Becton, Dickinson And Company · NYSE:BDX
Becton, Dickinson And — Technical Presentation (April 2020)
23 slides from Becton, Dickinson And's technical presentation, April 2020
Slide 1: Presenter views disclaimer
These presentations were developed by the respective presenter(s), and the findings, interpretations, and conclusions contained or expressed with them do not necessarily reflect the views of BD. To the extent these presentations relate to specific products, such products should always be used in acc
Slide 2: The UK VHP Framework 2020: Looking to the future
The UK VHP Framework 2020 Looking to the future YES Genuine need for IV therapy? NO Emergency Known Difficult Non- IV Access Continue via Emergency alternative route. Insert PIVC if Refer to Vascular SHOULD the therapy be Access Specialist NO peripheral administered via CVAD? (see access and/or besp
Slide 3: Disclosure
Disclosure • The UK VHP Framework – Infection Prevention Society(IPS) initiative working with NIVAS, RCN and Medusa Injectable Medicines Guide. – Adapted from US framework (Moureau et al, 2012). – Supported with an educational grant from Teleflex. – Teleflex continue to provide support for the proje
Slide 4: Drivers for the VHP Framework
Drivers for the VHP Framework • Default to PIVC, often delegated to the least experienced staff & unclear escalation (Jackson et al 2013, BJN) • Little consideration for the survival of the PIVC (Carr et al 2015) • 19% failure rate for 1st attempt cannulation (van Loon et al 2019) • Numerous cannula
Slide 5: One Million Global (OMG) PIVC Study Findings
One Million Global (OMG) PIVC Study Findings • 71% PIVC placed by nurses (range 26% - 97%) • Poorly placed PIVC in areas of flexion • 10% painful/signs of phlebitis • 10% signs of malfunction – Leaking – Dislodgement – Visible blood in the tubing (Alexandrou et al 2018 J.Hosp.Med) Specialists in Inf
Slide 6: OMG Study Conclusion
OMG Study Conclusion A stronger focus on insertion and management of PIVC, surveillance and improved assessment and decision making Specialists in Infection Prevention, Education and Training
Slide 7: Development of UK VHP Framework
Development of UK VHP Framework Specialists in Infection Prevention, Education and Training
Slide 8: Specialists in Infection Prevention, Education and Training
Specialists in Infection Prevention, Education and Training
Slide 9: Results from the Logic Outcome Evaluation of those using VHP
Results from the Logic Outcome Evaluation of those using VHP • Better patient experience • Improved device selection • Ongoing assessment of device • Improved knowledge • Junior doctors making device choice earlier/timelier referral • More successful placement • Decrease in multiple cannulations Spe
Slide 10: What Happened Next…..?
What Happened Next…..? • VHP framework originally developed in 2015 • Subsequent Review of evidence for each section • Updated ‘VHP framework 2020’ now near completion • Better understanding of implementation • Feedback from small scale studies and experts • Rationale to be included in changes • Pot
Slide 11: Peripheral Vein Assessment (original)
Peripheral Vein Assessment (original) Since 2015: • On going work at the Christie Hospital to validate • Used in an RCT Marsh et al. Trials (2018) 19:564 • Considered the Difficult IV Access studies Specialists in Infection Prevention, Education and Training
Slide 12: Specialists in Infection Prevention, Education and Training
Specialists in Infection Prevention, Education and Training
Slide 13: Peripheral Vein Assessment 2020
Peripheral Vein Assessment 2020 Suitable Vein Definition; Visible and compressible, 3mm or larger ( van Loon et al 2019) Grade Number of suitable veins Insertion Management* 1 4-5 veins Insertion by trained health care practitioner (HCP) 2 2-3 veins Insertion by trained HCP 3 1-2 veins Insertion by
Slide 14: Device Selection Algorithm (original)
Device Selection Algorithm (original) Specialists in Infection Prevention, Education and Training
Slide 15: Comparing Epic3 with MAGIC
Comparing Epic3 with MAGIC Epic3 2014 (adapted from O’Grady 2011) MAGIC 2015 • PIVC up to 7 – 10 days • PIVC up to 5 days • Midline 1 – 4 weeks • US guided PIVC 6 to 14 days • PICC 4 weeks – 6 months • Midline up to 14 days • NT CVC up to 7 – 10 days • PICC > 6 days • Tunnelled CVC • NT CVC up to 14
Slide 16: Device selection algorithm: Emergency / Known Difficult
YES Genuine need for IV therapy? NO Emergency Known Difficult Non- IV Access Emergency Continue via alternative route. Insert PIVC if Refer to Vascular SHOULD the therapy be Access Specialist NO peripheral administered via CVAD? (see access and/or bespoke patient pathway medicines section) available
Slide 17: Suitability of Medicines 2020
Suitability of Medicines 2020 The most important principle to use when assessing suitability for an infusion to be administered via a peripheral cannula, is that ALL intravenous medicines potentially pose a threat to vessel health. In broad terms the safety of a medicine infusion to prevent damage t
Slide 18: Daily Evaluation
Daily Evaluation • Evaluation still important component • I-DECIDED IV Assessment and decision tool (Ray-Barruel et al, 2018) – ‘has the device been used in last 24 hours’? – ‘Pain ≥ 2/10’? Gillian Ray-Barruel et al. BMJ Open 2018 Specialists in Infection Prevention, Education and Training
Slide 19: Daily Evaluation 2020
Daily Evaluation 2020 Specialists in Infection Prevention, Education and Training
Slide 20: Summary
Summary • The VHP framework is being used by many • Most cited JIP article in last 3 years • Revised Poster and pocket guides expected late spring – QR code with further information and rationale for changes • Ongoing requirements – evaluate impact on outcome – Understanding the barriers to implemen
Slide 21: UK Vessel Health and Preservation 2020 Right Line Decision Tool
INTRODUCTION Te Ut eva ted se nibh Preerennan Mh Ierewcrh i bausdn ubsened encetce nd gates etuaten natin ote angel? arene cate Sure ‘desea Oe uote the OOF Foavenerh artel Belt ante wval sine poet soty eoplaery) he beget ot sang toe Sarerwnr oe the nierten and navel Wen Dera ot 2017, Tre harewerthus
Slide 22: Clinical impact of PICCs vs implanted port catheters in patients with cancer
B J A British Journal of Anaesthesia, 122 (6): 734~741 (2019) doi: 10.1016/) bja,2019.01.038 ‘Advance Access Publication Date: 17 April 2019 CCinieal Practice Clinical impact of peripherally inserted central catheters us implanted port catheters in patients with cancer: an open-label, randomised, tw
Slide 23: Thank you for listening
Thank you for listening UK VHP review team Andrea Denton Helen Dunn Rose Gallagher Carole Hallam (Lead) Steve Hill Tim Jackson Susan Keeling Valya Weston Specialists in Infection Prevention, Education and Training
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