Ask the Care Expert about ... readmissions

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Sherrie Dornberger, RNC, CDONA, FACDONA, executive director, NADONA
Sherrie Dornberger, RNC, CDONA, FACDONA, executive director, NADONA

Readmissions to the hospital are one of our problems. The one population we seem to send to the hospital are the frail elderly because they are difficult sticks. We hate having to send residents to the ER to get IVs started or blood drawn. Can you help with anything we could be doing?

First, purchase a vein illuminator. I am familiar with a product called Accu-Vein. (I am not selling any product and do not represent any of them; I'm merely familiar with this product.)

Access to veins can mean the difference between sending a resident back to the hospital and keeping him/her in the facility. Sending residents back to the hospital has negative implications for facilities, hospitals and patients.

Of all invasive medical procedures, venipuncture is the most common and these venipuncture attempts can fail. As a result:

• Intravenous therapy may not begin promptly

• Residents may bruise or require additional healing time when stuck multiple times

• Outside assistance to access a difficult vein may be needed, creating additional expenses and delays

• Stress may increase for both residents and nursing staff

• A resident may ultimately need to be sent back to the hospital, resulting in empty beds.

Second, there is also a specialty group for Association for Vascular access nurses and also the Vascular Access Certification Corporation (, which tests and certifies nurses interested in specializing in vascular access. With the amount of picc lines, IVs and ports coming in and out of the post-acute continuum, we should encourage our staff to certify and specialize as it only enhances the quality of care we are able to administer within our facilities!