Implementation plan for VAC in the acute care unit of Royal Hospital

Running head: IMPLEMENTATION PLAN
Implementation plan
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1IMPLEMENTATION PLAN
Title: Implementation plan for VAC in the acute care unit of Royal Hospital
Background:
Adapting suitable research evidence into practice is one of the tenets of evidence based
practice (EBP) and the interest in knowledge translation principles has increased because of
growing engagement in EBP. Knowledge translation is a concept that requires understanding of
influencing factors at the individual and contextual level and application of knowledge within a
complex system of interactions (Brownson, 2017). The main purpose of this briefing paper is to
capture the benefits of a product or service for a target health setting. This briefing report mainly
aims to use knowledge translation principles to propose an implementation plan for vascular
access device (VAD) practice or product in a clinical setting. The report provides an overview of
the clinical setting and the effectiveness of new product or service. This briefing report would
play a role in accelerating recruitment and addition of the product in the desired setting.
Clinical setting:
It is planned to implement the VAD product in the acute care unit of the Royal hospital
(hypothetical). The Royal hospital is a 200 bed hospital with several departments such as
emergency unit, acute care unit, surgical unit and intensive care unit. The acute care unit of the
hospital mainly handles patients with acute and long term health needs. Patients requiring blood
transfusion and other intravenous therapy regularly come to the unit for treatment and care.
There are many patients who require intravenous therapy for short period or prolonged period.
Although currently the hospital has been provided with other types of CADs like peripheral
catheter, however many quality issues has been reported because of the use of them. For

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examples, staffs have reported challenges in handling several types of infection associated with
the use of CADs.
The review of the incidences related to the cause behind catheter associated infections in
the hospital has revealed that improper insertion of VADs has been the major reason for negative
patient events. Nursing staffs using the device has been found to make errors during the time of
insertion (). Hence, catheter malposition or insertion of catheter to another venous location is one
significant issue in the unit. Currently, PICC has not been used for providing intravenous therapy
to patients. Another gap found in the unit is that no education or proper guidelines for VADs has
been given to staffs thus resulting in negative patient outcome. Hence, by introducting PICC at
the hospital, accessibility issues in relation to the use of VADs can be avoided. In addition, many
catheter related infection will be controlled as the implementation plan focus on addressing
patient, staff, environmental and resource factors that affects efficacy of a medical device in
clinical setting.
Product summary:
VADs are medical devices that has been widely used in the clinical setting to access the
venous system and other body systems such as epidural system, pleural system and others. Apart
from medicine administration, VADs are routinely used during blood transfusion and other
clinical activities. There are numerous types of VADs available to health care professionals
which aids them in increasing survival rate and quality of life of patients (). For this briefing
report, the target VAD product that has been planned to be implemented in the surgical ward of
Royal hospital includes the peripherally inserted central catheters. PICC is a type of long-term
VADs which are made up of biocompatible and silicone material. It is a device that is inserted

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percutaneously at a peripheral location, extends to the posterior vena cava and remains within the
veins for several days or weeks. The device was first used in 1960s as a replacement for central
venous catheters. Use of PICC is indicated for all types of intravenous therapies. PICC is most
commonly used for patients requiring long-term therapy such as antibiotic therapy and
chemotherapy (Cooper, Kelly & Brown, 2017).
PICC has been recommended to be implemented in the surgical ward because of several
advantage associated with the product compared to other VADS. Catheter handling is generally
regarded as a burden in hospital setting because of increase in risk of catheter related infection.
However, the main advantage of PICC is that it is easily inserted allowing both drug infusion and
blood sampling. In this way, it lessens the risk of central venous catheter infection (Park, Jun &
Oh, 2016). Because of high satisfaction with users, the use of PICC has increases significantly in
clinical setting. There are numerous evidences that reports association between the use of PICC
and patients and caregivers satisfaction with the product. For example, the study by Chopra et al.
(2015) investigated about the patterns of use and outcomes related to PICC use in a skilled
nursing facility. The study reported that PICC provides many advantage to hospitalized
individual particularly older adults. This is because it reduces length of hospital stay and costs
related to intravenous treatment. Rickard (2018) investigated about the efficacy of PICCs
compared to peripheral catheters by means of randomized controlled trial. By the use of
questionnaires, patient satisfaction with the product was evaluated and patient satisfaction level
was found to be higher for PICC group compared to the PC group. Hence, PICC was found as a
more efficient product compared to PC.
This briefing report is focussed on developing a proper implementation plan for the PICC
product mainly because of several arguments related to PICC associated complications. As