Reflections on setting up a nurse-led paediatric peripherally inserted central catheter service

Historically, paediatric vascular access in the author's hospital has been performed by medical staff. The most commonly used device has been the peripheral venous catheter (PVC). Other devices used included tunnelled lines (Hickman lines) or totally implanted ports, also referred to as subcutaneously implanted ports. The tunnelled lines and the subcutaneously implanted ports are inserted in theatre under general anaesthesia using fluoroscopy. The rationale for escalation from use of a PVC to a tunnelled line or implanted port, and assessment for the need for short- or long-term vascular access, was inconsistent and there was no strategy to recognise a patient's potential need for vascular access at an earlier point in their patient journey. More recently, the hospital introduced an algorithm on the use of vascular access devices to aid this escalation process.

The Trust intravascular team (IV team), which provides an adult line service, has the aim of providing the right line for the right patient at the right time, to support vessel health and preservation (Moureau et al, 2012). As a member of the Trust's IV team and a paediatric nurse by background, the author was aware of a number of requests for paediatric vascular access made to the adult service. This prompted the aim of establishing a nurse-led paediatric IV service.