Vascular Access Specialist Teams Across Australia and New Zealand: A Survey of Workforce Models and Clinical Practice

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AIM: The study's aim is to describe workforce models and practices related to vascular access device (VAD) insertion, maintenance and monitoring across Australia and New Zealand. BACKGROUND: VAD failure is associated with device selection and insertion, factors typically determined by the inserting clinician. However, clinician training and skill in vascular assessment and insertion are often inconsistent and undervalued. DESIGN: A prospective, cross-sectional, internet-based survey of workforce models and vascular access specialist teams (VASTs). RESULTS: Among 237 participants (November 2023 to February 2024), most worked in metropolitan (n = 127; 54.0%) or regional hospitals (n = 54; 23%), caring for adult (n = 227; 95.8%) and/or paediatric (n = 170; 71.7%) patients. One-third (n = 78; 33.0%) had a VAST, primarily comprising clinical nurse specialist/consultants (n = 73; 93.6%), generalist nurses (n = 39; 50%) and anaesthetists (n = 15; 32%). VAD selection was most often performed by medical staff (n = 211; 89.0%), though 29.1% (n = 69) reported VAST-led selection. Escalation pathways for difficult vascular access (DIVA) were more common in facilities with a VAST (n = 65; 83.3%) than without (n = 55; 41.0%). Midline catheter use was higher where VAST were present (76.9% vs. 48.5%). CONCLUSION: VAST presence was associated with greater use of escalation pathways and varied device type/technique such as ultrasound guided-PIVCs and midlines. However, limited staffing restricts the broader implementation of these benefits.

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