Becton, Dickinson and Company · NYSE:BDX
Becton, Dickinson and — BD Medication Delivery Solutions (MDS20) EU (April 2020)
28 slides from Becton, Dickinson and's conference presentation, April 2020
Slide 1: Presentation 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: A Cross Hospital Vascular Access – Benefits to the Healthcare Organisation
A Cross Hospital Vascular Access – Benefits to the Healthcare Organisation Jacopo Fiorini Rn, Msn, Phd Student Vascular Access Specialist Policlinico Tor Vergata (Rome) 1
Slide 3: Azienda Ospedaliera Universitaria Policlinico Tor Vergata
Azienda Ospedaliera Universitaria POLICLINICO TOR VERGATA
Slide 4: Hub and Spoke Hospital
Hub and Spoke Hospital Beds Hospital 562 Accesses at A&E 52000
Slide 5: Vessel health and preservation
Vessel health and preservation Safe and reliable venous access is essential for patients receiving any type of intravenous (IV) therapy. (Bedford & Waterhouse, 2017; Walker & Todd, 2013)
Slide 6: Vascular Access Team
Vascular Access Team • An organizational value for health care services to care and cure patients. • A designated PICC team is associated with greater use of evidence-based practices for preventing CLABSI (Krein et al., 2019; Golombek et al., 2002).
Slide 7: Vascular Access Team
Vascular Access Team • The rate of complications is related to the knowledge and expertise of health care providers (McDiarmid et al., 2017; Hornsby et al., 2005). • A rapid increase in demand for PICC placement • A proactive approach to vessel health (Fiorini et al., 2019)
Slide 8: Aim of the study
Aim of the study • Reduce complication rate (i.e. catheter related infections and obstructions) Identification of clinical /economical and • Reduce costs and time for catheter organizational impact of a placement Vascular Access Team creation in an hospital setting • Evaluate Organizational impact i
Slide 9: Method
Method Analysis of a single center (Policlinico Tor Vergata) in two different Scenarios: pre and post Vascular Access Team creation (PICC Team) 1 2 Hospital with a Hospital with a significant number of significant number of catheters implanted catheters implanted without a dedicated with a dedicated
Slide 10: Scenari PTV
Scenari PTV • Scenario 1 – 2 RN working full time on duty – PICC insertion once for week in the operating theater – 1 ultrasound machine • Scenario 2 Creation of Vascular Access Team – 3 RN dedicated full time to devices placement and 2 RN working full time on duty – Devices insertion every day at b
Slide 11: Nursing Outpatients Clinic
NURSING OUTPATIENTS CLINIC
Slide 12: PICC/Midline Inserted
1200 PICC/Midline Inserted 1104 Nursing 1000 Outpatients Clinic 962 891 893 822 800 754 600 Vascular Access Team 400 First year 300 of PICC 250 placement 200 135 150 80 100 30 45 50 0 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019
Slide 13: Nursing outpatients clinic: continuity of care model
Nursing outpatients clinic: continuity of care Model 4430 4500 3909 4000 3518 3500 3000 2522 2500 2000 1500 1000 630 500 0 2015 2016 2017 2018 2019
Slide 14: Method
Method Data collection: • Literature Review (Cost of Infections, professionals and Devices) • Interviews and Questionnaire to clinicians and nurses involved in the catheter insertion procedure and management in the Hospital • Collaboration with statesman and economists. • Hospital Selection based on
Slide 15: Method
Method Report Structure 1. Organizational Analysis of the 2 Scenarios in terms of: – Healthcare professionals involved and implantation timing – Number of catheter implantation and devices used (CICC, PORT or PICC) – Catheter Related Infections – Internal staff training 2. Costs of vascular access d
Slide 16: Results Scenario 1
Results Scenario 1 IMPLANT PROCESS CICC Inserted by anaesthetist PORT Inserted by radiologist PICC Inserted by nurses during one weekly session PROFESSIONALS INVOLVED DEVICE CLINICIAN NURSE ANAESTHETIST RADIOLOGIST CICC 30 minutes 30 minutes 15 minutes PORT 45 minutes 45 minutes 15 minutes PICC 25 m
Slide 17: Results Scenario 1
Results Scenario 1 IMPLANTS AND INFECTIONS Number of PICC/Midline inserted 200/250 Number of CICC inserted 2.200 Number of PORT inserted 200 Number of device days 6.675 Infections incidence 14/1.000 Catheter days • Before the Vascular Access Team creation, PICC were implanted only during 1-2 afterno
Slide 18: Results Scenario 2
Results Scenario 2 IMPLANT PROCESS CICC Inserted by anaesthetist PORT Inserted by radiologist PICC Inserted by Vascular Access Team PROFESSIONALS INVOLVED DEVICE CLINICIAN NURSE VASCULAR ANAESTHETIST RADIOLOGIST TEAM CICC 30 min 30 min 15 min PORT 45 min 45 min 15 min PICC 25 min
Slide 19: Results Scenario 2
Results Scenario 2 IMPLANTS AND INFECTIONS Number of PICC/Midline inserted 950 Number of CICC inserted 1.600 Number of PORT inserted 50 Number of device days 22.592 Infections incidence 0,6/1.000 Catheter days • The Vascular Access Team can process 18 consulting request per day (50%-60% implant) • T
Slide 20: Analysis of Cost
Analysis of Cost PROFESSIONALS* Min Max Mean Clinician (30 minuti) 12,625 € 20,254 € 16,44 € Nurse (30 minuti) 6,945 € 8,680 € 7,81 € Radiologist (30 Minuti) 6,945 € 8,680 € 7,81 € COMPLICATIONS** DEVICES*** Cost DEVICE PRICE Infections CICC 10,03 € (due to increase of inpatient 13.035 € PORT 137 €
Slide 21: Analysis of Cost
Analysis of Cost PROFESSIONALS CLINICIAN NURSE ANAESTHETIST RADIOLOGIST Cost per minute 0,55 € 0,26 € 0,55 € 0,26 € DEVICE CLINICIAN NURSE ANAESTHETIST RADIOLOGIST CICC 30 minutes 30 minutes 15 minutes PORT 45 minutes 45 minutes 15 minutes PICC 25 minutes DEVICE CLINICIAN NURSE ANAESTHETIST RADIOLOG
Slide 22: Scenario Analysis
SCENARIO ANALYSIS NUMBER OF IMPLANTS DEVICE Scenario 1 (PTV pre Scenario 2 (PTV post Vascular Team) Vascular team) CICC 2.200 1.600 PORT 200 50 PICC/Midline 250 950 TOTAL 2.650 2.600
Slide 23: Scenario Analysis: Cost of Implants
SCENARIO ANALYSIS COST OF IMLANTS SCENARIO 1 CICC PORT PICC TOTAL Staff 28,2 € 40,35 € 6,5 € Device 10,03 € 137 € 120 € Unit cost 38,23 € 177,35 € 126,25 € (one implant) Number of implants 2.200 200 250 2.650 TOTAL COST 84.106 € 35.470 € 31.625 € 151.201 €
Slide 24: Scenario Analysis: Cost of Implants
SCENARIO ANALYSIS COST OF IMLANTS SCENARIO 2 CICC PORT PICC TOTAL Staff 28,2 € 40,35 € 6,5 € Device 10,03 € 137 € 120 € Unit cost 38,23 € 177,35 € 126,25 € (one implant) Number of implants 1.600 50 950 2.600 TOTAL COST 61.168 € 8.868 € 120.175 € 190.211 €
Slide 25: Scenario Analysis: Cost of Infections
SCENARIO ANALYSIS COST OF INFECTIONS Scenario 1 (PTV Scenario 2 (PTV pre Vasc. Team) post Vasc. Team) 14/1.000 gg 0,6/1.000 gg Infections incidence catetere catetere Catheter days 6.675 22.592 TOTAL INFECTIONS 93 14 NUMBER Infections unit cost 13.035 € 13.035 € TOTAL COST 1.218.121 € 176.692 €
Slide 26: Scenario Analysis: Costs Comparison
SCENARIO ANALYSIS COSTS COMPARISON Scenario 1 Scenario 2 (PTV pre (PTV post DELTA Vasc. Team) Vasc. Team) Devices 79.955 € 137.269 € 57.314 € Implant procedures 71.735 € 53.313 € - 18.422 € Infections 1.218.121 € 176.692 € - 1.041.429 € TOTAL COSTS 1.369.811 € 367.274 € - 1.002.537 €
Slide 27: Conclusions
CONCLUSIONS The introduction of a Vascular Team: • Improves and standardizes Vascular Access care and maintenance • Decreases infections and complications rate • Reduces delayed discharge and costs • Decreases inappropriate implant of CICC and Porth • Develops a proactive approach for vessel health
Slide 28: ‘Tor Vereat®; re Ee a
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