catheter Associated Bloodstream Infection: Changing Practice in a Complex Environment”. When she says changing practice she was not referring to changing standards but rather how to get the system and personnel to change to the standards. Now there is a difficult task and she approached the subject with great enthusiasm. The presentation dove tailed in very nicely with Dr Mallory’s as they both dealt with working within a complex institutional environment. I think that is a nice way of saying hospital politics. It was a very good job of presenting what is sometimes a dry subject in a positive and engaging way.   Nancy Bagnall-Trick, RN, CRNI told us that a personal loss had spurred her interest in “Waterborne Pathogens: Is Your VAD Patient at Risk?” her topic for today. She said that waterborne pathogens, as in our tap water, is a “largely unrecognized hazard.” Since this is the first time I have ever seen this topic in a general session I would say she has that right. She illustrated with case history how contaminated water supplies had adversely affected patients, including death. Further more the water we are using daily is not sterile by any means. This is something that can affect our immunosuppressed patients and perhaps we need to dig deeper into it. Thanks Nancy for peaking our interest.   A highlight of the annual meeting is the presentation of the Suzanne LaVere Herbst Award for excellence in vascular access. This award goes to a person that has been nominated by their peers and then gone through a rigorous selection process. This person must have contributed significantly to the promotion of excellence in vascular access. I had the honor of meeting the award’s name sake for the first time. What a charming and wonderful person she is. I spoke with others about Suzanne and the adjectives used to describe this nurse included wonderful, outstanding, amazing and humble. Without Suzanne AVA would not exist so maybe we can add visionary to the list of adjectives. The annual award is made possible by a generous grant from Genentech.   This year’s winner was Janet Pettit, MSN, RNC, NNP. She is a neonatal nurse practitioner practicing in California. She talked about “Trimming of Peripherally Inserted Central Catheters: The End Result”. Her clients are truly special with special needs. She showed us a picture of a “dollar baby”, a baby next to a dollar bill; the bill was larger than the child. The standard “short” PICCs (20 cm) were nearly twice as long as the child. So the debate has been do they coil or other wise leave the excess catheter exposed or do they trim the catheter. She looked a variety of neonatal catheters under a microscope. She examined untrimmed tips, scissor cut , cutting device cut and scalpel cut tips. She did stress this was very preliminary work and the data for outcomes and complication rates for the various cutting methods is still being collected. So all we have is gross microscopic examinations. First the myth that the manufactured tips are smooth and round is that, a myth. The tips while having a pretty clean cut were almost always at a slight angle, not the preferred 90 degree angle we seek. While no method yielded perfect results every time, the cutting device did have the best average. The scissors almost always caused some irregularities. The scalpel was pretty good most of the time except with silicone catheters. I will anxiously wait for her to collect and analyze all her data and publish this study. I think it will go a long way toward giving us some evidenced based data on which to base our trimming practice in neonates. The next logical step will be to see if what applies to the little babies applies to babies at any age.   Then it was off to have lunch and view the exhibits. I can not say how nice it is to have lunch provided. So often at conferences you have to run off to find lunch somewhere during your exhibit time and I hate missing out on time I could be talking with vendors and learning and seeing new things. Again I will not share my little gems because we all come from different areas and have different needs and my treasure may be your junk and I do not want to appear to favor any one manufacturer over another. They are all wonderful and I do thank each one for their presence and support of AVA as I make my rounds.   The rest of the afternoon was kind of different. We had a round of breakout sessions again. Once again a great cross section of topics and amazing well qualified speakers. At the same time there was a “Central Line Lecture Series”. A triad of advanced lectures on central venous access topics. I managed to time things right and got in one breakout and one of the series lectures. All the rooms seemed full and I have heard wonderful feedback on the various offerings.   After a short rest it was off to the annual party. This year we can thank the gracious contributions of (in alphabetical order) Bard Access Systems, Boston Scientific and RyMed Technologies. Without industry support our organization could not exist. Thanks for all the wonderful products we use everyday and your support of AVA!   Prior to beginning the festivities we had the honor of hearing Suzanne Herbst recount her twenty plus year history with AVA which began as a small group of concerned practitioners in the San Francisco Bay area under the name of BAVAN (Bay Area Vascular Access Network) and later NAVAN. She told us how we got the logo (IV bag and catheter design with the “V”). It was designed by the husband of a patient of hers. I had never known that story nor did I realize that design went all the way back to 1985. One of the reasons the name NAVAN was chosen was so we could retain that logo. She had original documents from the first few years that were fun to see. Suzanne commented on the energy and professionalism of those original members and went on to say that she has found that same energy and professionalism in today’s members. She is a wonderful person and we can all be proud of this organization; where we have been and where we are going.   So you want to know what happen at the party? Well, what happens in Indy…. This much I can tell you. The food was fabulous. There prize for most unique was the mashed potatoes served in a martini glass. Some people thought it was ice cream but were baffled as to why you would put chives, bacon bits and cheese on top of ice cream. There was plenty of room for the guests but as always the dance floor was a bit crowded. But then I think that is standard issue for a dance floor any where. We danced so hard that one of the speakers blew out and it took about five minutes to resuscitate it. The last song the DJ played was “last dance”; cute. It was a wild good time. I didn’t see any major spills or injuries on the dance floor. Too bad, they over staffed the ED this time.   PS: thanks for the kind well wishes for my wife at some of you sent. Seems she has shaken it off and will be better just in time to return to work Monday. Isn't this a wonderful life? LOL.