We have decided that it is time to start a debate in Poland on the implementation of vascular access strategies, its proper care and the full use of the potential of healthcare providers.

The Midline Academy is the place for the idea of improving the quality of vascular access care in its complexity: from proper qualification, to safe and comfortable cannulation for the patient, to proper handling for maintaining the vascular catheter for as long as the intravenous therapy lasts. The Midline Academy brings together people who are leaders in their local centres and are committed to the best care for the patient with an IV cannula of any type.

Why did we decide to implement infusion team concepts in our centres?

The reasons were the same as in any country. Numerous cannulations, numerous hospitalisations and therefore difficult intravenous access. This was the trigger when we realised how many central catheters, and therefore the complications associated with them, we were able to avoid. Lynn Hadaway 2021 wrote about this. Working in a large hospital, we observed that everyone was playing their own game, that there was a problem with implementing strategies and thinking about the patient and their future in terms of vascular access. It is sad to admit, but the quality of vascular access care was not the best either.

But in order to change this, a diagnosis had to be made. This is of course due to the general problems in Poland – there is not yet a specialisation field in Poland: infusion nursing. It is customarily dealt with by anaesthesia nurses and anaesthesiologists. There are situations where, as medics, we place another PIVC and eventually, when there is no other option left, we have to introduce a CVC. We decided to change that. At the same time, it’s hard to ask people to think about strategy when they don’t have real support in access selection and infusion management. There was a strong need for a team when we started to be aware of the possibilities.

What steps have we taken?

It all started in the COVID-19 pandemic, it was 2020, and we were running an intensive care unit for COVID-19 patients in an atmosphere of great stress, an organisational effort of PPE. Many patients had no other problems apart from respiratory failure and therefore rarely required central access. Their condition on the ward deteriorated suddenly and reliable intravenous access was needed by everyone, but not always central access. Dr Bartosz Sadownik and Maciej Latos, M.D., wondered how the world was coping with these problems, to which the pandemic gave contrast? We began a careful reading of US and UK guidelines and decided to spread the use of midline catheters.

What adversities have we encountered?

There was basically no widespread distribution of this type of cannula in Poland, but we managed to import some samples. We started reading, looking for protocols, observing patients and staff. The solution worked well. In Poland, nursing competence is very unstructured and we were faced with the dilemma of whether midline insertion could be carried out by nursing staff. We wrote to national consultants, to scientific societies. We got the green light. We created a procedure, started proposing midline as an alternative to CVC when the only indication was difficult intravenous access. Implantation was handled by the interventional team, which until then had been helping patients and nurses with cases of difficulty with cannulation. The first Vascular Access Team was established at the University Clinical Centre Central Clinical Hospital of the Warsaw Medical University. This was followed by the Czerniakowski Hospital in Warsaw. Further teams to which we have been able to pass on our experience are being established in Poland.

We started a debate on the need to develop the field of Infusion Nursing in Poland, through training, webinars, social media. It turned out that medics see the problem, only it was standing still.

What are the current benefits of having a vascular access team?

Patients, nurses and doctors receive real support. This ranges from choosing the right vascular access to infusion dilemmas and infusion education. Every day, Monday to Friday, one person is on call at all times. She helps choose the right vascular access, implants midline and pivc, helps solve dilemmas and trains staff. Patients know us, especially those who return for treatment, and often suggest contacting us themselves because they know it’s difficult with them, that they will get real help. That this is not to detract from the competence of the staff dealing with them just a strategy.

We are now passing on our experience to anyone interested in the concept of implementing the right access for the right patient with the proactive involvement of healthcare providers.

We train staff from Poland and Europe and take part in national and international training ourselves.

Members of the Midline Academy during the exchange of experiences in Prague at the 8th World Congress on Vascular Access (WoCoVA).

We provide training in cooperation with the Polish Society of Infusion Nursing and the Centre for Simulation and Medical Innovation of the Warsaw Medical University, as well as with any partner who wishes to engage in educational activities.