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Exam Number : VACC
Exam Name : VACC Vascular Access
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VACC exam Format | VACC Course Contents | VACC Course Outline | VACC exam Syllabus | VACC exam Objectives


DOMAIN CATEGORY I: Clinical Knowledge and Application

A. Device Assessment and Selection

1. Central venous access devices

2. Peripheral intravenous devices

3. Dialysis, apheresis and aquapheresis catheters

4. Intraosseous devices

5. Arterial catheters

6. Pulmonary artery catheters

7. Device characteristics (e.g., single versus multi-lumen devices, optimal insertion and tip location)

B. Patient Assessment

1. Vascular pathology (e.g., impact of disease processes on vascular access)

2. Device selection (e.g., infusion therapy, alternative to IV placement, vesicants and osmolality)

3. Patient specific characteristics (e.g., compromised skin integrity, product reaction) and resources to maintain vascular access devices

4. Imaging technology (e.g., ultrasound, transillumination, fluoroscopy / venogram, chest x-ray)

C. Preparation

1. Infection prevention procedures, concepts and principles (e.g., sterile field, aseptic non-touch technique [ANTT], common pathogens)

2. Anatomy and physiology

3. Growth and development implications

DOMAIN CATEGORY I (continued): Clinical Knowledge and Application

D. Insertion

1. Vascular access device and insertion components

2. Insertion techniques (e.g., Modified Seldinger)

3. Flushing and locking solutions / procedures

4. Imaging technology (e.g., ultrasound, infra-red, transillumination)

5. Laboratory values relevant to device placement and maintenance

6. Tip location and confirmation systems

7. Engineered securement devices

8. Complications and emergency interventions (e.g., inadvertent arterial puncture, pneumothorax, catheter tip malposition, nerve injury)

E. Care and Maintenance of Vascular Access

1. Insertion / exit site exam

2. Lumen patency and catheter clearance (e.g., flushing protocol, occlusion therapy)

3. Infusion equipment and add-on supplies (e.g., needleless connector)

4. Dressing change procedure

5. Patient / caregiver education

6. Care plan throughout the healthcare continuum (e.g., catheter insertion information, care and maintenance instructions, patient restrictions)

7. Vascular access device removal (e.g., removal length of PICC, removal complications, patient tolerance of removal procedure)

F. Troubleshooting, Complications, and Interventions

1. Post-insertion risks and complications (e.g., extravasation, thrombosis, infection, catheter tip migration, occlusion, nerve damage, phlebitis)

2. Pharmacologic interventions (e.g., catheter clearance, antibiotic lock, ethanol lock, extravasation treatment)

3. Catheter repair / exchange

4. Other complications (e.g., central vein occlusion, internal fracture, compromised skin integrity)

DOMAIN CATEGORY II: Interpersonal and Communication Skills

A. Interpersonal Communication

1. Communication with patient / caregiver (e.g., risks, benefits and alternatives; device care; infection prevention)

2. Communication with patient / caregiver with additional needs (e.g., developmental/ cognitive deficit, psychosocial concerns)

3. Cultural competency (e.g., cultural and religious differences, family involvement, language barrier)

4. Collaboration with patient's care team

B. Mentoring and education

1. Educational / staff development opportunities (e.g., quality improvement, hospital committees, early exam for vessel preservation)

2. Infection control measures and techniques

DOMAIN CATEGORY III: Professional Development

A. Evidence-based Practice and Continuing Education

1. Evidence-based practice guidelines (e.g., AVA, INS, MAGIC, KDOQI, ACCP, SHEA)

2. Process improvement initiatives and outcome evaluation (e.g., implementation of new techniques and / or products)

3. Professional practice and development (e.g., seminars, webinars, conferences, certification)

4. Critical analysis of published research (e.g., research methodologies)

DOMAIN CATEGORY IV: Legal and Ethical Considerations

A. Legal Considerations

1. Professional codes of conduct, professional guidelines, scope of practice and standards of care

2. Legal principles in the practice of vascular access (e.g., consent, liability, HIPAA)

3. Documentation requirements

4. Manufacturer's guidelines for product use (e.g., Instructions for Use [IFUs], expiration dates, off-label use)

B. Ethical Considerations

1. Patient advocacy (e.g., patient preferences, end of life care)

2. Reporting requirements (e.g., MAUDE database, Joint Commission [JC], state health department)

3. Fiscal responsibility (e.g., accurate recording of charges, use of supplies and equipment, use of time)



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could researchers enhance a vaccine to reduce dangerous ldl cholesterol? | Killexams.com Resources

  • All americans want some ldl cholesterol, but having too excessive cholesterol levels can also be bad, principally to areas of cardiovascular health.
  • research is ongoing to discover new the right way to support people hold cholesterol within a match latitude.
  • data from a contemporary examine on animals discovered a vaccine that can be beneficial at lowering cholesterol.
  • Future analysis is required before this facts will also be applied in clinical apply with people.
  • levels of cholesterol outdoor a suit range will also be bad for heart health, however what alternatives exist for reducing ldl cholesterol?

    Most frequently, americans can manipulate cholesterol levels through changing add-ons of their way of life or taking definite medicinal drugs. youngsters, the options for assistance with cholesterol administration may well be increasing.

    A examine posted in npj vaccines examined the effectiveness of a cholesterol-lowering vaccine.

    The study checked out mouse and nonhuman primate models, and located that a bivalent vaccine without difficulty decreased levels of cholesterol.

    The results factor to promising analysis and the knowledge building of an extra technique to support people retain cholesterol in a in shape latitude.

    analyze creator Dr. Bryce Chackerian, Regent’s professor of molecular genetics and microbiology at the tuition of new Mexico faculty of drugs, explained the reasoning in the back of the analysis to scientific information these days.

    “The typical medicines to treat increased cholesterol are statins,” he advised us. “despite the fact, statins don’t work for all and sundry, and a few patients on statins experience facet consequences.”

    “currently, a new type of medication, known as PCSK9 inhibitors, had been approved to lessen cholesterol. PCSK9 inhibitors are very effective at decreasing cholesterol, however lamentably they're also very expensive, which has limited their use. They had been interested in developing a lessen-cost vaccine-based method for inhibiting PCSK9. The theory at the back of this strategy is that the vaccine induces antibodies in opposition t PCSK9, which then lessen cholesterol levels.”

    – Dr. Bryce Chackerian

    The analysis notes that the body eliminates low-density lipoprotein (LDL) cholesterol, also referred to as “unhealthy” cholesterol, by way of the low-density lipoprotein receptor (LDL-R).

    The protein PCSK9 helps inhibit this procedure, as a consequence leading to greater degrees of LDL ldl cholesterol within the bloodstream. There are just a few how you can inhibit PCSK9 — one potential means is through a vaccine.

    The examine explored the efficacy of these skills vaccines in monkeys and mice. The researchers looked on the effectiveness of two PCSK9 vaccines: single and bivalent.

    They found that single and bivalent vaccines decreased levels of cholesterol amongst mice. youngsters, the only vaccine type didn't lower LDL ldl cholesterol to a statistically massive stage.

    among monkeys, researchers had been in a position to carefully measure levels of cholesterol over time to assist test vaccine efficacy. They also established how the vaccines labored in aggregate with statins.

    They found that the bivalent vaccine become useful in decreasing LDL ldl cholesterol. although, the only vaccine changed into no longer useful on its own and had to be combined with statins to be valuable.

    Dr. Chackerian, Ph.D. defined: “In their analyze, they recognized a vaccine that dramatically lowers ldl cholesterol in two different animal species. In monkeys, for example, vaccination ended in a 30% discount in LDL levels of cholesterol, without requiring statins. Importantly, the vaccine additionally had long-lasting effects on levels of cholesterol, meaning that it is likely that sufferers would not need normal injections.”

    is this anti-ldl cholesterol vaccination regime more likely to be helpful in humans? firstly, the researchers be aware that their analyze focused on animals, so greater research is required earlier than medical doctors might use the vaccine in scientific apply with human sufferers.

    The researchers also mentioned that the typical baseline of LDL cholesterol in the monkeys become common, which could have restrained how a lot LDL turned into reduced.

    it's also no longer completely clear why the bivalent vaccine turned into extra valuable within the monkeys, so here's another enviornment for researchers to explore.

    The analysis also blanketed a small number of monkeys, that means future reports could consist of larger trial organizations. more analysis is needed to verify the vaccine’s lengthy-term effectiveness and the abilities want for boosters.

    moreover, the study authors be aware that the experimental vaccine of their look at became less valuable than different ldl cholesterol-lowering strategies. on the other hand, they element out that even decreasing ldl cholesterol by using a small amount can play an important position in decreasing cardiovascular activities.

    Dr. Richard Wright, a board-licensed heart specialist at windfall Saint John’s fitness core in Santa Monica, CA, who became no longer worried within the current research, commented on the findings, offering right here phrases of caution:

    “alas, there are inadequate information to demonstrate how lengthy, or notwithstanding, this classification of vaccine would lessen the LDL in humans. The larger difficulty is the magnitude of advantage: no vaccination has been shown to be as valuable as current remedies, and in this latest study, the magnitude of LDL reduction is less than what's potential with current not pricey statin drugs and much lower than received with administration of exogenous monoclonal antibodies or RNA therapeutics.”

    nevertheless, if analysis moves ahead in this area, it may be incredibly a good idea for individuals at a more robust possibility for problems from excessive ldl cholesterol. And it may well be probably used in combination with other remedies.

    Dr. Cheng-Han Chen, board-certified interventional heart specialist and scientific director of the Structural heart application at MemorialCare Saddleback medical center in Laguna Hills, CA, also not involed in the look at, referred to that “[t]he skills scientific benefit of any such vaccine would be colossal.”

    “latest PCSK9 inhibitors in medical use, whereas extraordinarily efficacious, are very costly. moreover, these therapeutics require pursuits administration. A vaccine-based concentrated on of PCSK9 might doubtlessly provide long-lasting reducing of LDL degrees with a longer period of effect. this would decrease fitness care costs for the device whereas enhancing cardiovascular results,” he delivered.

    As cited via the centers for disease handle and Prevention (CDC), the liver is the organ that produces ldl cholesterol. Chlesterol is essential for the creation of definite hormones and the digestion of meals high in fats.

    there's also ldl cholesterol in definite meals. the two leading kinds of ldl cholesterol are LDL ldl cholesterol and high-density lipoproteins (HDL) cholesterol.

    LDL ldl cholesterol is once in a while known as “bad” ldl cholesterol as a result of when levels of it within the body get too excessive, it will probably raise the risk of coronary heart assault and stroke.

    definite culture decisions can enhance the chance of excessive cholesterol, comparable to eating a food plan high in saturated fat, not exercising always, and smoking.

    individuals could make lifestyle and dietary alterations to help lessen their levels of cholesterol. they can also take medicines like statins to help reduce levels of cholesterol.

    however even with these interventions, cholesterol can nevertheless be a challenge to preserve in a fit range. here's why it is important that researchers proceed to explore potential new how you can manipulate levels of cholesterol.


     

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