Incorporating Near Infrared Light Vein Visualization Technology Into Peripheral Intravenous Access Protocols.

Placement of peripheral intravenous catheters (PIVCs) is a frequent occurrence. Yet, PIVCs consistently require multiple attempts for successful cannulation, leading to an increased use of resources and risk of complications. Even though hospitals have established vascular access teams to improve outcomes and increase longevity of PIVCs, not every facility has one, and some struggle to meet demand. In these cases, PIVC placement depends on the confidence and skills of bedside nurses. Difficult access risk identification tools, as well as vein visualization technologies, like near infrared (nIR), have been developed to assist nurses with cannulation. This study sought to explore how hospitals are using vein visualization technology in nurse-driven protocols and to evaluate whether the technology is being meaningfully integrated into venous assessment and PIVC access protocols. In a survey sent to facilities utilizing nIR technology, 48% of respondents incorporated nIR in nurse-driven protocols. Of these respondents, 88% reported improvement in patient satisfaction, 92% saw a reduction in escalations, and 79% reported a reduction in hospital-acquired infections associated with PIVC placement. Integrating vein visualization technology into nurse-driven PIVC placement protocols has the potential to make a positive impact but requires future research to reproduce these findings in clinical studies.

Intraoperative waste segregation initiative among anesthesia personnel to contain disposal costs.

Approximately 90% of medical waste generated in the operating room (OR) is considered to be non-infectious and non-regulated (Wyssusek, Keys & van Zundert, 2019). Frequently, this waste is inappropriately disposed of into infectious regulated medical waste containers. Due to differences in waste treatment, improper segregation can lead to the misuse or inappropriate allocation of resources, environmental pollution, and increased cost for institutions. A waste segregation initiative was instituted in a tertiary care medical center in the anesthesia work-space of 35 ORs. This initiative included education of medical waste management to increase anesthesia staff knowledge and compliance with waste segregation and optimization of existing waste disposal containers to decrease waste disposal costs. After implementation, there was an increase in overall provider knowledge (p < 0.001) particularly in the categories of medication vial disposal, medication disposal and identification of items for disposal in the sharps containers (p ≤ 0.05). Data suggests a 34.7% increase in providers reporting to always practice waste segregation (p ≤ 0.05). Additionally, there was a statistically significant decrease in overall weight of regulated medical waste items from 0.33 kg/case to 0.09 kg/case (p < 0.001). This decrease in regulated waste supports an improvement in waste segregation and inappropriate items being disposed of in the general trash container. The omission of inappropriate waste was further confirmed by a segregation audit that showed an overall increase in correctly segregated regulated waste of 65%. Collectively, this lead to a cost savings of $15.60 per OR per week, or $28,392 annually.