From its humble beginnings in 2003, when there were just three vascular access nurses in all of BC, the provincial vascular access services team (PVAST) has quickly evolved as a highly effective, multidisciplinary group.
With representation from all areas of renal care, including radiologists, nephrologists, and renal nurses, PVAST was well equipped for the initial task it was given by the BC Provincial Renal Agency in 2004: to develop a best practices framework and provincial guidelines for vascular access.
Vascular access is a method for securing entry to the bloodstream to allow dialysis. Hemodialysis accesses include fistulae, grafts, or catheters. Peritoneal dialysis uses a peritoneal catheter.Vascular access problems can lead to significant complications for patients with end stage renal disease, and the renal agency wanted PVAST’s recommendations on how best to minimize the access issues for patients throughout the province. As a result, BC is now the only province in Canada with evidence-based provincial standards for the creation, maintenance and repair of vascular accesses.
Following the success of PVAST’s efforts to develop provincial guidelines for vascular access, the Renal Agency called upon the group to take the next step and deliver further recommendations for improving vascular access in the province. PVAST-2, as it was called, resulted in further vascular access guidelines and recommendations for a vascular access database in PROMIS, for developing vascular access clinics, and for a process for moving vascular access patients in remote areas closer to the clinical support they require.
“The PVAST committee has done some exceptional work and has accomplished a lot in a relatively short time,” says committee co-chair, Rick Luscombe, vascular access clinical nurse leader for Providence Health Care.
Rick says the PVAST’s recommendations have been “very well received” by the renal community in BC and by renal professionals across Canada. Together with Anita Salmon, a vascular access nurse from Vancouver Island Health Authority, Rick recently presented the PVAST’s work on establishing vascular access clinics at a national conference of nephrology nurses and technicians.
“The feedback we got from other nurses is they’re very envious of us here in BC, and the way we work collaboratively on these issues,” says Rick.
Although the PVAST has now fully delivered on the tasks it was given by the BCPRA, Rick feels the committee still has a job to do. He sees a role for the PVAST in helping facilitate some of its recommendations within the health authorities, and working to develop the vascular access database.