Table 6. Neonatal VAT Training, Evaluation, and
Responsibilities
1. After receiving training, who may be a proceduralist on a Neonatal VAT?
• Neonatal nurse practitioners, registered nurses (in accordance with State Board
of Nursing scope of practice), neonatal fellows with appropriate supervision,
neonatologists
2. What should clinical training and education for proceduralists include?
• Indications and contraindications of PICC placement
• Increased awareness of pain management
• Knowledge of the anatomy of venous and arterial systems
• Maintenance of the sterile insertion bundle
3. What knowledge and clinical competencies should a proceduralist be able to demonstrate
after training?
• Knowledge of published guidelines and standards of infusion therapy
• Appropriate catheter care and maintenance
• Ability to recognize and manage complications
• Successful placement of at least 5 PICC lines
4. How many procedures should a proceduralist perform to maintain competency?
Proceduralists should consistently perform a requisite number of procedures, as defined
by the local facility's delineation of privileges. At a minimum, a proceduralist should
perform 5 successful PICC insertions per year.
5. What are examples of quality measures that a VAT should monitor?
• Success rate of individual proceduralists
• Rates of complications (CLABSI, thrombus, pericardial and pleural effusions, etc.).
• Confirmation of final line location via radiographic imaging or point-of-care
ultrasound
6. What additional responsibilities might a VAT handle?
• Troubleshooting and managing complications
• Providing formal and informal staff education-related to care and maintenance of
central lines
• Performing catheter site surveillance and dressing changes
• Discussing removal of PICC line when patient reaches 120 mL/kg/day of enteral
intake
