Complications and failure of intravascular devices place significant burden on nursing workloads, patient outcomes and the health care system. The development and implementation of evidence to improve clinical practice surrounding the insertion and management of intravascular devices is an ongoing challenge to which nurse practitioners (NPs) in vascular access can respond.

NPs use their clinical expertise to lead practice, facilitate change and monitor effectiveness of interventions to prevent complications. This places NPs in an ideal position to incorporate research into practice and lead the development of new research. But the demands and recency of the role means that NPs frequently find themselves inadequately prepared to lead the development and implementation of new research.
Collaborative relationships between NPs and academic researchers, scientific and clinical staff are necessary to promote effective and efficient health services, research and nursing practice. This is especially evident within the field of vascular access. Together, such collaborations are able to create and share knowledge that has meaning for the practitioners, to optimise the NP’s role, and provide a bridge to overcome gaps in knowledge translation and evidence implementation.

This paper aims to explore the research aspects of the vascular access NP role within the context of multidisciplinary health research collaborations. It uses a case study of an NP involved in a health research collaboration within the vascular access specialty to illustrate this development, and further describes the potential impact of NPs upon evidence-based practice development.

Background: Peripheral arterial catheters (AC) are widely used in critical care patients for continuous blood pressure monitoring and blood sampling, yet failure — from dislodgement, accidental removal, phlebitis, pain, occlusion or infection — is common. Effective methods of dressing and securement are needed to prevent complications that cause failure, yet few studies have been conducted that explore this problem.
Aim: To perform a narrative review of research literature about dressing and securement of ACs.
Methods: A literature search of the Cochrane Central Register of Controlled Trials, Ovid MEDLINE, Ovid EMBASE, and EBSCO CINAHL, as well as Google and Google Scholar was performed. A meta-analysis or systematic review was not possible because of scarce literature.
Results: Guidelines for dressing and securement of intravascular devices did not specifically address ACs. One large, non-randomised study compared “band aids” with a sutureless securement device, finding a significant reduction in catheter failure associated with the sutureless securement device. Other studies of polyurethane dressings versus sutureless securement devices only studied intravenous, not ACs. One small, pilot, randomised controlled trial (RCT) indicated feasibility of the use of tissue adhesive plus a polyurethane dressing for ACs.
Conclusion: There is limited high-quality research literature about effective dressing and securement of ACs.

Purpose: Increased vascular access flow after percutaneous transluminal angioplasty (PTA) for central venous stenosis and occlusion (central venous disease, CVD) can affect cardiac function in hemodialysis (HD) patients. We evaluated the cardiac function, etiology, and treatment in HD patients with CVD.
Methods: HD patients with CVD treated by PTA between June 2006 and February 2013 were studied.
Results: Of the 26 patients, 22 had left arteriovenous fistulas (AVFs), 1 left arteriovenous graft (AVG), 2 right AVFs, and 1 right AVG. CVD sites were the left brachiocephalic vein (LBCV; n=13), left subclavian vein (LSCV; n=7), both LBCV and LSCV (n=3), right BCV (n=2), and right SCV (n=1). Computed tomography findings indicated a high extrinsic compression rate for the LBCV (91%) and LSCV (50%). The success rate of PTA was 96%. The primary patency rates at 3, 6, 9, and 12 months were 81%, 73%, 65%, and 57%, respectively. The post-PTA brachial artery flow volume was significantly increased compared with the pre-PTA volume (1306 vs. 957 ml/min; p=0.005). The post-PTA left ventricular ejection fraction and expiration inferior vena cava diameter were the same as the pre-PTA values (57% versus 60%, p=0.2 and 17 versus 17 mm, p=0.9, respectively).
Conclusions: Our findings suggest that increased vascular access flow after PTA for CVD has no relation to cardiac function.