Joint Practice Guideline for Sterile Technique during Vascular and Interventional Radiology Procedures
There is a need for current formal recommendations in the interventional radiology (IR) literature concerning the use of sterile technique during IR procedures. This is particularly important given the increasing incidence of antibiotic resistance, complications from nosocomial infection, cost of health care, and emphasis on quality of care. This document summarizes the findings from the available surgical and IR literature on this topic. There is, however, a general lack of published randomized controlled studies on this subject. This guideline represents a joint effort with our nursing colleagues from the Association of periOperative Room Nurses (AORN) and the Association for Radiologic and Imaging Nursing.
ARIN endorses the routine use of capnography for all patients who receive moderate sedation/analgesia during procedures in the imaging environment. This position is based on an extensive literature review demonstrating technical superiority and cost advantages with capnography use.
The obese patient presents specific challenges within the imaging department because of the constraints of imaging technology design, weight limits, positioning limitations; potential respiratory depression related to sedative and analgesia medications combined with cardiac and respiratory system factors unique to the obese patient; and availability of instruments of appropriate length to target the identified lesion. Screening may reveal that anesthesia may be the most appropriate level of care to maximize safe and successful outcomes.
Imaging nurses influence patient care in a variety of settings and nursing roles. Imaging nurses are involved in the assessment, care planning, and direct care of patients before, during, and after diagnostic and therapeutic imaging procedures. Imaging nurses promote high quality patient care in those environments.
The imaging nurse uses evidence-based practice to provide quality nursing care for patients in the imaging setting. The nurse is knowledgeable in meeting the physical, psychological, cultural, and educational needs of patients.
Moderate Sedation and Analgesia medications are frequently administered by Imaging Nurses. Moderate Sedation and Analgesia is defined as a drug‐induced depression of consciousness during which patients respond purposefully to verbal commands, either alone or accompanied by light tactile stimulation.
Medications used in the treatment of cancer are considered hazardous to healthcare workers. The term “hazardous” describes medications that need special handling because of health risks that may result from exposure. These risks are a result of the inherent toxicities of the medications.
Extravasation of contrast medium can occur during hand or power injection. Iodinated contrast media are toxic to surrounding tissues, particularly skin. Some patients will experience stinging or burning, but other patients will have little to no immediate discomfort.
AORN Position Statement on Criminalization of Human Errors in the Perioperative Setting
AORN Position Statement on Creating a Patient Safety Culture
APIC Position Paper on Safe Injection, Infusion and Medication Vial Practices in Healthcare
ANSR 2010 Consensus Document