August 10, 2018 • 38 mins
Episode 5 of the ISAVE That Podcast, features a chat at WoCoVA in Copenhagen with Marcia Wise, RN, VA-BC™, the 2018 AVA Scientific Meeting Design Team Chair and an interview with vascular access and home infusion specialist Elizabeth Dow, BSN, RN, CRNI®, WCC, VA-BC™ and NHIA Vice President for Clinical Services Jenn Charron, RN, MSN, CNE about the current state of home infusion and its place in the vascular access continuum of care.
0:00 – A word from our Episode 5 sponsor, the AVA Foundation
0:52 – Hello! It's Judy's turn to be on vacation, so Ramzy and Eric welcome you to Episode 5. The annual AVA Scientific Meeting is a little more than a month away!
7:30 – Another check-in from Episode 5 sponsor, the AVA Foundation
9:06 – Queen Marcia! AVA's 2018 D-Team chair and do-it-all player, Marcia sat down with Ramzy in Copenhagen while at WoCoVA to talk about what we can expect at this year's Scientific Meeting. Talk about some serious educational opportunities!
17:16 – NHIA Vice President for Clinical Services Jenn Charron, RN, MSN, CNE and vascular access and infusion specialist Elizabeth Dow, BSN, RN, CRNI®, WCC, VA-BC™ join Eric to hash out the current state of home infusion in the workplace, as well as its position in the current continuum of the vascular access specialty.
34:45 – AVA Member Services Coordinator Jennifer Livsey lets you know about the upcoming AVA Events that could be in your area. And did we mention the scientific meeting is next month?
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
This episode of the ISAVE That Podcast is made
possible by the support from TheAVA Foundation, which was
created to support AVA'smission: Protect the Patient|
Educate the Clinician| Save theLine.
The AVA Foundation servesclinicians interested in
vascular access, students ofhealthcare professions as well
as patients and their familiesthrough funding vascular access,
(00:22):
innovation, research andeducation.
For more information, visitwww.avafoundationinfo.org
Marcia (00:35):
From the Association for Vascular Access.
This is the ISAVE That Podcast.
You are in Episode 5, Season 1of the ISAVE That Podcast.
(00:56):
This is Ramzy Nasrallah joinedby Eric Seger, the Director of
Communications and JAVAEditor-in-Chief.
Eric, how you doing man?
Good man.
I can't believe it's alreadyapproaching the middle of
August.
I don't know where this year isgoing.
As we seem to say every singleepisode that we do this, but I'm
good.
You sound like you're dealingwith something wonderful in
(01:18):
terms of your sinuses.
I'm sure that's going well.
I have been traveling allsummer, which means I've been
breathing recycled air and mysinuses finally said uncle.
So, I'm trying to get over that.
The good news is that I'm goingto be on a plane or two planes
to Australia tomorrow, so it'smore of the same coming my way
to my immune system.
You mentioned that it's Augustand that's in any other
(01:40):
industry, like where peoplecheck out and have some downtime
in the summer.
Right.
But when you work for AVA,August is the month before
conference and that's, this isour busy season.
What have you been dealing withhere as we barrel towards
Columbus in September?
I'm trying to get a whole lot ofcontent finished and wrapped up.
Uh, whether it be for JAVA, wehaven't an issue that's going to
(02:04):
print in the next week or so.
It's due out the beginning ofSeptember, so it's ready before
conference, you know, so we canhave that fresh stuff.
Biggest issue of the year.
Huge issue.
Yeah.
It's the one that we can't delayat all.
Like it's, it's a big one.
And then also the, ourelectronic newsletter
Intravascular Quarterly, uh,that's due out in August.
So, just trying to get all kindof, you know, cross my t's and
(02:28):
my i's, that sort of thing toget that finished up and
promoting conference.
I'm helping anywhere that I canwith marketing and with
planning.
Cause you know, Tonya, shedominates that as she always
has, but she can always use ahelping hand here and there.
So, that's keeping me plentybusy and, and I'm sure that
you're doing the same.
(02:49):
Talking about flying all acrossthe country as you always do.
What have you been up to otherthan battling your sinus
infection or whatever.
Across the country and overoceans.
It's too much travel.
I don't recommend it.
A we approach a conference, Iget a lot more calls from
industry partners and potentialindustry partners.
So, I just found out thismorning there's a, there's a
(03:11):
company that's just in itsinception in Ireland that's
going to be at a conference thatI met with them in Denmark at
WoCoVA and they have created anovel new catheter securement
device and it's very difficultto describe on a podcast, but
they're going to be at AVA,they're doing two focus groups.
They're going to be showingconcepts and prototypes to our
(03:31):
attendees and I assure you it'snot like nothing that they've
ever seen before.
So I'm excited to see that kindof innovation, these new ideas
being brought into the space.
In the meantime, aside fromindustry partners and inventors
contacting me, I am charged withwriting a General Session
speech.
(03:51):
So, I am doing that– 10 minuteson stage in front of, you know,
four figure people.
That's not a bad thing.
I'm also writing an article forMedline about upgrading patient
healthcare literacy andstandardizing patient treatment
expectations.
And that ties both into myGeneral Session speech as well
as into the most exciting,bedside initiative that AVA has
ever undertaken that we'reputting a bow on now.
(04:14):
That is, and fortunately, I'llagain be on a plane that has a
desk for, you know, 30 hours.
So I've, I've got a lot of timewhere I can either watch,
Forrest Gump again or writestuff.
I probably could do a little bitof both.
Speaking of conference– we talkabout, we always shout out the
(04:35):
first time attendees or I do andI think the President will as
well at AVA.
And not, not the humble brag butneither one of us is going to be
a first time attendee.
I think this is my 13th AVA, mysecond as an employee of AVA and
Eric, you are now a neophyte.
Your, this is your year 2 forit.
Right.
This is also my second as anemployee of AVA, but it's my
(04:57):
second AVA ever.
So I still consider myself a bitof a newbie.
But you know, last yeardefinitely was an experience
that being a first timeattendee, I kinda felt like my
head was spinning a little bitjust because there was so much
to look at and so much to takein and so many great people to
talk to and network with.
But then all of a sudden thefour days of conference was
(05:18):
over.
And it was like, where did thetime go?
So, I think, you know, firsttime attendees have, have plenty
to look forward to.
I mean the education that wehave in the speakers that we
have lined up for this year'sconference are pretty pretty
extensive and pretty well known,you know, key opinion leaders
within the vascular accessspace.
So yeah, I think all first-timeattendees to try to get to
(05:41):
those, you know, obviouslyattend the General Sessions like
everyone else does, but youknow, find speakers that you're
interested in hearing fun topicsthat you're looking forward to
learning more about and thengoing, take good notes and pay
attention and do all that kindof stuff and even try to take
some time and look at theposters.
That's one thing that I did notdo enough last year that I hope
(06:01):
to this year and just take the10 or 15 or 30 minutes, however
long it takes to read theposters and take in that great
data and that conversation andthink about how you can bring it
back to your own facilities.
Yeah.
It's hard to go to AVA and notleave feeling a lot smarter.
Which is a good feeling.
(06:21):
You're bombarded withinformation and I can, I'll
treat this like my second AVAsince there's a behind the
curtain element to what you andI have been exposed to with,
with last year and now thisyear.
The level of content andpresentation is so robust and
scientific now.
I'm so proud of what they've puttogether.
By the way, if you haven'tregistered for the AVA
(06:43):
Scientific Meeting coming up inSeptember in Columbus, you can
go to avainfo.org/annual and allthat information is there for
you.
If you have any questions forEric and me and anyone at AVA
that you would like to hear onthis podcast, either about the
conference or about anythingregarding vascular access or the
organization, you can shoot anemail to podcast@avainfo.org or
(07:04):
just sneak into our mentions onsocial media, which we'll rattle
those off at the end of thebroadcast.
But when we return we'll betalking to AVA Scientific
Meeting Design Team chairwoman,Marcia Wise about what to expect
in Columbus.
The Queen! You forgot she's theQueen.
Speaker 1 (07:31):
The AVA Foundation provides research grants to
develop and evaluate practices,technologies and innovations
within Vascular Access thatimproved clinical outcomes.
This funding is competitivelyawarded and assessed by The
Foundation's board across thecriteria of significance in
innovation, scientific qualityand team capability.
The Foundation also providesfunding to healthcare
(07:53):
practitioners for bothspecialized and higher education
in Vascular Access so that theymay deliver the highest level of
vascular access care.
It supports seminars, panels,and education programs to
provide updates in VascularAccess practice and stimulate
learning.
Travel awards scholarships areavailable to clinicians
attending the AVA AnnualScientific Meeting to promote
(08:14):
hands on involvement andeducation.
The AVA Foundation strives topromote patient education by
funding support for educationalvideos and consumer literature
along with consumer oriented PRand editorial articles.
Family and patient education canhelp ensure that recipients of
Vascular Access can understandhow to participate in their
healthcare.
(08:35):
To make a one-time donation orschedule regular donations to
the AVA Foundation, please visitwww.avafoundationinfo.org.
You may earmark your donationfor innovation research
education or to the overallmission of The AVA Foundation.
Together we can drive thechanges and improvements
(08:55):
necessary to ensure VascularAccess is as safe as possible
for the millions of patients whoundergo these procedures every
day.
Marcia (09:06):
Joined now by Marcia Wise, who is the chairperson of
the D-TEAM, the Design Team forthe AVA Scientific Meeting
coming up in Columbus, Ohio,this September.
We're at WoCoVA in Copenhagen.
Marcia, how are you doing?
Well, I'm finally getting overjet lag.
Great! On the last day of theconference, perfect.
Just in time to go back home.
Talk a little bit about WoCoVA,what you're doing here and some
(09:29):
of the highlights for the peoplewho aren't able to make it to
Europe.
Yeah.
Well, actually I was an invitedspeaker to speak about tissue
adhesive for Vascular Access,which is exciting, but I've
really enjoyed the conference.
WoCoVA, not only is the cityincredibly beautiful, but we
have the conference is very wellstructured, great content, lots
(09:49):
going on.
You know, how they pack in somuch in three days is just
amazing to me.
A really engaging speakers andcontent.
I've really enjoyed it.
Great.
Yeah, likewise.
That's my impression too.
And you just created a greatsegue way into the AVA
Scientific Meeting talking aboutgreat content and speakers,
which is coming up in Septemberin Columbus.
You are leading the Design Teamthat creates the conference,
(10:12):
puts the curriculum together anddecides what is presented, how
it's presented.
Can you share with our listenersexactly what that process has
been like for the 2018conference?
The D-TEAM is a fun experienceand I've really enjoyed being a
committee member as well aschairing this year.
It's a very scientific processthat goes on in a very short
(10:33):
period of time.
So we spend three or four monthsrequesting information from
people that might want topresent.
So, there's a call forpresentations and then the
committee, which I think it'sabout 15 or so people, we all
met in Columbus and, there is avery– led by Megan Schofield– a
(10:55):
very organized process of goingthrough all the abstracts and
picking those that we thinkwould make great content.
And then there's a veryorganized process of plugging
them in and it's an amazingexperience.
What occurs in two days.
I mean, two days! Long days,but, a lot of banter back and
forth.
What's the best content and howdo we make sure that our
(11:18):
audience, we're meeting all ofthe AVA membership through that
organization through ourconference.
And it's just an incredibleexperience.
We're going to have a greatprogram this year as we always
do, but you know, every year youthink it's going to get a little
bit better, a little bit better.
And we've got some kind ofinteresting new things we're
going to do.
(11:38):
We're going to have this lunchand learn kind of debate on the
last day.
And that's going to be, youknow, we picked a topic that we
think is pretty controversialand we're going to have sort of
a debate on the pros and cons ofthis topic.
Ramzy (11:52):
What is this topic?
Marcia (11:54):
Well it's about antimicrobial catheters.
And do they really make adifference?
Ramzy (11:59):
Pros, cons.
Reasons to believe, reasons notto, OK.
Marcia (12:02):
And AVATAR is sort of leading that session with all of
their work in research.
I think it's going to be anexciting one.
And then we've got some otherreally, you know, interesting
topics going on.
Our keynote and I think we'vetalked quite a bit about him,
Marcus Engel, he's going to beincredible I think.
And you know, we're reallyfocusing on the patient advocacy
(12:22):
side and such as WoCoVA here andwe're kind of in sync with this
a patient first.
And we do need to continue tobelieve that there's a patient
on the end of this line thatwe're placing.
And focusing around how do webring that patient into our
world.
I think this is– he was apatient and he had some pretty
(12:43):
bad things happen to him as ayoung man and how he's going to
share with us how, you know,patient care from his
caregivers, got him through hisordeal and the impact that that
made.
Then we've of course got thetopics around all the
controversies, the MAGICguidelines, GAVeCeLT Guidelines,
algorithms versus algorithms.
(13:04):
So that'll be fun.
Just really some interestingthings.
Intraosseous we're covering,peripheral catheters and
securement will be a hot topicas it is here.
It's interesting to see us movea little bit away from the
traditional PICC line thing andmove into some other categories:
dialysis, multidisciplinary,patient-focused and we have some
(13:30):
great physician speakers as wellas nursing educators speaking
this year.
Then Columbus itself, it's justfun place.
Ramzy (13:39):
It is a fun place.
Disclosure, I'm from there.
I have nothing but kind thingsto say about Central Ohio.
Marcia (13:43):
I've told a lot of people, they go, why Columbus?
And I said, you know, I don'tthink you would top of mind
think about that from aconference standpoint.
But once I was there, I was veryimpressed.
I had been in National Harbor afew years back and that's, it's
reminiscent of that, the littleboardwalk around the area there
and all the, yeah, all the shopsand the conference center itself
(14:07):
is just incredible.
The shrink wrap off of it.
Yeah, it's beautiful.
Everybody's going to love it.
Lots of place for people togather and network and talk.
Ramzy (14:16):
I don't think people realize the city.
Do you know, it's like the 14thlargest city in the country.
Marcia (14:21):
I didn't know that!
Ramzy (14:23):
I mean, having been from there, I'm like, that was kind
of a cow town, but I lived therein the 80s so it's come a long
way.
They benefited from me leaving.
Marcia (14:32):
Well, I think it Kinda got redone right a few years
back or something.
Ramzy (14:37):
It's the confluence of academia and business coming
together and converging onColumbus that developed it into
what you'll see in September isreally a vibrant, eclectic and
really thriving place to have aconvention and you know, even
live.
One last question before we getback to WoCoVA: If you could
think of a couple of reasons togo from a scientific standpoint
(14:58):
based on the curriculum we'veput together.
I'm thinking about going toColumbus for the AVA meeting
because of...
Marcia (15:05):
Well I think the technology is changing so
quickly and I don't know how ina staff situation in a hospital
you can stay up with that.
You've got to get to theseconferences and uh, just the
networking experience alone, butthen the scientific content that
you can pick up and take back toyour organizations is
(15:26):
incredible.
And you know, if our practice ismoving so quickly that I don't
know how anybody keeps upanymore without going to one of
these every year.
Because every year there is, youknow, 90% of it's relatively
new.
You can't just go one or fiveyears.
You've got pretty much go everyyear or every other year at
(15:47):
least to keep up.
Ramzy (15:48):
It's like you ate once and now you're nourished
forever.
You need to keep eating.
Marcia (15:53):
Well and I think we've done a really good blend of
those that are, you know,there's a lot of new people
coming in to Vascular Accesscause it's such a hot specialty
right now and so much going onand so challenging and people
are very passionate.
Our challenge always on theD-TEAM is to have enough content
for those advanced practitionersthat have been doing this for
awhile as well as the new peoplecoming in that are just learning
(16:15):
how to use ultrasound, etc.
And I think we've worked realhard on the D-TEAM this year to
keep that balance.
So we have stuff for people thatare new versus people that have
been around for a while.
Ramzy (16:24):
It's great tracks just based on where you are in your
career and your proficiency.
A beginner, intermediate,advanced, Marcia.
Marcia (16:32):
No, Marcia is out! I'm in the cadaver lab already.
Ramzy (16:38):
She's famously said, even after she leaves and retires,
Marcia will return to an AVAScientific Meeting in the
cadaver lab.
She is Marcia Wise, thechairperson of the D-TEAM and so
much more.
Thanks for taking some time outtoday.
Marcia (16:49):
Thanks Ramzy.
Eric (16:54):
After a quick break, I'll chat with Vascular Access and
Home Infusion Specialist,Elizabeth Dow as well as Jenn
Charron, the Vice President forClinical Services for the
National Home InfusionAssociation about the current
state of home infusion and whereit sits in the continuum of
Vascular Access care.
(17:16):
And it is my distinct honor tobe joined today by Beth Dow
board certified Vascular Accessand Infusion Specialist as well
as Jenn Charron, who is the VicePresident for Clinical Services
at the National Home InfusionAssociation to chat a little bit
about infusion and certificationwithin that area of Vascular
(17:38):
Access.
How are you ladies doing today?
Beth (17:42):
Doing great.
Jenn (17:45):
Doing well, thanks for asking.
Eric (17:47):
I heard you guys are dealing with some swampy
conditions over there on theeast coast in Boston and New
Hampshire.
It's been similar to that inOhio.
I think we're all just kindapushing and waiting for fall to
get here to maybe get somecooler temperatures.
Jenn (18:02):
Yeah, I'm not going to wish for fall to come quickly,
because then comes winter.
Eric (18:07):
That's true.
With all the nor'easters lastyear.
I don't think you guys wantanymore.
So, we can just dive right inhere.
I know you guys have done somegreat work within both
personally and then Jenn, we,we've had you on the podcast
before to discuss the NHIAcollaboration with AVA.
(18:29):
I know that you guys have somemain points about with the
clinicians bearing theresponsibility maybe to to
maintain the practice standardsand keep pac, with best practice
advances.
Beth you have any thoughts youwant to dive into that and kick
us off?
Beth (18:46):
Dive in a shall! Yes, thank you so much, Eric, I
appreciate that.
Looking at where we're going asfar as home infusion, it
definitely is relevant openingup the number of patients we
have week to week, month tomonth, year to year is just
exponentially growing.
And I was talking with Jennearlier and we were in agreement
(19:06):
that there is a little bit of agap here as far as practice
standards and clinical educationgoes for clients who are
receiving care at home and alsoclinicians who are providing
care at home.
It really is an area that cameround, and I think that right
now looking to the establishedareas, we've got primarily NHIA,
(19:28):
thank you very much Jenn.
We've also got AVA and we've gotINS and those are our three
really big pillars that we haveto look to.
We've got ONS.
But as far as the home carepopulation goes, I don't see
them being really activecurrently.
But you know, maybe that willchange.
Hopefully, we can look at thethree main ones that we haven't
kind of put together a littlebit more of a patient-centric
(19:51):
and home care clinician-centricgroup of education.
And that would really be veryhelpful to all parties involved
because right now there is nopractice standards specific to
home care infusion.
And that's a gap.
There's definitely one for acutecare.
We look to people who are inacute care to trickle down into
(20:14):
the sub acute areas.
But lots of times that doesn'tnecessarily really happen.
And we also know that as we lookat marketing and we look to
financial flows and we look toindustry for education quite,
quite frequently.
That's where a lot of oureducation comes from.
Clinician educators coming outand teaching us about new
products and new techniques, butthat doesn't usually happen in a
(20:36):
tertiary market.
It doesn't happen outside ofacute care or doctor's offices
because traditionally home caredoes not qualify really as a
purchaser.
So that education is reallymissing.
It's really sort of a lostmarket.
That being said employers, evenin the home care area, when they
want to be able to provideeducation to their staff, they
(20:58):
don't always have access tothose resources either because
they're not going to be a bigpurchaser.
So you know, industry just, youknow, it's hard for them to take
all of that, all of that time,all of that money, all those
hours and bring it to a placethat's definitely not going to
return for them.
So looking at having a standardof practice or having a
(21:18):
certification that individualclinicians can reach towards,
that would bring them continuingeducation and the best practice
standards specific to home carewhere they have to be really
autonomous, they have to haveprogressive knowledge, they have
to be really on top of thereassessments and feel comfortable
and confident in their skillsbecause there's no one else
(21:41):
there.
They're in a home.
It sounds silly when I say it'shome care.
You know, you're in a home, butthat's it.
You have yourself and you havethe bag that you brought into
the home with you and there'snothing else there.
So if something goes wrong,you're really on your own.
So having clinicians that arecloser to entry level, doing
this job is really probably notwhat we want.
(22:01):
We probably want to be able toestablish a higher standard and
be able to empower individualclinicians to aspire to that
higher standard prior to leavingthe more structured and stable
acute care environment.
Jenn (22:14):
Yeah.
I think there's so many pointsthere that I can absolutely
agree with that.
Part of joining NHIA was thislove for home infusion nursing
and feeling like we just don'tfit into a lot of the molds that
we have out there.
And to your point, we're kindof, you know, picking, you know,
a little bit from here a littlebit from there and really trying
(22:37):
to then interpret some of thosethings to be specific to the
home environment.
So beyond upping our clinicalpractice and ensuring that we're
meeting standards don't have alot of data associated with
outcomes in the homeenvironment.
That's something that NHIA isreally starting to look at.
(22:58):
We're starting a data initiativecoming up this fall.
But again, that, that wholepiece of it is lacking in our,
in our industry.
And I think coming from that,you have not, I don't think the
level of respect for what a homeinfusion nurse is required to do
and does on a daily basis isreally understood by the
(23:21):
industry.
And to your point aboutcertification, these are nurses,
that are doing biologics.
Sometimes they're doing woundcare, they're taking care of
people with massive infections,long term care patients who need
TPN for life.
(23:42):
And these are very complexstations that are living in
their home.
And the standards, to your pointare something that we're calling
from many areas, many of itwork.
But I think there's a lot to besaid for collaborating with our
associations can build thatstandard of practice.
Eric (24:02):
That's a lot of great points and I think it's awesome
that NHIA has started tocollaborate the data that you
mentioned Jenn.
What are you guys' thoughtsabout how to get industry to
understand more about homeinfusion and what the
specialists in that field do.
Jenn (24:19):
Yeah.
You know, it's interesting toobecause it's not talked about
either and colleges.
It's not even usually brought upas something that nurses are
taught that is a field.
And so I think we typically gofrom, you know, nursing
education, I get my nursingdegree, I go into acute care,
(24:41):
skilled facility and then youkind of move out and you need
that stage.
But we need to let people knowhow awesome it is to be a home
infusion nurse as well.
It's amazing the level of carethat you can provide and the
satisfaction you get as aclinician working with these
patients.
Eric (25:03):
Beth, I'm sure you don't have any thoughts on that.
Beth (25:06):
Well, if you let me open the door on that.
I can probably talk to youstraight through next Thursday.
In this area in home infusion,there is no other area other
than home infusion, mobileinfusion, mobile Vascular
Access, whatever term you wantto use to to call what it is
that we do.
There is no other area whereyou're going to find a matched
(25:28):
level of autonomy.
And also, that is jobsatisfaction including patient
closure.
And when I say patient closure,I mean seeing something through
to the end.
And in knowing what happens toyour patient and making sure
that at the end of the day youhave a happy ending one way or
the other, you're actuallymaking something work for your
(25:50):
client in a way that no one elsecan.
And that is something really,really special that you're not
going to find in other areas ofreally any clinical practice.
I've been a nurse Gypsy for along time and I've kind of been
all over the place with mycareer.
This is the only thing that'sheld me for almost 12 years now,
which is kind of saying a lotbecause I tend to hop around
(26:13):
quite a bit and and I've beenheld here, which is, which is
impressive.
It's not often that you get tospend an amount of time with a
client in a setting where you'reable to see what their lifestyle
is.
You're able to generate a planof care that matches that
lifestyle, inclusive with theirfamily and their goals, and then
(26:36):
see it through and navigate thehealthcare system the way those
people need it done for them.
And to Jenn's point, I mean it'snot just the infusion.
You know you've got people withmassive gaping wounds and
negative pressure.
You've got people with massivesepsis, you've got all kinds of
autonomic issues that we've gotpeople with you know, pemphigus
(26:59):
and you've got people withdisreflexia.
Then you've got all kinds ofdifferent stuff where you have
to navigate those things inorder to make that person's life
livable for them.
And when you're in the homesetting, you're actually able to
do that.
Lots of times, home care nursesfind things, home infusion
nurses, home care nurses, findissues that have been overlooked
for years and years and years bytraditional healthcare because
(27:21):
patients are screened for 5, 10,maybe 15 minutes in a room, in a
doctor's office on a table andthey're not ever assessed in
their home, native environmentand deficits that are picked up
by people in the home care fieldis really needs to be researched
(27:41):
more.
And I'm glad to hear that Jennand her group are doing more
research because I think we'regoing to find that a lot of
improvement in a lot of thenavigation and coordination that
happens between the silos wehave in healthcare.
Are undercovered when we look tohome infusion and we look to the
specialties that go on in thehome.
Jenn (28:08):
There's another point I wanted to make– Liz talked a lot
about home care agencies and ina home infusion.
In our market we've done somesurveys to our members and more
than 50% of the nursing visitsthat are provided to home
infusion patients are actuallydone by home health or visiting
(28:29):
nurse agencies.
So, working together issomething that we do every day,
right.
Between a home health companyand home infusion.
That's very typical.
But the resources vary foreducation, to Liz's point, vary
greatly between home healthagencies.
So, large agencies that do a lotof home infusion, they might
(28:53):
have a lot of resources foreducation, but you see a lot of,
I would say I think of it alittle bit of dabbling in the
home infusion market where youmay only have one or two nurses
that can do infusion.
That's not really specializedand I feel like that again is
another area that AVA and NHIAcould collaborate to develop
(29:13):
educational programming for thatgroup.
That'll up the level of carethat we're providing patients
across the continuum in a, in areally different way.
Eric (29:27):
That's definitely something that should be on the
table moving forward.
And we're starting theconversation right now.
I think the collaborationbetween AVA and NHIA is a key
component of that to break downthe silos that, that Beth
mentioned.
But on a more local level whatare your guys' thoughts on sort
of breaking down those barriersand, instituting the clinical
(29:50):
learning and growth and howthat's best accomplished?
Beth (29:55):
I really think it comes down to individual clinician
needing to have the autonomy andthe self-respect to be able to
say,'I need more education.
If We really stop and thinkabout it.
The most basic part of whatyou're going to do with
infusion, is start peripheralIV, pretty, pretty basic and
culturally nurses take that askind of a blase thing,'Oh no big
(30:17):
deal.
Go ahead, put the 22 in somebodyand make sure you wash your
hands first.' Sometimes we don'teven use sterile technique and
we do that, which should be, butsometimes we don't.
That's considered very basic,very entry level and we teach
that to young nurses, but if wego and we look at other areas of
healthcare, is there any otherarea where we would say, yeah,
sure, go ahead.
Why don't you try thatendoscope?
(30:39):
Nowhere else would we do that.
Nowhere else would be say itwould be entry level to invade
that body system.
Even though it's peripheral andit's on the outside, but you're
still going to do some of thevascular system like that.
That's a risk of sepsis, that'shuge.
Even with the peripheral IV.
So, it's something really that Ithink we need to stop and look
(31:00):
at the way we teach and trainall of our healthcare clinicians
from the get go, like just rightfrom the word start that, if
we're going to be intravascularat all, if we're going to be
into the vein at all, we reallyneed to stop and think about
what we're doing.
And I really don't think itshould be the type of thing that
is entry level.
(31:20):
I really think you should havesomebody who has a little bit of
a respect for what it is thatthey're doing and they
understand what therepercussions are of doing
something wrong.
Jenn (31:29):
I just want to make a couple comments on that.
Personal responsibility for yourown practice is huge.
And thinking the things that wedo in infusion as basic in a big
mistake.
Care and maintenance, just acentral line dressing change,
that people think,'You know, I'mjust, you know, I do this every
(31:51):
day' and we're not as payingattention to what we're doing as
we should.
NHIA, for the first time, had abasic course for home infusion
and really all it was wasinformation about dressing
changes, lab draws, peripheralinsertion, preventing
complications.
And we had hands on trainingwith the nurses got to practice
(32:16):
doing a dressing change.
And I can't tell you how manypeople said to me,'Oh Gosh, I've
done this a million times.
You know, it's just so easy.'And one clinician in particular
is like,'let's just do it.
You're here, let's just do it.'And what happened was she did
the dressing change and did notcover the statlock leaving a
(32:41):
wide open area, forcontamination in the central
line! And it's not becausepeople are trying to do
something wrong, it's becausewe're not paying attention in
our own practice and ensuringthat we're meeting every
guideline available
Beth (33:00):
It happens every single day.
Every single day I see somethinglike this that needs to be
remediated.
Not a day in my practice goes bywhere I don't see something
where I have to correct that.
Educate the patient and say,listen, if you see this, it's
wrong.
It needs to be done that way.
Do you need an air-occlusivedressing and explain what
(33:21):
air-occlusive is you need, youknow, going step by step and
educating the patient as thepatient is the clinician is
really critical.
And then going back andremediating that person who made
the mistake and it comes down toindividual clinicians becoming
kind of blase in their practice.
And you know, when you start toget boring and work starts to
(33:42):
become ho hum and here we go.
Gonna get on a donkey trail andgo to work again.
It's time to switch.
It's time to leave.
It's time to find something elseto do because you, you're not
going to help anyone if you'retaking for great the work that
you do and you're not excitedabout it and it's interesting to
you and you're not committed toand you're not focused a hundred
percent on what it is thatyou're doing, you shouldn't be
(34:04):
doing it.
Eric (34:05):
Most definitely.
I really appreciate the timefrom both of you.
I think this has been a reallyconstructive conversation and
something that our members andthose that listen to this
podcast are going to kind ofstand out to them as far as
like, I need to do this, I needto do more than this.
I need to educate myself.
I need to continue my, gettingthese credits and consider a
certification in these areas.
(34:26):
So, they are Beth Dow and JennCharron.
Thank you ladies so much.
I really appreciate it.
Jenn (34:33):
Thank you.
Beth (34:33):
Thank you, Eric.
Thanks Jenn.
This episode of the ISAVE That Podcast is made
possible by the support from TheAVA Foundation, which was
created to support AVA'smission: Protect the Patient|
Educate the Clinician| Save theLine.
The AVA Foundation servesclinicians interested in
vascular access, students ofhealthcare professions as well
as patients and their familiesthrough funding vascular access,
(00:22):
innovation, research andeducation.
For more information, visitwww.avafoundationinfo.org
Marcia (00:35):
From the Association for Vascular Access.
This is the ISAVE That Podcast.
You are in Episode 5, Season 1of the ISAVE That Podcast.
(00:56):
This is Ramzy Nasrallah joinedby Eric Seger, the Director of
Communications and JAVAEditor-in-Chief.
Eric, how you doing man?
Good man.
I can't believe it's alreadyapproaching the middle of
August.
I don't know where this year isgoing.
As we seem to say every singleepisode that we do this, but I'm
good.
You sound like you're dealingwith something wonderful in
(01:18):
terms of your sinuses.
I'm sure that's going well.
I have been traveling allsummer, which means I've been
breathing recycled air and mysinuses finally said uncle.
So, I'm trying to get over that.
The good news is that I'm goingto be on a plane or two planes
to Australia tomorrow, so it'smore of the same coming my way
to my immune system.
You mentioned that it's Augustand that's in any other
(01:40):
industry, like where peoplecheck out and have some downtime
in the summer.
Right.
But when you work for AVA,August is the month before
conference and that's, this isour busy season.
What have you been dealing withhere as we barrel towards
Columbus in September?
I'm trying to get a whole lot ofcontent finished and wrapped up.
Uh, whether it be for JAVA, wehaven't an issue that's going to
(02:04):
print in the next week or so.
It's due out the beginning ofSeptember, so it's ready before
conference, you know, so we canhave that fresh stuff.
Biggest issue of the year.
Huge issue.
Yeah.
It's the one that we can't delayat all.
Like it's, it's a big one.
And then also the, ourelectronic newsletter
Intravascular Quarterly, uh,that's due out in August.
So, just trying to get all kindof, you know, cross my t's and
(02:28):
my i's, that sort of thing toget that finished up and
promoting conference.
I'm helping anywhere that I canwith marketing and with
planning.
Cause you know, Tonya, shedominates that as she always
has, but she can always use ahelping hand here and there.
So, that's keeping me plentybusy and, and I'm sure that
you're doing the same.
(02:49):
Talking about flying all acrossthe country as you always do.
What have you been up to otherthan battling your sinus
infection or whatever.
Across the country and overoceans.
It's too much travel.
I don't recommend it.
A we approach a conference, Iget a lot more calls from
industry partners and potentialindustry partners.
So, I just found out thismorning there's a, there's a
(03:11):
company that's just in itsinception in Ireland that's
going to be at a conference thatI met with them in Denmark at
WoCoVA and they have created anovel new catheter securement
device and it's very difficultto describe on a podcast, but
they're going to be at AVA,they're doing two focus groups.
They're going to be showingconcepts and prototypes to our
(03:31):
attendees and I assure you it'snot like nothing that they've
ever seen before.
So I'm excited to see that kindof innovation, these new ideas
being brought into the space.
In the meantime, aside fromindustry partners and inventors
contacting me, I am charged withwriting a General Session
speech.
(03:51):
So, I am doing that– 10 minuteson stage in front of, you know,
four figure people.
That's not a bad thing.
I'm also writing an article forMedline about upgrading patient
healthcare literacy andstandardizing patient treatment
expectations.
And that ties both into myGeneral Session speech as well
as into the most exciting,bedside initiative that AVA has
ever undertaken that we'reputting a bow on now.
(04:14):
That is, and fortunately, I'llagain be on a plane that has a
desk for, you know, 30 hours.
So I've, I've got a lot of timewhere I can either watch,
Forrest Gump again or writestuff.
I probably could do a little bitof both.
Speaking of conference– we talkabout, we always shout out the
(04:35):
first time attendees or I do andI think the President will as
well at AVA.
And not, not the humble brag butneither one of us is going to be
a first time attendee.
I think this is my 13th AVA, mysecond as an employee of AVA and
Eric, you are now a neophyte.
Your, this is your year 2 forit.
Right.
This is also my second as anemployee of AVA, but it's my
(04:57):
second AVA ever.
So I still consider myself a bitof a newbie.
But you know, last yeardefinitely was an experience
that being a first timeattendee, I kinda felt like my
head was spinning a little bitjust because there was so much
to look at and so much to takein and so many great people to
talk to and network with.
But then all of a sudden thefour days of conference was
(05:18):
over.
And it was like, where did thetime go?
So, I think, you know, firsttime attendees have, have plenty
to look forward to.
I mean the education that wehave in the speakers that we
have lined up for this year'sconference are pretty pretty
extensive and pretty well known,you know, key opinion leaders
within the vascular accessspace.
So yeah, I think all first-timeattendees to try to get to
(05:41):
those, you know, obviouslyattend the General Sessions like
everyone else does, but youknow, find speakers that you're
interested in hearing fun topicsthat you're looking forward to
learning more about and thengoing, take good notes and pay
attention and do all that kindof stuff and even try to take
some time and look at theposters.
That's one thing that I did notdo enough last year that I hope
(06:01):
to this year and just take the10 or 15 or 30 minutes, however
long it takes to read theposters and take in that great
data and that conversation andthink about how you can bring it
back to your own facilities.
Yeah.
It's hard to go to AVA and notleave feeling a lot smarter.
Which is a good feeling.
(06:21):
You're bombarded withinformation and I can, I'll
treat this like my second AVAsince there's a behind the
curtain element to what you andI have been exposed to with,
with last year and now thisyear.
The level of content andpresentation is so robust and
scientific now.
I'm so proud of what they've puttogether.
By the way, if you haven'tregistered for the AVA
(06:43):
Scientific Meeting coming up inSeptember in Columbus, you can
go to avainfo.org/annual and allthat information is there for
you.
If you have any questions forEric and me and anyone at AVA
that you would like to hear onthis podcast, either about the
conference or about anythingregarding vascular access or the
organization, you can shoot anemail to podcast@avainfo.org or
(07:04):
just sneak into our mentions onsocial media, which we'll rattle
those off at the end of thebroadcast.
But when we return we'll betalking to AVA Scientific
Meeting Design Team chairwoman,Marcia Wise about what to expect
in Columbus.
The Queen! You forgot she's theQueen.
Speaker 1 (07:31):
The AVA Foundation provides research grants to
develop and evaluate practices,technologies and innovations
within Vascular Access thatimproved clinical outcomes.
This funding is competitivelyawarded and assessed by The
Foundation's board across thecriteria of significance in
innovation, scientific qualityand team capability.
The Foundation also providesfunding to healthcare
(07:53):
practitioners for bothspecialized and higher education
in Vascular Access so that theymay deliver the highest level of
vascular access care.
It supports seminars, panels,and education programs to
provide updates in VascularAccess practice and stimulate
learning.
Travel awards scholarships areavailable to clinicians
attending the AVA AnnualScientific Meeting to promote
(08:14):
hands on involvement andeducation.
The AVA Foundation strives topromote patient education by
funding support for educationalvideos and consumer literature
along with consumer oriented PRand editorial articles.
Family and patient education canhelp ensure that recipients of
Vascular Access can understandhow to participate in their
healthcare.
(08:35):
To make a one-time donation orschedule regular donations to
the AVA Foundation, please visitwww.avafoundationinfo.org.
You may earmark your donationfor innovation research
education or to the overallmission of The AVA Foundation.
Together we can drive thechanges and improvements
(08:55):
necessary to ensure VascularAccess is as safe as possible
for the millions of patients whoundergo these procedures every
day.
Marcia (09:06):
Joined now by Marcia Wise, who is the chairperson of
the D-TEAM, the Design Team forthe AVA Scientific Meeting
coming up in Columbus, Ohio,this September.
We're at WoCoVA in Copenhagen.
Marcia, how are you doing?
Well, I'm finally getting overjet lag.
Great! On the last day of theconference, perfect.
Just in time to go back home.
Talk a little bit about WoCoVA,what you're doing here and some
(09:29):
of the highlights for the peoplewho aren't able to make it to
Europe.
Yeah.
Well, actually I was an invitedspeaker to speak about tissue
adhesive for Vascular Access,which is exciting, but I've
really enjoyed the conference.
WoCoVA, not only is the cityincredibly beautiful, but we
have the conference is very wellstructured, great content, lots
(09:49):
going on.
You know, how they pack in somuch in three days is just
amazing to me.
A really engaging speakers andcontent.
I've really enjoyed it.
Great.
Yeah, likewise.
That's my impression too.
And you just created a greatsegue way into the AVA
Scientific Meeting talking aboutgreat content and speakers,
which is coming up in Septemberin Columbus.
You are leading the Design Teamthat creates the conference,
(10:12):
puts the curriculum together anddecides what is presented, how
it's presented.
Can you share with our listenersexactly what that process has
been like for the 2018conference?
The D-TEAM is a fun experienceand I've really enjoyed being a
committee member as well aschairing this year.
It's a very scientific processthat goes on in a very short
(10:33):
period of time.
So we spend three or four monthsrequesting information from
people that might want topresent.
So, there's a call forpresentations and then the
committee, which I think it'sabout 15 or so people, we all
met in Columbus and, there is avery– led by Megan Schofield– a
(10:55):
very organized process of goingthrough all the abstracts and
picking those that we thinkwould make great content.
And then there's a veryorganized process of plugging
them in and it's an amazingexperience.
What occurs in two days.
I mean, two days! Long days,but, a lot of banter back and
forth.
What's the best content and howdo we make sure that our
(11:18):
audience, we're meeting all ofthe AVA membership through that
organization through ourconference.
And it's just an incredibleexperience.
We're going to have a greatprogram this year as we always
do, but you know, every year youthink it's going to get a little
bit better, a little bit better.
And we've got some kind ofinteresting new things we're
going to do.
(11:38):
We're going to have this lunchand learn kind of debate on the
last day.
And that's going to be, youknow, we picked a topic that we
think is pretty controversialand we're going to have sort of
a debate on the pros and cons ofthis topic.
Ramzy (11:52):
What is this topic?
Marcia (11:54):
Well it's about antimicrobial catheters.
And do they really make adifference?
Ramzy (11:59):
Pros, cons.
Reasons to believe, reasons notto, OK.
Marcia (12:02):
And AVATAR is sort of leading that session with all of
their work in research.
I think it's going to be anexciting one.
And then we've got some otherreally, you know, interesting
topics going on.
Our keynote and I think we'vetalked quite a bit about him,
Marcus Engel, he's going to beincredible I think.
And you know, we're reallyfocusing on the patient advocacy
(12:22):
side and such as WoCoVA here andwe're kind of in sync with this
a patient first.
And we do need to continue tobelieve that there's a patient
on the end of this line thatwe're placing.
And focusing around how do webring that patient into our
world.
I think this is– he was apatient and he had some pretty
(12:43):
bad things happen to him as ayoung man and how he's going to
share with us how, you know,patient care from his
caregivers, got him through hisordeal and the impact that that
made.
Then we've of course got thetopics around all the
controversies, the MAGICguidelines, GAVeCeLT Guidelines,
algorithms versus algorithms.
(13:04):
So that'll be fun.
Just really some interestingthings.
Intraosseous we're covering,peripheral catheters and
securement will be a hot topicas it is here.
It's interesting to see us movea little bit away from the
traditional PICC line thing andmove into some other categories:
dialysis, multidisciplinary,patient-focused and we have some
(13:30):
great physician speakers as wellas nursing educators speaking
this year.
Then Columbus itself, it's justfun place.
Ramzy (13:39):
It is a fun place.
Disclosure, I'm from there.
I have nothing but kind thingsto say about Central Ohio.
Marcia (13:43):
I've told a lot of people, they go, why Columbus?
And I said, you know, I don'tthink you would top of mind
think about that from aconference standpoint.
But once I was there, I was veryimpressed.
I had been in National Harbor afew years back and that's, it's
reminiscent of that, the littleboardwalk around the area there
and all the, yeah, all the shopsand the conference center itself
(14:07):
is just incredible.
The shrink wrap off of it.
Yeah, it's beautiful.
Everybody's going to love it.
Lots of place for people togather and network and talk.
Ramzy (14:16):
I don't think people realize the city.
Do you know, it's like the 14thlargest city in the country.
Marcia (14:21):
I didn't know that!
Ramzy (14:23):
I mean, having been from there, I'm like, that was kind
of a cow town, but I lived therein the 80s so it's come a long
way.
They benefited from me leaving.
Marcia (14:32):
Well, I think it Kinda got redone right a few years
back or something.
Ramzy (14:37):
It's the confluence of academia and business coming
together and converging onColumbus that developed it into
what you'll see in September isreally a vibrant, eclectic and
really thriving place to have aconvention and you know, even
live.
One last question before we getback to WoCoVA: If you could
think of a couple of reasons togo from a scientific standpoint
(14:58):
based on the curriculum we'veput together.
I'm thinking about going toColumbus for the AVA meeting
because of...
Marcia (15:05):
Well I think the technology is changing so
quickly and I don't know how ina staff situation in a hospital
you can stay up with that.
You've got to get to theseconferences and uh, just the
networking experience alone, butthen the scientific content that
you can pick up and take back toyour organizations is
(15:26):
incredible.
And you know, if our practice ismoving so quickly that I don't
know how anybody keeps upanymore without going to one of
these every year.
Because every year there is, youknow, 90% of it's relatively
new.
You can't just go one or fiveyears.
You've got pretty much go everyyear or every other year at
(15:47):
least to keep up.
Ramzy (15:48):
It's like you ate once and now you're nourished
forever.
You need to keep eating.
Marcia (15:53):
Well and I think we've done a really good blend of
those that are, you know,there's a lot of new people
coming in to Vascular Accesscause it's such a hot specialty
right now and so much going onand so challenging and people
are very passionate.
Our challenge always on theD-TEAM is to have enough content
for those advanced practitionersthat have been doing this for
awhile as well as the new peoplecoming in that are just learning
(16:15):
how to use ultrasound, etc.
And I think we've worked realhard on the D-TEAM this year to
keep that balance.
So we have stuff for people thatare new versus people that have
been around for a while.
Ramzy (16:24):
It's great tracks just based on where you are in your
career and your proficiency.
A beginner, intermediate,advanced, Marcia.
Marcia (16:32):
No, Marcia is out! I'm in the cadaver lab already.
Ramzy (16:38):
She's famously said, even after she leaves and retires,
Marcia will return to an AVAScientific Meeting in the
cadaver lab.
She is Marcia Wise, thechairperson of the D-TEAM and so
much more.
Thanks for taking some time outtoday.
Marcia (16:49):
Thanks Ramzy.
Eric (16:54):
After a quick break, I'll chat with Vascular Access and
Home Infusion Specialist,Elizabeth Dow as well as Jenn
Charron, the Vice President forClinical Services for the
National Home InfusionAssociation about the current
state of home infusion and whereit sits in the continuum of
Vascular Access care.
(17:16):
And it is my distinct honor tobe joined today by Beth Dow
board certified Vascular Accessand Infusion Specialist as well
as Jenn Charron, who is the VicePresident for Clinical Services
at the National Home InfusionAssociation to chat a little bit
about infusion and certificationwithin that area of Vascular
(17:38):
Access.
How are you ladies doing today?
Beth (17:42):
Doing great.
Jenn (17:45):
Doing well, thanks for asking.
Eric (17:47):
I heard you guys are dealing with some swampy
conditions over there on theeast coast in Boston and New
Hampshire.
It's been similar to that inOhio.
I think we're all just kindapushing and waiting for fall to
get here to maybe get somecooler temperatures.
Jenn (18:02):
Yeah, I'm not going to wish for fall to come quickly,
because then comes winter.
Eric (18:07):
That's true.
With all the nor'easters lastyear.
I don't think you guys wantanymore.
So, we can just dive right inhere.
I know you guys have done somegreat work within both
personally and then Jenn, we,we've had you on the podcast
before to discuss the NHIAcollaboration with AVA.
(18:29):
I know that you guys have somemain points about with the
clinicians bearing theresponsibility maybe to to
maintain the practice standardsand keep pac, with best practice
advances.
Beth you have any thoughts youwant to dive into that and kick
us off?
Beth (18:46):
Dive in a shall! Yes, thank you so much, Eric, I
appreciate that.
Looking at where we're going asfar as home infusion, it
definitely is relevant openingup the number of patients we
have week to week, month tomonth, year to year is just
exponentially growing.
And I was talking with Jennearlier and we were in agreement
(19:06):
that there is a little bit of agap here as far as practice
standards and clinical educationgoes for clients who are
receiving care at home and alsoclinicians who are providing
care at home.
It really is an area that cameround, and I think that right
now looking to the establishedareas, we've got primarily NHIA,
(19:28):
thank you very much Jenn.
We've also got AVA and we've gotINS and those are our three
really big pillars that we haveto look to.
We've got ONS.
But as far as the home carepopulation goes, I don't see
them being really activecurrently.
But you know, maybe that willchange.
Hopefully, we can look at thethree main ones that we haven't
kind of put together a littlebit more of a patient-centric
(19:51):
and home care clinician-centricgroup of education.
And that would really be veryhelpful to all parties involved
because right now there is nopractice standards specific to
home care infusion.
And that's a gap.
There's definitely one for acutecare.
We look to people who are inacute care to trickle down into
(20:14):
the sub acute areas.
But lots of times that doesn'tnecessarily really happen.
And we also know that as we lookat marketing and we look to
financial flows and we look toindustry for education quite,
quite frequently.
That's where a lot of oureducation comes from.
Clinician educators coming outand teaching us about new
products and new techniques, butthat doesn't usually happen in a
(20:36):
tertiary market.
It doesn't happen outside ofacute care or doctor's offices
because traditionally home caredoes not qualify really as a
purchaser.
So that education is reallymissing.
It's really sort of a lostmarket.
That being said employers, evenin the home care area, when they
want to be able to provideeducation to their staff, they
(20:58):
don't always have access tothose resources either because
they're not going to be a bigpurchaser.
So you know, industry just, youknow, it's hard for them to take
all of that, all of that time,all of that money, all those
hours and bring it to a placethat's definitely not going to
return for them.
So looking at having a standardof practice or having a
(21:18):
certification that individualclinicians can reach towards,
that would bring them continuingeducation and the best practice
standards specific to home carewhere they have to be really
autonomous, they have to haveprogressive knowledge, they have
to be really on top of thereassessments and feel comfortable
and confident in their skillsbecause there's no one else
(21:41):
there.
They're in a home.
It sounds silly when I say it'shome care.
You know, you're in a home, butthat's it.
You have yourself and you havethe bag that you brought into
the home with you and there'snothing else there.
So if something goes wrong,you're really on your own.
So having clinicians that arecloser to entry level, doing
this job is really probably notwhat we want.
(22:01):
We probably want to be able toestablish a higher standard and
be able to empower individualclinicians to aspire to that
higher standard prior to leavingthe more structured and stable
acute care environment.
Jenn (22:14):
Yeah.
I think there's so many pointsthere that I can absolutely
agree with that.
Part of joining NHIA was thislove for home infusion nursing
and feeling like we just don'tfit into a lot of the molds that
we have out there.
And to your point, we're kindof, you know, picking, you know,
a little bit from here a littlebit from there and really trying
(22:37):
to then interpret some of thosethings to be specific to the
home environment.
So beyond upping our clinicalpractice and ensuring that we're
meeting standards don't have alot of data associated with
outcomes in the homeenvironment.
That's something that NHIA isreally starting to look at.
(22:58):
We're starting a data initiativecoming up this fall.
But again, that, that wholepiece of it is lacking in our,
in our industry.
And I think coming from that,you have not, I don't think the
level of respect for what a homeinfusion nurse is required to do
and does on a daily basis isreally understood by the
(23:21):
industry.
And to your point aboutcertification, these are nurses,
that are doing biologics.
Sometimes they're doing woundcare, they're taking care of
people with massive infections,long term care patients who need
TPN for life.
(23:42):
And these are very complexstations that are living in
their home.
And the standards, to your pointare something that we're calling
from many areas, many of itwork.
But I think there's a lot to besaid for collaborating with our
associations can build thatstandard of practice.
Eric (24:02):
That's a lot of great points and I think it's awesome
that NHIA has started tocollaborate the data that you
mentioned Jenn.
What are you guys' thoughtsabout how to get industry to
understand more about homeinfusion and what the
specialists in that field do.
Jenn (24:19):
Yeah.
You know, it's interesting toobecause it's not talked about
either and colleges.
It's not even usually brought upas something that nurses are
taught that is a field.
And so I think we typically gofrom, you know, nursing
education, I get my nursingdegree, I go into acute care,
(24:41):
skilled facility and then youkind of move out and you need
that stage.
But we need to let people knowhow awesome it is to be a home
infusion nurse as well.
It's amazing the level of carethat you can provide and the
satisfaction you get as aclinician working with these
patients.
Eric (25:03):
Beth, I'm sure you don't have any thoughts on that.
Beth (25:06):
Well, if you let me open the door on that.
I can probably talk to youstraight through next Thursday.
In this area in home infusion,there is no other area other
than home infusion, mobileinfusion, mobile Vascular
Access, whatever term you wantto use to to call what it is
that we do.
There is no other area whereyou're going to find a matched
(25:28):
level of autonomy.
And also, that is jobsatisfaction including patient
closure.
And when I say patient closure,I mean seeing something through
to the end.
And in knowing what happens toyour patient and making sure
that at the end of the day youhave a happy ending one way or
the other, you're actuallymaking something work for your
(25:50):
client in a way that no one elsecan.
And that is something really,really special that you're not
going to find in other areas ofreally any clinical practice.
I've been a nurse Gypsy for along time and I've kind of been
all over the place with mycareer.
This is the only thing that'sheld me for almost 12 years now,
which is kind of saying a lotbecause I tend to hop around
(26:13):
quite a bit and and I've beenheld here, which is, which is
impressive.
It's not often that you get tospend an amount of time with a
client in a setting where you'reable to see what their lifestyle
is.
You're able to generate a planof care that matches that
lifestyle, inclusive with theirfamily and their goals, and then
(26:36):
see it through and navigate thehealthcare system the way those
people need it done for them.
And to Jenn's point, I mean it'snot just the infusion.
You know you've got people withmassive gaping wounds and
negative pressure.
You've got people with massivesepsis, you've got all kinds of
autonomic issues that we've gotpeople with you know, pemphigus
(26:59):
and you've got people withdisreflexia.
Then you've got all kinds ofdifferent stuff where you have
to navigate those things inorder to make that person's life
livable for them.
And when you're in the homesetting, you're actually able to
do that.
Lots of times, home care nursesfind things, home infusion
nurses, home care nurses, findissues that have been overlooked
for years and years and years bytraditional healthcare because
(27:21):
patients are screened for 5, 10,maybe 15 minutes in a room, in a
doctor's office on a table andthey're not ever assessed in
their home, native environmentand deficits that are picked up
by people in the home care fieldis really needs to be researched
(27:41):
more.
And I'm glad to hear that Jennand her group are doing more
research because I think we'regoing to find that a lot of
improvement in a lot of thenavigation and coordination that
happens between the silos wehave in healthcare.
Are undercovered when we look tohome infusion and we look to the
specialties that go on in thehome.
Jenn (28:08):
There's another point I wanted to make– Liz talked a lot
about home care agencies and ina home infusion.
In our market we've done somesurveys to our members and more
than 50% of the nursing visitsthat are provided to home
infusion patients are actuallydone by home health or visiting
(28:29):
nurse agencies.
So, working together issomething that we do every day,
right.
Between a home health companyand home infusion.
That's very typical.
But the resources vary foreducation, to Liz's point, vary
greatly between home healthagencies.
So, large agencies that do a lotof home infusion, they might
(28:53):
have a lot of resources foreducation, but you see a lot of,
I would say I think of it alittle bit of dabbling in the
home infusion market where youmay only have one or two nurses
that can do infusion.
That's not really specializedand I feel like that again is
another area that AVA and NHIAcould collaborate to develop
(29:13):
educational programming for thatgroup.
That'll up the level of carethat we're providing patients
across the continuum in a, in areally different way.
Eric (29:27):
That's definitely something that should be on the
table moving forward.
And we're starting theconversation right now.
I think the collaborationbetween AVA and NHIA is a key
component of that to break downthe silos that, that Beth
mentioned.
But on a more local level whatare your guys' thoughts on sort
of breaking down those barriersand, instituting the clinical
(29:50):
learning and growth and howthat's best accomplished?
Beth (29:55):
I really think it comes down to individual clinician
needing to have the autonomy andthe self-respect to be able to
say,'I need more education.
If We really stop and thinkabout it.
The most basic part of whatyou're going to do with
infusion, is start peripheralIV, pretty, pretty basic and
culturally nurses take that askind of a blase thing,'Oh no big
(30:17):
deal.
Go ahead, put the 22 in somebodyand make sure you wash your
hands first.' Sometimes we don'teven use sterile technique and
we do that, which should be, butsometimes we don't.
That's considered very basic,very entry level and we teach
that to young nurses, but if wego and we look at other areas of
healthcare, is there any otherarea where we would say, yeah,
sure, go ahead.
Why don't you try thatendoscope?
(30:39):
Nowhere else would we do that.
Nowhere else would be say itwould be entry level to invade
that body system.
Even though it's peripheral andit's on the outside, but you're
still going to do some of thevascular system like that.
That's a risk of sepsis, that'shuge.
Even with the peripheral IV.
So, it's something really that Ithink we need to stop and look
(31:00):
at the way we teach and trainall of our healthcare clinicians
from the get go, like just rightfrom the word start that, if
we're going to be intravascularat all, if we're going to be
into the vein at all, we reallyneed to stop and think about
what we're doing.
And I really don't think itshould be the type of thing that
is entry level.
(31:20):
I really think you should havesomebody who has a little bit of
a respect for what it is thatthey're doing and they
understand what therepercussions are of doing
something wrong.
Jenn (31:29):
I just want to make a couple comments on that.
Personal responsibility for yourown practice is huge.
And thinking the things that wedo in infusion as basic in a big
mistake.
Care and maintenance, just acentral line dressing change,
that people think,'You know, I'mjust, you know, I do this every
(31:51):
day' and we're not as payingattention to what we're doing as
we should.
NHIA, for the first time, had abasic course for home infusion
and really all it was wasinformation about dressing
changes, lab draws, peripheralinsertion, preventing
complications.
And we had hands on trainingwith the nurses got to practice
(32:16):
doing a dressing change.
And I can't tell you how manypeople said to me,'Oh Gosh, I've
done this a million times.
You know, it's just so easy.'And one clinician in particular
is like,'let's just do it.
You're here, let's just do it.'And what happened was she did
the dressing change and did notcover the statlock leaving a
(32:41):
wide open area, forcontamination in the central
line! And it's not becausepeople are trying to do
something wrong, it's becausewe're not paying attention in
our own practice and ensuringthat we're meeting every
guideline available
Beth (33:00):
It happens every single day.
Every single day I see somethinglike this that needs to be
remediated.
Not a day in my practice goes bywhere I don't see something
where I have to correct that.
Educate the patient and say,listen, if you see this, it's
wrong.
It needs to be done that way.
Do you need an air-occlusivedressing and explain what
(33:21):
air-occlusive is you need, youknow, going step by step and
educating the patient as thepatient is the clinician is
really critical.
And then going back andremediating that person who made
the mistake and it comes down toindividual clinicians becoming
kind of blase in their practice.
And you know, when you start toget boring and work starts to
(33:42):
become ho hum and here we go.
Gonna get on a donkey trail andgo to work again.
It's time to switch.
It's time to leave.
It's time to find something elseto do because you, you're not
going to help anyone if you'retaking for great the work that
you do and you're not excitedabout it and it's interesting to
you and you're not committed toand you're not focused a hundred
percent on what it is thatyou're doing, you shouldn't be
(34:04):
doing it.
Eric (34:05):
Most definitely.
I really appreciate the timefrom both of you.
I think this has been a reallyconstructive conversation and
something that our members andthose that listen to this
podcast are going to kind ofstand out to them as far as
like, I need to do this, I needto do more than this.
I need to educate myself.
I need to continue my, gettingthese credits and consider a
certification in these areas.
(34:26):
So, they are Beth Dow and JennCharron.
Thank you ladies so much.
I really appreciate it.
Jenn (34:33):
Thank you.
Beth (34:33):
Thank you, Eric.
Thanks Jenn.
Popular Podcasts
Are You A Charlotte?
In 1997, actress Kristin Davis’ life was forever changed when she took on the role of Charlotte York in Sex and the City. As we watched Carrie, Samantha, Miranda and Charlotte navigate relationships in NYC, the show helped push once unacceptable conversation topics out of the shadows and altered the narrative around women and sex. We all saw ourselves in them as they searched for fulfillment in life, sex and friendships. Now, Kristin Davis wants to connect with you, the fans, and share untold stories and all the behind the scenes. Together, with Kristin and special guests, what will begin with Sex and the City will evolve into talks about themes that are still so relevant today. "Are you a Charlotte?" is much more than just rewatching this beloved show, it brings the past and the present together as we talk with heart, humor and of course some optimism.
On Purpose with Jay Shetty
I’m Jay Shetty host of On Purpose the worlds #1 Mental Health podcast and I’m so grateful you found us. I started this podcast 5 years ago to invite you into conversations and workshops that are designed to help make you happier, healthier and more healed. I believe that when you (yes you) feel seen, heard and understood you’re able to deal with relationship struggles, work challenges and life’s ups and downs with more ease and grace. I interview experts, celebrities, thought leaders and athletes so that we can grow our mindset, build better habits and uncover a side of them we’ve never seen before. New episodes every Monday and Friday. Your support means the world to me and I don’t take it for granted — click the follow button and leave a review to help us spread the love with On Purpose. I can’t wait for you to listen to your first or 500th episode!
Dateline NBC
Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations. Follow now to get the latest episodes of Dateline NBC completely free, or subscribe to Dateline Premium for ad-free listening and exclusive bonus content: DatelinePremium.com