Sales Tel: +63 945 7983492  |  Email Us    
SMDC Residences

Air Residences

Features and Amenities

Reflective Pool
Function Terrace
Seating Alcoves

Air Residences

Green 2 Residences

Features and Amenities:

Wifi ready study area
Swimming Pool
Gym and Function Room

Green 2 Residences

Bloom Residences

Features and Amenities:

Recreational Area
2 Lap Pools
Ground Floor Commercial Areas

Bloom Residences

Leaf Residences

Features and Amenities:

3 Swimming Pools
Gym and Fitness Center
Outdoor Basketball Court

Leaf Residences

Contact Us

Contact us today for a no obligation quotation:


+63 945 7983492
+63 908 8820391

Copyright © 2018 SMDC :: SM Residences, All Rights Reserved.


































































VACC dumps with Real exam Questions and Practice Test - smresidences.com.ph

Great Place to download 100% free VACC braindumps, real exam questions and practice test with VCE exam simulator to ensure your 100% success in the VACC - smresidences.com.ph

Pass4sure VACC dumps | Killexams.com VACC real questions | http://smresidences.com.ph/

VACC VACC Vascular Access

Study Guide Prepared by Killexams.com Medical Dumps Experts

Exam Questions Updated On :



Killexams.com VACC Dumps and Real Questions

100% Real Questions - Exam Pass Guarantee with High Marks - Just Memorize the Answers



VACC exam Dumps Source : VACC Vascular Access

Test Code : VACC
Test Name : VACC Vascular Access
Vendor Name : Medical
: 80 Real Questions

worked difficult on VACC books, but the whole thing changed into in the .
Have just passed my VACC exam. Questions are valid and accurate, which is the good news. I was ensured 99% pass rate and money back guarantee, but obviously I have got excellent scores. Which is the good news.


forget about the whole thing! simply forcus on those VACC Questions and answers if you want to pass.
I purchased this because of the VACC questions, I thought I could do the QAs part just based on my prior experience. Yet, the VACC questions provided by killexams.com were just as useful. so you really need targeted prep materials, I passed easily, all thanks to killexams.com.


updated and actual question bank state-of-the-art VACC.
My exam preparation passed off into 44 right replies of the aggregate 50 inside the planned 75 mins. It worked simplytruly the brilliant. I were given an attractive enjoy relying on the killexams.com dumps for the exam VACC. The aide clarified with compact solutions and reasonable cases.


VACC examination isn't always any greater tough to pass with these .
Im very masses happy along with your test papers particularly with the solved issues. Your test papers gave me courage to seem in the VACC paper with self assurance. The end result is seventy seven.25%. Over again I complete heartedly thank the killexams.com employer. No other manner to pass the VACC exam apart from killexams.com model papers. I in my view cleared distinct test with the help of killexams.com question economic organization. I suggest it to each one. If you need to pass the VACC exam then take killexams.com help.


attempt out these actual VACC dumps.
I passed VACC paper within weeks,thanks on your incredible QA test materials.marks ninety six percentage. I am very assured now that i will do higher in my last three exams and clearly use your exercise material and propose it to my buddies. thanks very a good deal to your incredible on-line exam simulator product.


VACC exam is not any more hard with those QAs.
Knowing thoroughly approximately my time constraint, began out attempting to find an smooth way out earlier than the VACC exam. After an extended searh, determined the query and solutions through killexams.com which in reality made my day. Imparting all in all likelihood questions with their short and pointed solutions helped keep near subjects in a short time and felt happy to comfortable accurate marks within the exam. The materials also are smooth to memorise. I am stimulated and satiated with my outcomes.


It is unbelieveable, but VACC actual test questions are availabe here.
that is an definitely valid and dependable useful resource, with real VACC questions and correct solutions. The testingengine works very clean. With extra data and true customer support, this is a very precise offer. No free random braindumps to be had on line can evaluate with the top class and the coolest enjoy I had with Killexams. I passed with a in reality high marks, so Im telling this based on my personal revel in.


it's miles amazing perfect to prepare VACC examination with dumps.
This is the best VACC resource on internet. killexams.com is one I trust. What they gave to me is more valuable than money, they gave me education. I was studying for my VACC test when I made an account on here and what I got in return worked purely like magic for me and I was very surprised at how amazing it felt. My VACC test seemed like a single handed thing to me and I achieved success.


No source is more powerful than this VACC source.
Its a completely beneficial platform for opemarks experts like us to practice the questions and answers anywhere. I am very an awful lot grateful to you people for creating such a terrific exercise questions which changed into very beneficial to me within the final days of exams. i have secured 88% marks in VACC exam and the revision exercise exams helped me loads. My idea is that please increase an android app in order that humans like us can practice the tests whilst travelling also.


How a whole lot profits for VACC certified?
The association time for VACC exam become surely a nice experience for me. efficaciously passing, i have found outthe way to clear all the further tiers. because of killexams.com Questions & answers for all of the assistance. I had constrained time for preparation but killexams.com brain dumps became out to be a assist for me. It had vast question and solutions that made me plan in a quick compass.


Medical VACC Vascular Access

VACC designs new software to educate industry professionals on vascular entry | killexams.com Real Questions and Pass4sure dumps

Apr 22 2014

figuring out the needs of health suppliers and their interplay with sufferers is paramount to the position of the employees of ICU scientific which provides clinicians all over with ingenious and affordable options for scientific wants. As such, ICU medical selected to contain members of its firm within the Vascular access trade companion™ certificate software, designed to teach business authorities on the fundamental fundamentals of vascular access. VACC's software emphasizes terminology, kinds of gadgets, makes use of, issues with vascular access and the unique concerns facing special populations.

"The adventure has been useful," noted Joe Vienneau, ICU clinical's director of corporate sales working towards. "many of the people felt the modules helped their knowledge base and they are excited to have the VACC emblem companion on their enterprise card." 

each of ICU scientific's revenue corporations participated in an extensive software that blanketed important care, oncology, alternate web site, renal, health center, animal fitness and corporate money owed. Vienneau pointed out the enterprise's participation in the software stemmed from a clear dedication to customer aid and repair, proposing a chance to "supply their revenue force a leg up on their rivals in a vascular entry expertise base in order that they could be a real resource for his or her shoppers."

For professional veterans like Joleen Weihs, regional revenue director for PDI, the  Vascular access trade companion™ certificates program gives a wealth of assistance for those searching for a refresher. PDI provides inventive products, academic substances, practising and aid to steer clear of an infection transmission and promote health and well being.  "continuing education is crucial to make sure they be mindful their clinicians' approaches and protocols," Weihs referred to. "Vascular access encompasses a big range of needs…there are loads of protocols and procedures they deserve to take note with the intention to work more quite simply with their consumers. The practicing breaks the counsel into modules that construct on every other so that you see how the entire constituents relate. it be a brilliant strategy to give tips for people new to the industry as well as greater experienced pals."

As a pacesetter, Weihs has considered advantages to her acquaintances in a few areas in that they've been in a position to be aware what the customer organization is making an attempt to achieve and support them to obtain their dreams.  "they are asking better questions, really understanding the client's desires and challenges," she pointed out, including that an understanding and confidence can on no account be underestimated, above all for people in revenue dealing at once with the client.  "acquaintances have more self belief because of their practising. they're capable of engage in good conversations with clinicians who've decades of adventure and gigantic expertise. ordinary, it be been a really empowering experience for them," she referred to.

supply:

Vascular entry Certification organisation


VACC Calls on Healthcare facilities to Certify Vascular entry professionals | killexams.com Real Questions and Pass4sure dumps

HERRIMAN, Utah, July 10, 2014 /PRNewswire-USNewswire/ -- The Vascular access Certification supplier (VACC) has issued a name to action to hospitals all the way through the country to believe encouraging authorities working within the field of vascular entry to are seeking for certification.

speakme on behalf of the VACC board of directors, Board President Hudson J. Garrett, Jr., PhD, MSN, MPH, FNP, VA- BC™, cited Memorial Sloan Kettering cancer middle as an instance for hospitals to observe.  "The professionals at Memorial Sloan Kettering melanoma core are shining examples of licensed vascular entry professionals who are showing delight of their area of expertise," stated Garrett. "authorities working in the field of vascular entry can exhibit mastery of specialised expertise by using meeting standards and passing the examination offered with the aid of the Vascular entry Certification organisation, the credentialing arm of the affiliation for Vascular entry."

"We stand at the back of their specialties and that is why I inspire the team to searching for certification in vascular access," spoke of Jane Sallustro, RN, MPA, CNML, and Nurse chief at Memorial Sloan Kettering cancer center.

In VACC's call to motion, the board spoke of that as with other scientific specialties, their organization is dedicated to raising the vascular access bar via evidence based mostly follow, professionalism and advocating secure and accountable practice for sufferers and households.

Certification through VACC is multidisciplinary in scope and contains a large range of fitness care authorities actively engaged in the apply of vascular entry, together with however now not constrained to registered nurses, physicians, nurse practitioners, radiology technicians, respiratory therapists, an infection preventionists and emergency clinical functions gurus.

The Vascular entry Certification organisation (VACC), established in 2009, is an impartial non-earnings firm committed to the validation, through certification, of a really good physique of abilities for all professionals working within the container of vascular access.

www.vacert.org

supply Vascular access Certification supplier


Vascular entry Certification organization Creates New tutorial program | killexams.com Real Questions and Pass4sure dumps

 knowing the wants of health suppliers and their interaction with patients is paramount to the position of the personnel of ICU clinical which provides clinicians around the globe with inventive and cost-effective options for medical wants. As such, ICU clinical chose to involve members of its firm within the Vascular entry business accomplice™ certificate program, designed to educate trade authorities on the basic fundamentals of vascular access. VACC's program emphasizes terminology, kinds of devices, uses, complications with vascular access and the exciting issues facing particular populations.

"The experience has been useful," mentioned Joe Vienneau, ICU scientific's director of company revenue training. "most of the individuals felt the modules helped their skills base and they are excited to have the VACC emblem partner on their company card." 

each and every of ICU clinical's revenue organizations participated in an intensive application that blanketed essential care, oncology, alternate web site, renal, sanatorium, animal fitness and company accounts. Vienneau mentioned the enterprise's participation in the application stemmed from a clear commitment to client help and repair, presenting an opportunity to "provide their revenue force a leg up on their opponents in a vascular entry competencies base so they may be a real resource for his or her clients."

For seasoned veterans like Joleen Weihs, regional sales director for PDI, the  Vascular access business accomplice™ certificate application provides a wealth of tips for those in the hunt for a refresher. PDI gives ingenious items, educational supplies, practising and help to steer clear of an infection transmission and promote fitness and well being.  "continuing education is essential to be sure they keep in mind their clinicians' techniques and protocols," Weihs observed. "Vascular access encompasses a wide range of wants…there are a lot of protocols and processes they should have in mind so as to work extra without difficulty with their consumers. The practicing breaks the assistance into modules that build on every other so you see how all of the components relate. it's a superb technique to give suggestions for people new to the business in addition to extra experienced buddies."

As a leader, Weihs has considered advantages to her friends in a couple of areas in that they have got been in a position to take note what the client company is making an attempt to accomplish and support them to achieve their dreams.  "they're asking more suitable questions, in fact figuring out the client's desires and challenges," she referred to, including that an realizing and self belief can under no circumstances be underestimated, particularly for americans in income dealing at once with the client.  "buddies have extra self belief as a result of their practising. they're capable of interact in respectable conversations with clinicians who've decades of adventure and massive skills. overall, or not it's been a very empowering event for them," she said.

The Vascular entry Certification employer (VACC), centered in 2009, is an impartial non-income company dedicated to the validation, through certification, of a really good physique of knowledge for all gurus working within the box of vascular access.www.vacert.org

source Vascular access Certification company

Copyright (C) 2014 PR Newswire. All rights reserved


While it is very hard task to choose reliable certification questions / answers resources with respect to review, reputation and validity because people get ripoff due to choosing wrong service. Killexams.com make it sure to serve its clients best to its resources with respect to exam dumps update and validity. Most of other's ripoff report complaint clients come to us for the brain dumps and pass their exams happily and easily. They never compromise on their review, reputation and quality because killexams review, killexams reputation and killexams client confidence is important to us. Specially they take care of killexams.com review, killexams.com reputation, killexams.com ripoff report complaint, killexams.com trust, killexams.com validity, killexams.com report and killexams.com scam. If you see any false report posted by their competitors with the name killexams ripoff report complaint internet, killexams.com ripoff report, killexams.com scam, killexams.com complaint or something like this, just keep in mind that there are always bad people damaging reputation of good services due to their benefits. There are thousands of satisfied customers that pass their exams using killexams.com brain dumps, killexams PDF questions, killexams practice questions, killexams exam simulator. Visit Killexams.com, their sample questions and sample brain dumps, their exam simulator and you will definitely know that killexams.com is the best brain dumps site.

Back to Braindumps Menu


1Z0-493 practice exam | CAT-040 practice questions | 500-325 questions and answers | PMI-100 pdf download | 050-890 study guide | CA0-002 exam prep | 650-987 real questions | VCS-371 free pdf download | 1Z0-980 dumps | HP0-M39 practice questions | MB3-210 cheat sheets | 000-154 braindumps | HP0-M21 brain dumps | HP0-M24 Practice test | HH0-110 real questions | 920-533 dumps questions | 1Z0-453 examcollection | 1Z0-808 test prep | HP0-660 bootcamp | HP2-896 questions answers |


killexams.com VACC VACC Vascular Access exam brain dumps with practice programming.
Simply experience their Questions answers and sense guaranteed around the VACC exam. You will pass your exam at high marks or your cash back. They have accumulated a database of VACC Dumps from actual test to have the capacity to give you a prep to get prepared and pass VACC exam at the first attempt. Essentially introduce their Exam Simulator and prepare. You will pass the exam.

killexams.com have its specialists operating ceaselessly for the gathering of real test questions of VACC. All the pass 4 sure Questions and Answers of VACC gathered by their cluster are looked into and updated by their VACC certification cluster. they have an approach to keep related to the candidates showed up within the VACC exam to induce their reviews regarding the VACC exam, they have an approach to gather VACC exam tips and traps, their expertise regarding the procedures utilised as an area of the important VACC exam, the errors they wiped out the important exam and later on enhance their braindumps as required. Click http://killexams.com/pass4sure/exam-detail/VACC killexams.com Discount Coupons and Promo Codes are as under; WC2017 : 60% Discount Coupon for all exams on website PROF17 : 10% Discount Coupon for Orders larger than $69 DEAL17 : 15% Discount Coupon for Orders larger than $99 SEPSPECIAL : 10% Special Discount Coupon for All Orders When you expertise their killexams.com Questions and Answers, you will feel certain regarding each one of the themes of exam and feel that your information has been considerably captive forward. These pass4sure Questions and Answers are not merely practice questions, these are real test Questions and Answers that are sufficient to pass the VACC exam first attempt.

The most ideal approach to get accomplishment in the Medical VACC exam is that you should get trustworthy braindumps. They guarantee that killexams.com is the most direct pathway toward confirming Medical VACC Vascular Access exam. You will be triumphant with full surety. You can see free questions at killexams.com before you buy the VACC exam items. Their copied tests are in various choice the same As the real exam outline. The questions and answers collected by the guaranteed experts. They give you the experience of stepping through the real exam. 100% certification to pass the VACC real test.

killexams.com Medical Certification examine guides are setup by IT specialists. Packs of understudies have been crying that exorbitantly various questions in such enormous quantities of preparing exams and study helpers, and they are as of late tired to deal with the cost of any more. Seeing killexams.com pros work out this broad shape while still accreditation that all the data is anchored after significant research and exam. Everything is to make comfort for contenders on their road to accreditation.

We have Tested and Approved VACC Exams. killexams.com gives the correct and latest IT exam materials which for all intents and purposes contain all data centers. With the guide of their VACC brain dumps, you don't need to misuse your chance on examining reference books and basically need to consume 10-20 hours to pro their VACC real questions and answers. Likewise, they outfit you with PDF Version and Software Version exam questions and answers. For Software Version materials, Its offered to give indistinguishable experience from the Medical VACC exam in a real situation.

We give free updates. Inside authenticity period, if VACC brain dumps that you have purchased updated, they will hint you by email to download latest rendition of . If you don't pass your Medical VACC Vascular Access exam, They will give you full refund. You need to send the verified copy of your VACC exam report card to us. Ensuing to certifying, they will quickly give you FULL REFUND.

If you prepare for the Medical VACC exam using their testing programming. It is definitely not hard to win for all certifications in the principle attempt. You don't need to deal with all dumps or any free storm/rapidshare all stuff. They offer free demo of each IT Certification Dumps. You can take a gander at the interface, question quality and accommodation of their preparation exams before you buy.

killexams.com Huge Discount Coupons and Promo Codes are as under;
WC2017: 60% Discount Coupon for all exams on website
PROF17: 10% Discount Coupon for Orders greater than $69
DEAL17: 15% Discount Coupon for Orders greater than $99
DECSPECIAL: 10% Special Discount Coupon for All Orders


VACC | VACC | VACC | VACC | VACC | VACC


Killexams 920-163 free pdf | Killexams BAS-010 braindumps | Killexams CTAL-TA_Syll2012 VCE | Killexams C2080-474 exam questions | Killexams 000-623 practice test | Killexams JN0-633 real questions | Killexams C9020-662 free pdf download | Killexams MD0-205 questions and answers | Killexams 310-502 dumps questions | Killexams P2065-016 dumps | Killexams HP2-Z13 practice questions | Killexams 000-573 practice exam | Killexams A2090-612 study guide | Killexams LOT-838 examcollection | Killexams 7497X bootcamp | Killexams HP0-M19 brain dumps | Killexams F50-533 exam prep | Killexams CAT-180 free pdf | Killexams C2020-635 free pdf | Killexams 70-339 cram |


killexams.com huge List of Exam Braindumps

View Complete list of Killexams.com Brain dumps


Killexams LOT-956 test prep | Killexams 250-430 free pdf download | Killexams 090-601 dumps | Killexams 000-896 braindumps | Killexams HP2-W104 study guide | Killexams HP2-Z05 practice questions | Killexams 000-996 braindumps | Killexams GB0-360 free pdf | Killexams 000-N02 free pdf | Killexams 250-503 Practice test | Killexams HP0-336 test prep | Killexams 72-642 mock exam | Killexams 000-189 test prep | Killexams 920-551 sample test | Killexams HP0-D06 braindumps | Killexams ICDL-WINDOWS examcollection | Killexams NCLEX-PN questions and answers | Killexams 200-601 practice test | Killexams HP0-513 study guide | Killexams MA0-101 free pdf |


VACC Vascular Access

Pass 4 sure VACC dumps | Killexams.com VACC real questions | http://smresidences.com.ph/

FDA permits marketing of first catheter-based systems used to create vascular access for hemodialysis patients | killexams.com real questions and Pass4sure dumps

Español

Today, the U.S. Food and Drug Administration permitted marketing of two catheter-based devices designed to create a connection to veins and arteries in patients with chronic kidney disease who need hemodialysis.

Specifically, the FDA granted marketing authorization for the use of the Ellipsys Vascular Access System and the everlinQ endoAVF System to make what’s called an arteriovenous (AV) fistula for patients who need hemodialysis access.

“Dialysis is a necessary and life-saving procedure for thousands of individuals. With today’s action, there will be additional, less-invasive vascular access options for patients who will require hemodialysis,” said Bram Zuckerman, M.D., director of the Division of Cardiovascular Devices in the FDA’s Center for Devices and Radiological Health.

According to the National Institutes of Health, more than 661,000 Americans have kidney failure, of which approximately two-thirds are on hemodialysis. Hemodialysis utilizes a dialyzer, or artificial kidney, to filter a patient’s blood outside of their body. Before patients can start dialysis, however, they need to have an AV fistula created. An AV fistula is traditionally made by surgically joining an artery and a vein under the skin in the arm. After some time, the mature vein can then receive the two needles used for each hemodialysis session. Surgically created AV fistulas typically take several months to heal and for the vein to mature before being usable for hemodialysis.

The devices granted marketing authorization today are designed to create AV fistulas percutaneously (through the skin). A catheter is inserted into a blood vessel in the arm and is guided to the site of the planned AV fistula. The devices then deliver energy to form a connection between an upper forearm artery and an adjacent vein. The Ellipsys Vascular Access System uses one catheter, the everlinQ endoAVF System uses two.

For the Ellipsys Vascular Access System, the FDA reviewed data from a non-randomized, multi-center study of 103 patients. The Ellipsys Vascular Access System was used in a procedure to create an AV fistula in these patients, of which 92 patients (89.3 percent) met the criteria for a usable AV fistula within three months after the procedure.  Almost all patients (96.1 percent) required an additional procedure (such as balloon angioplasty) in the first 12 months to maintain the fistula.

For the everlinQ endoAVF System, the FDA reviewed data from a non-randomized, multi-center study of 60 patients, in addition to supporting data from three other studies and clinical use of the device outside the U.S. The everlinQ endoAVF System was used in a procedure to create an AV fistula in these patients. In the main study, 52 patients (86.7 percent) met the criteria for a usable AV fistula within three months after the procedure.  Almost all patients (96.7 percent) required an additional procedure at the time the fistula was created, while 28.3 percent of patients required an additional procedure (such as balloon angioplasty) in the first 12 months to maintain the fistula.

Both devices are contraindicated, or should not be used, for creation of anastomoses (connections) in vessels that are less than two millimeters in diameter or too far apart (for example, in the wrist or in the hand). For both devices, complications include blocking (occlusion) or collapse (stenosis) of the fistula, bruising and need for additional procedures.

The Ellipsys Vascular Access System and everlinQ endoAVF System were reviewed through the De Novo premarket review pathway, a regulatory pathway for some low to moderate risk devices of a new type. This action also creates a new regulatory classification, which means that subsequent devices with the same intended use may go through the FDA’s 510(k) process, whereby devices can obtain marketing authorization by demonstrating substantial equivalence to a predicate device.

The FDA granted marketing authorization of the Ellipsys Vascular Access System to Avenu Medical.

The FDA granted marketing authorization of the everlinQ endoAVF System to TVA Medical, Inc.

The FDA, an agency within the U.S. Department of Health and Human Services, protects the public health by assuring the safety, effectiveness, and security of human and veterinary drugs, vaccines and other biological products for human use, and medical devices. The agency also is responsible for the safety and security of their nation’s food supply, cosmetics, dietary supplements, products that give off electronic radiation, and for regulating tobacco products.

###


Exploring Approaches 'Beyond the Bundle' to Help Decrease Vascular Access Device-Associated Infections | killexams.com real questions and Pass4sure dumps

By Chellie DeVries

It has been more than 10 years since The New England Journal of Medicine published the Keystone project’s ground breaking work on reducing ICU CLABSIs using a central line insertion bundle. Since that time, this has become the absolute standard throughout healthcare settings in the United States. When it comes to completing the central line insertions checklist, many of us only accept “yes” and “yes with prompting” as possible responses. Our accrediting agencies expect this as a standard of practice. 

With CMS/NHSN mandated reporting now in its seventh year, there are reports of tremendous improvements in reported central line-associated bloodstream infection (CLABSI) incidence as this and other evidence-based standards are more fully adopted. Hospitals are analyzing their data and examining contributing factors to determine where improvements are most needed. What happens when opportunities for improvement persist and bundle compliance (both insertion and maintenance) is consistently high?  It may be time to look beyond those bundles to examine additional approaches that may be beneficial.

For so long now they have (rightly) stressed the importance of maximum sterile barrier precautions for insertion of central lines and daily re-view of line necessity to get them out promptly, yet many units continue to have central line utilization in excess of reported means. How much progress could be made by also looking more critically at device selection and early vascular assessment as part of a prevention strategy?  MAG-IC gives us the framework for assessing the hierarchy of device options before using a central line for difficult access or peripherally compatible infusates. How much further could they get if they slowed the progress to central lines or got them out even a day or two sooner while still ensuring reliable access? It is true that many of their patients truly require a central line, but when they go through the motion of “daily review of line necessity” are they truly asking whether the patient still needs the device they have?  There is a difference between needing vascular access and needing a central line. 

At my organization, they are tackling this in a number of different ways – starting now in the emergency room. They have completed the first year of their midline program at the hospital (managed by their PICC team) with over 3500 midline days and tracked their outcomes closely. For their primary, power injectable line they are now at nearly 3,000 midline days with zero BSIs. Based on those successes and feedback from their medical staff leaders that there remains an opportunity for addressing lines placed in the emergency room they are now in the early phases of training interested ER nurses in ultrasound skills to allow them to assist with preventing unnecessary central line insertions (and subsequent excess central line days) by giving them (after completing competencies) the ability to place a high flow, power injectable midline if it is appropriate for the patient’s vascular access needs.  Those lines will be monitored for outcomes and the impact they may contribute to the organization’s central line utilization ratios.   

As they reviewed their 2016 CLABSIs there was considerable discussion about the CLABSIs that were occurring in their critical care step down units; although they are not included in state or federal reporting they represent a considerable source of morbidity (and potential mortality) for their patients and central line days exceeds what are seen in their intensive care units (ICUs). Recent conversations, supported by their ICU medical director will help drive staff to more carefully consider whether central lines can be reduced or replaced with midlines for patients with continuing need for therapy as they leave the ICU with medications not contraindicated for peripheral infusion. Review the available evidence to see which devices may be able to most safely help you achieve your goals, by keeping a patient focused prevention strategy.

When you look beyond your bundles what else do you see?  What other trends bear further investigation?  A review of their bloodstream infections (CLABSI and peripheral line related) for 2016 showed that 25 percent had documentation of problems with the dressing based on chart review documenting reinforced dressings or premature dressing changes.  Concordant review of charts with direct observation suggested that the dressing disruption rate was even more significant. Knowing that repeated dressing changes has significant impact on CLABSI incidence, solving this problem became a priority. Several different strategies were used, starting with re-education on appropriate use of their dressings. When that was insufficient they created an intervention bundle that included a dressing in conjunction with a gum mastic based medical adhesive. Combining a securement dressing with these adhesive allowed us, in their pilot, to achieve 93 percent fully adherent dressings (without any tape reinforcement or lifted edges) and zero disrupted dressings.   

We are in the process of expanding the study across multiple other devices in their organization to find the bundle that works best for us.  By studying this in the careful manner they did, they have the potential to decrease excess dressing changes and the related BSI risks but also save nursing time through allowing their dressings to remain in place and intact, while protecting their investment in protective strategies like CHG sponge dressing and advanced securement dressings.   

I am fortunate to get to talk with colleagues in vascular access and infection control across the country on a weekly basis. I hear the struggles they are facing with the implications of Value-Based Purchasing and most recently the impact that rebaselining had on many facilities’ standardized infection ratios (SIRs). I hear the pressure that Infection Prevention and Vascular Access teams are under to improve their CLABSI numbers. I am frightened by some of what has been shared with me.  I have heard programs be actively encouraged to NOT try to decrease central line days – because leaving them high helps to make rates or SIRs look better. Rather than focusing on decreasing the risk by ensuring optimal compliance with prevention strategies, this leaves their patients at unacceptable risk by potentially leaving in a device that is not actually necessary for care.   I am equally concerned with hospitals who are suggesting that central lines should not be used… since then there could be no CLABSIs.  That is a disturbing proposition in terms of vessel health – their veins are meant to last us a lifetime and must be treated with careful consideration of what is infused into devices and how those devices are placed and maintained. On the flip side, I have heard of hospitals who look at their rates and because they are “OK” they are not pushing further to improve outcomes or improve compliance with the process measures that drive those outcomes.  If they continue to have patients with potentially fatal infections, how can they allow ourselves to become complacent?

Please partner with your vascular access teams or whomever has primary responsibility for those considerations in your hospital. Share the data you have from NHSN and any process measures you follow for all vascular access devices; ask them to share the measurables they track for their productivity.    Learn together how you can collaborate to help make your hospital the safest possible place they can be for their patients.  In September, I am teaching a “Power Hour” at the National Association for Vascular Access conference focusing on NHSN surveillance and how to leverage that data for vascular access teams. That came about because so many of these professionals have indicated they do not have strong, open relationship with their infection preventionists. Please reach out and collaborate – you truly will not find better allies in the organization for achieving their mutual goals.

Chellie DeVries has been involved in infection control and hospital epidemiology with a passion for vascular access considerations for more than 20 years. She was a reviewer for the 2016 Infusion Therapy Standards of Practice, wrote the Infection Prevention and Control Chapter for the forthcoming new edition of Infusion Nursing: An Evidence Based Approach and the chapter on Vascular Access Device Associated Infections for the International Federation of Infection Control text book.. She volunteers as an advisor for AVA's Patient Advocacy Committee and a member of their PIV task force and serves as a director-at-large with the Vascular Access Certification Corporation (VACC).

References:Chopra V, Flanders SA and Saint S. (Sept. 15, 2015). The Michigan Appropriateness Guide for Intravenous Catheters (MAGIC): Results fro a Multispecialty Panel Using the RAND/UCLA Appropriateness Method. Annals of Internal Medicine, 163(163), S1-S39.

Chopra V, Ratz D and Kuhn L. (April 2014). PICC-associated bloodstream infections: prevalence, patterns, and predictors. American Journal of Medicine, 127(4), 319-28. http://dx.doi.org/10.1016/j.amjmed.2014.01.001

Fabiani A, Dreas L and Samson G. (January-February 2017). Ultrasound-guided deep-arm veins insertion of long peripheral catheters in pa-tients with difficult venous access after cardiac surgery. Heart and Lung, 46(1), 46-53. http://dx.doi.org/http://dx.doi.org/10.1016/j.hrtlng.2016.09.003

Institute for Healthcare Improvement. (2012). How-to Guide: Prevent Central Line-Associated Bloodstream Infections. Retrieved from http://www.ihi.org/resources/Pages/Tools/HowtoGuidePreventCentralLineAssociatedBloodstreamInfection.aspx

Kim JS, Holton P and Vigon C. (2011). Reduction of catheter-related bloodstream infections through the use of a central venous line bundle: Epidemiologic and economic consequences. American Journal of Infection Control, 39, 640-6.

Moureau N, Siegl G and Hill M. (2015). How to Establish an Effective Midline Program: A Case Study of 2 Hospital. Journal of the Association for Vascular Access, 20, 179-88. http://dx.doi.org/http://dx.doi.org/10.1016/j.java.2015.05.001

Pathak R, Patel A and Ennui H. (May 2015). The incidence of central line-associated bacteremia after the introduction of midline catheters in a ventilator unit population. Infectious Diseases in Clinical Practice, 23(3), 131-34.

Provonost P, Needham D and Berenholtz S. (2006, December 28). An intervention to decrease catheter-related bloodstream infections in the ICU. New England Journal of Medicine, 355(26), 2725-32.

Scoppettuolo G, Pittiruti M and Pitoni S. (2016). ORIGINAL RESEARCH Open Access Ultrasound-guided “short” midline catheters for difficult venous access in the emergency department: a retrospective analysis. International Journal of Emergency Medicine, 9(3), 1-7. http://dx.doi.org/10.1186/s12245-016-0100-0

Timsit JF, Bouadma L and Ruckly S. (June 2012). Dressing disruption is a major risk factor for catheter-related infections. Critical Care Medi-cine, 40(16), 1707-14. http://dx.doi.org/10.1097/CCM.0b013e31824e0d46


Vascular Access Needs To Be Improved for Hemodialysis Patients | killexams.com real questions and Pass4sure dumps

Patients with end-stage renal disease rely on hemodialysis to survive. About 500,000 Americans are in the end-stage renal disease and are being treated with hemodialysis, which requires repeated access to the blood. Failure to maintain adequate access to the vasculature can cause death for these patients, reveals a new study.

A new study in The American Journal of Pathology provides information about the mechanisms underlying failure of the most common type of hemodialysis vascular access, the arteriovenous fistula. Despite being the preferred approach, there is currently limited understanding of the mechanisms involved in fistula maturation failure.

‘Kidney failure and cardiovascular disease may be associated with poor nitric acid responsiveness.’

Hemodialysis removes waste products from the blood and establishes electrolyte and fluid balance in patients whose kidneys can no longer function properly. There are several approaches that doctors use to establish connections with the blood supply for hemodialysis."The arteriovenous fistula is the preferred type of vascular access because of lower complication rates compared with synthetic arteriovenous grafts or central venous catheters. However, up to 60% of newly created fistulas never become usable for dialysis because they fail to mature (meaning the vessels do not enlarge enough to support the dialysis blood circuit)," explained lead investigator Xiaoyong Tong, MD, PhD, of the Innovative Drug Research Centre, Chongqing University, Chongqing (China).

This study examined vein tissue obtained at the time 19 patients underwent surgical creation of arteriovenous fistulas at Boston University. Success was defined as the ability to use the fistula for 75% of hemodialysis sessions during the fifth month after fistula creation.

The investigators focused in on the ability of smooth muscle cells to respond to nitric acid, a vasodilator derived from the inner-most cells of blood vessels. When smooth muscle cells from the vein segments were grown in culture, the investigators found that nitric oxide-induced inhibition of smooth muscle cell migration, but not proliferation, was significantly greater in cells from patients with subsequent fistula maturation success than from those with subsequent fistula maturation failure (17% inhibition versus 5.7% inhibition). They also found that overexpression of the calcium regulatory protein, sarcoplasmic/endoplasmic reticulum calcium ATPase (SERCA), or down-regulation of Nox4, a major source of reactive oxygen species in blood vessels, significantly improved nitric oxide responsiveness of smooth muscle cells from poor nitric oxide responders.

These findings suggest that impairment in responsiveness to nitric oxide that occurs in some patients with end-stage renal disease may result in hyperplasia (excessive growth) of the innermost layer of the blood vessels or reduced ability of the vessels to dilate. Either abnormality can limit the maturation and viability of the arteriovenous fistula.

This research raises the possibility that therapeutic restoration of nitric oxide responsiveness through manipulation of local mediators may prevent fistula maturation failure in patients and potentially contribute to their ability to remain on hemodialysis.

"The superficial location and accessibility of the fistula make it highly suited for application of local drug or gene therapies both during and after its surgical creation. The findings from these studies may also have applicability to the more general problem of impaired nitric oxide responsiveness associated with kidney failure and cardiovascular disease," commented co-investigator Laura M. Dember, MD, of the Renal, Electrolyte and Hypertension Division and Center for Clinical Epidemiology and Biostatistics at the University of Pennsylvania Perelman School of Medicine (Philadelphia).

Source: Eurekalert



Direct Download of over 5500 Certification Exams

3COM [8 Certification Exam(s) ]
AccessData [1 Certification Exam(s) ]
ACFE [1 Certification Exam(s) ]
ACI [3 Certification Exam(s) ]
Acme-Packet [1 Certification Exam(s) ]
ACSM [4 Certification Exam(s) ]
ACT [1 Certification Exam(s) ]
Admission-Tests [13 Certification Exam(s) ]
ADOBE [93 Certification Exam(s) ]
AFP [1 Certification Exam(s) ]
AICPA [2 Certification Exam(s) ]
AIIM [1 Certification Exam(s) ]
Alcatel-Lucent [13 Certification Exam(s) ]
Alfresco [1 Certification Exam(s) ]
Altiris [3 Certification Exam(s) ]
Amazon [2 Certification Exam(s) ]
American-College [2 Certification Exam(s) ]
Android [4 Certification Exam(s) ]
APA [1 Certification Exam(s) ]
APC [2 Certification Exam(s) ]
APICS [2 Certification Exam(s) ]
Apple [69 Certification Exam(s) ]
AppSense [1 Certification Exam(s) ]
APTUSC [1 Certification Exam(s) ]
Arizona-Education [1 Certification Exam(s) ]
ARM [1 Certification Exam(s) ]
Aruba [8 Certification Exam(s) ]
ASIS [2 Certification Exam(s) ]
ASQ [3 Certification Exam(s) ]
ASTQB [8 Certification Exam(s) ]
Autodesk [2 Certification Exam(s) ]
Avaya [101 Certification Exam(s) ]
AXELOS [1 Certification Exam(s) ]
Axis [1 Certification Exam(s) ]
Banking [1 Certification Exam(s) ]
BEA [5 Certification Exam(s) ]
BICSI [2 Certification Exam(s) ]
BlackBerry [17 Certification Exam(s) ]
BlueCoat [2 Certification Exam(s) ]
Brocade [4 Certification Exam(s) ]
Business-Objects [11 Certification Exam(s) ]
Business-Tests [4 Certification Exam(s) ]
CA-Technologies [20 Certification Exam(s) ]
Certification-Board [10 Certification Exam(s) ]
Certiport [3 Certification Exam(s) ]
CheckPoint [43 Certification Exam(s) ]
CIDQ [1 Certification Exam(s) ]
CIPS [4 Certification Exam(s) ]
Cisco [318 Certification Exam(s) ]
Citrix [48 Certification Exam(s) ]
CIW [18 Certification Exam(s) ]
Cloudera [10 Certification Exam(s) ]
Cognos [19 Certification Exam(s) ]
College-Board [2 Certification Exam(s) ]
CompTIA [76 Certification Exam(s) ]
ComputerAssociates [6 Certification Exam(s) ]
Consultant [2 Certification Exam(s) ]
Counselor [4 Certification Exam(s) ]
CPP-Institute [4 Certification Exam(s) ]
CSP [1 Certification Exam(s) ]
CWNA [1 Certification Exam(s) ]
CWNP [13 Certification Exam(s) ]
CyberArk [1 Certification Exam(s) ]
Dassault [2 Certification Exam(s) ]
DELL [11 Certification Exam(s) ]
DMI [1 Certification Exam(s) ]
DRI [1 Certification Exam(s) ]
ECCouncil [22 Certification Exam(s) ]
ECDL [1 Certification Exam(s) ]
EMC [128 Certification Exam(s) ]
Enterasys [13 Certification Exam(s) ]
Ericsson [5 Certification Exam(s) ]
ESPA [1 Certification Exam(s) ]
Esri [2 Certification Exam(s) ]
ExamExpress [15 Certification Exam(s) ]
Exin [40 Certification Exam(s) ]
ExtremeNetworks [3 Certification Exam(s) ]
F5-Networks [20 Certification Exam(s) ]
FCTC [2 Certification Exam(s) ]
Filemaker [9 Certification Exam(s) ]
Financial [36 Certification Exam(s) ]
Food [4 Certification Exam(s) ]
Fortinet [14 Certification Exam(s) ]
Foundry [6 Certification Exam(s) ]
FSMTB [1 Certification Exam(s) ]
Fujitsu [2 Certification Exam(s) ]
GAQM [9 Certification Exam(s) ]
Genesys [4 Certification Exam(s) ]
GIAC [15 Certification Exam(s) ]
Google [4 Certification Exam(s) ]
GuidanceSoftware [2 Certification Exam(s) ]
H3C [1 Certification Exam(s) ]
HDI [9 Certification Exam(s) ]
Healthcare [3 Certification Exam(s) ]
HIPAA [2 Certification Exam(s) ]
Hitachi [30 Certification Exam(s) ]
Hortonworks [4 Certification Exam(s) ]
Hospitality [2 Certification Exam(s) ]
HP [752 Certification Exam(s) ]
HR [4 Certification Exam(s) ]
HRCI [1 Certification Exam(s) ]
Huawei [21 Certification Exam(s) ]
Hyperion [10 Certification Exam(s) ]
IAAP [1 Certification Exam(s) ]
IAHCSMM [1 Certification Exam(s) ]
IBM [1533 Certification Exam(s) ]
IBQH [1 Certification Exam(s) ]
ICAI [1 Certification Exam(s) ]
ICDL [6 Certification Exam(s) ]
IEEE [1 Certification Exam(s) ]
IELTS [1 Certification Exam(s) ]
IFPUG [1 Certification Exam(s) ]
IIA [3 Certification Exam(s) ]
IIBA [2 Certification Exam(s) ]
IISFA [1 Certification Exam(s) ]
Intel [2 Certification Exam(s) ]
IQN [1 Certification Exam(s) ]
IRS [1 Certification Exam(s) ]
ISA [1 Certification Exam(s) ]
ISACA [4 Certification Exam(s) ]
ISC2 [6 Certification Exam(s) ]
ISEB [24 Certification Exam(s) ]
Isilon [4 Certification Exam(s) ]
ISM [6 Certification Exam(s) ]
iSQI [7 Certification Exam(s) ]
ITEC [1 Certification Exam(s) ]
Juniper [65 Certification Exam(s) ]
LEED [1 Certification Exam(s) ]
Legato [5 Certification Exam(s) ]
Liferay [1 Certification Exam(s) ]
Logical-Operations [1 Certification Exam(s) ]
Lotus [66 Certification Exam(s) ]
LPI [24 Certification Exam(s) ]
LSI [3 Certification Exam(s) ]
Magento [3 Certification Exam(s) ]
Maintenance [2 Certification Exam(s) ]
McAfee [8 Certification Exam(s) ]
McData [3 Certification Exam(s) ]
Medical [68 Certification Exam(s) ]
Microsoft [375 Certification Exam(s) ]
Mile2 [3 Certification Exam(s) ]
Military [1 Certification Exam(s) ]
Misc [1 Certification Exam(s) ]
Motorola [7 Certification Exam(s) ]
mySQL [4 Certification Exam(s) ]
NBSTSA [1 Certification Exam(s) ]
NCEES [2 Certification Exam(s) ]
NCIDQ [1 Certification Exam(s) ]
NCLEX [3 Certification Exam(s) ]
Network-General [12 Certification Exam(s) ]
NetworkAppliance [39 Certification Exam(s) ]
NI [1 Certification Exam(s) ]
NIELIT [1 Certification Exam(s) ]
Nokia [6 Certification Exam(s) ]
Nortel [130 Certification Exam(s) ]
Novell [37 Certification Exam(s) ]
OMG [10 Certification Exam(s) ]
Oracle [282 Certification Exam(s) ]
P&C [2 Certification Exam(s) ]
Palo-Alto [4 Certification Exam(s) ]
PARCC [1 Certification Exam(s) ]
PayPal [1 Certification Exam(s) ]
Pegasystems [12 Certification Exam(s) ]
PEOPLECERT [4 Certification Exam(s) ]
PMI [15 Certification Exam(s) ]
Polycom [2 Certification Exam(s) ]
PostgreSQL-CE [1 Certification Exam(s) ]
Prince2 [6 Certification Exam(s) ]
PRMIA [1 Certification Exam(s) ]
PsychCorp [1 Certification Exam(s) ]
PTCB [2 Certification Exam(s) ]
QAI [1 Certification Exam(s) ]
QlikView [1 Certification Exam(s) ]
Quality-Assurance [7 Certification Exam(s) ]
RACC [1 Certification Exam(s) ]
Real Estate [1 Certification Exam(s) ]
Real-Estate [1 Certification Exam(s) ]
RedHat [8 Certification Exam(s) ]
RES [5 Certification Exam(s) ]
Riverbed [8 Certification Exam(s) ]
RSA [15 Certification Exam(s) ]
Sair [8 Certification Exam(s) ]
Salesforce [5 Certification Exam(s) ]
SANS [1 Certification Exam(s) ]
SAP [98 Certification Exam(s) ]
SASInstitute [15 Certification Exam(s) ]
SAT [1 Certification Exam(s) ]
SCO [10 Certification Exam(s) ]
SCP [6 Certification Exam(s) ]
SDI [3 Certification Exam(s) ]
See-Beyond [1 Certification Exam(s) ]
Siemens [1 Certification Exam(s) ]
Snia [7 Certification Exam(s) ]
SOA [15 Certification Exam(s) ]
Social-Work-Board [4 Certification Exam(s) ]
SpringSource [1 Certification Exam(s) ]
SUN [63 Certification Exam(s) ]
SUSE [1 Certification Exam(s) ]
Sybase [17 Certification Exam(s) ]
Symantec [135 Certification Exam(s) ]
Teacher-Certification [4 Certification Exam(s) ]
The-Open-Group [8 Certification Exam(s) ]
TIA [3 Certification Exam(s) ]
Tibco [18 Certification Exam(s) ]
Trainers [3 Certification Exam(s) ]
Trend [1 Certification Exam(s) ]
TruSecure [1 Certification Exam(s) ]
USMLE [1 Certification Exam(s) ]
VCE [6 Certification Exam(s) ]
Veeam [2 Certification Exam(s) ]
Veritas [33 Certification Exam(s) ]
Vmware [58 Certification Exam(s) ]
Wonderlic [2 Certification Exam(s) ]
Worldatwork [2 Certification Exam(s) ]
XML-Master [3 Certification Exam(s) ]
Zend [6 Certification Exam(s) ]





References :







Back to Main Page





Killexams exams | Killexams certification | Pass4Sure questions and answers | Pass4sure | pass-guaratee | best test preparation | best training guides | examcollection | killexams | killexams review | killexams legit | kill example | kill example journalism | kill exams reviews | kill exam ripoff report | review | review quizlet | review login | review archives | review sheet | legitimate | legit | legitimacy | legitimation | legit check | legitimate program | legitimize | legitimate business | legitimate definition | legit site | legit online banking | legit website | legitimacy definition | pass 4 sure | pass for sure | p4s | pass4sure certification | pass4sure exam | IT certification | IT Exam | certification material provider | pass4sure login | pass4sure exams | pass4sure reviews | pass4sure aws | pass4sure security | pass4sure cisco | pass4sure coupon | pass4sure dumps | pass4sure cissp | pass4sure braindumps | pass4sure test | pass4sure torrent | pass4sure download | pass4surekey | pass4sure cap | pass4sure free | examsoft | examsoft login | exams | exams free | examsolutions | exams4pilots | examsoft download | exams questions | examslocal | exams practice |

www.pass4surez.com | www.killcerts.com | www.search4exams.com | http://smresidences.com.ph/