When we say that vascular access takes a team, we mean it. It takes floor nurses, interventional radiologists, physicians, infection preventionists, and more just within the hospital. When a patient goes home with their device, the patient or their caregivers step up. That’s where the important role of a pharmacist comes in.
Infusion pharmacists see patients with long-term vascular access devices. They work with providers to coordinate orders, prepare sterile products, and make sure the patients leave with the right medications and supplies.
Because these patients live for months or years with these devices, they are often capable of administering their own care independent of their nursing team. The pharmacist then becomes the health care provider they see most. The pharmacist may provide care for years and with multiple vascular devices.
And, as Brenda Gray, PharmD, CNSC, BCNSP, CVAA(c), VA-BC, BCSCP, FASPEN, explains, it becomes the pharmacist’s duty to be knowledgeable about vascular access to best take care of these patients.
“I don’t want to do the nurses’ role. I want to be part of the team that takes care of the patient,” said Dr. Gray.
Where pharmacists fit in
Dr. Gray, senior clinical director at a pharmacy consulting company, confirmed the need for infusion pharmacists to have this advanced knowledge when she received her own central line.
“It was in getting my lines that I realized how little training I had and how much more there was that I needed to know to be an appropriate clinician for these patients,” she said. “I was looking around and realizing that I was the specialist those patients depended on. I must ensure I have the information to keep them safe.”
When they have the appropriate education, pharmacists can help spot a compromised device. They can answer questions a patient has about their care, especially since insurance may not cover all nursing visits for some patients. And, maybe most importantly, they can advocate for the patient if they need additional care outside of a pharmacist’s abilities.
“I can’t go back and make it go away. I may not be able to provide a remedy. But I can certainly identify it before it becomes septic shock and life threatening,” she explains. “I am their safety net.”
Getting started and staying up-to-date
Getting a start in vascular access has a learning curve according to Dr. Gray, but it does not have to be steep. Start by partnering with nurses to learn the basics. For infusion pharmacists especially, look at the supplies you send out: What role does each supply play? What do you do if you don’t have one of them? And what kind of lines require which supplies?
Then, keep going in your education by attending vascular access or infusion-related webinars and conferences. When they are ready, Dr. Gray encourages pharmacists to gain additional certifications like the Vascular Access-Board Certified™ credential.
“The VA-BC™ gives me validation and also credibility when I speak to the providers that many pharmacists don’t have. It shows the team that I have the foundation to voice valid concerns and provide guidance.”
Dr. Gray immerses herself in continued education for her patients. She remembers patients who ran out of access options and entered hospice therapy. Her involvement in vascular access and infusion spaces equips her with the tools to help patients like these whose long-term access is their lifeline.
“By staying current – making sure I’m staying current in the literature and the practice and in my teachings – then at least I might prevent one of those in the future.”
She compares it to the story of starfish flooding a beach after a storm. It might seem like a small act to throw a starfish back into the ocean when so many have washed ashore, but it makes a difference to those few that get a second chance.
“You might not save them all, but to that one it matters. To that patient, it matters.”
