For something so routine, vascular access carries a disproportionate amount of clinical risk. Peripheral IVs are placed countless times a day across every hospital unit, yet the variability in skill, outcomes, and oversight remains significant. For clinicians at the bedside, this often translates into repeated insertion attempts, delayed therapies, and preventable complications.
This is exactly the gap that Vascular Access Teams (VATs) were designed to address.
The Hidden Complexity of “Routine” IV Access
It’s easy to underestimate IV placement because of how frequently it’s performed. Globally, conservative estimates suggest that more than 1.2 billion peripheral IV catheters (PIVCs) are inserted each year, and at any given time, nearly half of hospitalized patients have some form of vascular access in place.¹,²
But clinicians know the reality is more complicated. Patients with difficult vascular access (DIVA), chronic illness, obesity, or a history of repeated admissions quickly turn a “simple IV” into a time consuming and frustrating process. Multiple failed attempts are not just inefficient—they increase infection risk, damage vessels, and erode patient trust.
In many hospitals, vascular access is still treated as a general nursing task rather than a specialized clinical skill. That variability is where outcomes begin to diverge.
What Changes When a VAT Is Involved
A well-functioning Vascular Access Team brings consistency to an otherwise inconsistent process. These teams are typically composed of highly trained clinicians with expertise in ultrasound guided insertion, device selection, and line management across the continuum of care.
The difference is immediately noticeable in practice. First attempt success rates improve significantly, particularly in patients with difficult access. Instead of multiple blind attempts, clinicians can escalate early to a team that has both the tools and the experience to secure access efficiently.³
More importantly, VATs shift the focus from simply “getting a line in” to choosing the right device from the start. Choosing the appropriate device—whether a standard PIV, extended dwell catheter, midline, or PICC—can positively influence complication rates, support successful therapy completion, and enhance the overall patient experience.³,⁵
Hospitals that invest in VATs consistently report reductions in infiltration, phlebitis, catheter failure, and unplanned line restarts—freeing frontline clinicians to focus on direct patient care rather than troubleshooting access issues.³ ,⁵
Not Every Hospital Has One—and It Shows
Despite the evidence, not all hospitals have formal VATs. Data from multiple health systems suggest that a substantial proportion of hospitals still operate without dedicated vascular access services or rely on informal, non-standardized coverage models.³
In those environments, the burden falls back on bedside staff, often without clear escalation pathways or advanced training. The result is predictable: more variability, more delays, and more complications.
Building a VAT: What Actually Matters
From a clinical perspective, building a VAT is less about structure on paper and more about how the team integrates into daily workflow.
The most successful programs begin by identifying where breakdowns already exist—frequent failed IV attempts, delays in therapy, or high complication rates. From there, the team’s scope is defined clearly: not just inserting lines, but guiding device selection, supporting difficult access, and standardizing care.
This approach aligns closely with the NIVAS framework, which emphasizes that effective vascular access teams are responsible not only for device insertion, but also for assessment, planning, education, surveillance, and governance.⁴ By shifting accountability from individual clinicians to a specialized service, hospitals can reduce variation and improve first attempt success.
Training is a major differentiator. Ultrasound guided insertion and early escalation pathways (such as a two-attempt rule) significantly change outcomes for patients who would otherwise require repeated attempts or unnecessary escalation to central access.³ ,⁴
Equipping the team appropriately—with ultrasound devices, modern catheter options, and standardized protocols—is what allows them to function efficiently rather than as a bottleneck.⁵
Initial Steps to Consider
- Identify staffing and training needs
- Define roles and responsibilities
- Standardize clinical protocols
- Incorporate continuous monitoring tools
- Measure outcomes consistently
A Shift in How We Think About IV Access
The role of vascular access in hospitals is evolving. What was once viewed as a basic task is now recognized as a critical component of patient safety and operational efficiency.
Hospitals that continue to treat vascular access as an ad hoc responsibility will continue to see variability in outcomes. Those that invest in specialized teams—and support them with the right technology—are moving toward a more consistent, proactive model of care.
How Continuous IV Monitoring Complements Vascular Access Teams
Even with a highly trained VAT and excellent insertion practices, IV complications such as infiltration and extravasation can still occur between routine visual assessments.
You can learn about the causes of infiltration and extravasation here, as even in the most skilled of hands, adverse events can occur. It’s important to know how they leak outside the vein.
Continuous IV monitoring fills this critical gap.
By detecting early changes at the IV site in real time, continuous monitoring technology gives clinicians actionable insights before complications become visible. This results in:
- Faster intervention
- Reduced severity of infiltration/extravasation
- Better patient outcomes
- Stronger alignment with infusion safety standards
When combined with a dedicated Vascular Access Team, continuous IV monitoring creates a comprehensive safety ecosystem:
VAT expertise ensures optimal insertion and care.
Continuous monitoring ensures ongoing protection between assessments.
Together, they deliver the highest standard of IV therapy safety.
- Alexandrou E, Ray‑Barruel G, Carr PJ, et al.
International prevalence of the use of peripheral intravenous catheters.
Journal of Hospital Medicine. 2015;10(8):530–533.
https://pmc.ncbi.nlm.nih.gov/articles/PMC11227807/ - Fernández‑Fernández I, Parra‑García G, Blanco‑Mavillard I, et al.
Vascular access specialist teams versus standard practice for catheter insertion and prevention of failure: a systematic review.
BMJ Open. 2024;14:e082631.
https://bmjopen.bmj.com/content/14/7/e082631 - Quinn M, Horowitz JK, Krein SL, Gaston A, Ullman A, Chopra V.
The role of hospital‑based vascular access teams and implications for patient safety: a multi‑methods study.
Journal of Hospital Medicine. 2024;19(1):13–23.
doi:10.1002/jhm.13253 - National Infusion and Vascular Access Society (NIVAS).
The Benefits of a Nursing Led Vascular Access Service Team. White Paper. June 2022.
https://vascular-access.files.svdcdn.com/production/images/NIVAS-White-paper-final-27.7.22-ready-for-print.pdf - Rosich‑Soteras A, Bonilla‑Serrano C, Llauradó‑González MÀ, et al. Implementation of a vascular access team and an intravenous therapy programme: a first‑year activity analysis.
Journal of Vascular Access. 2024;26(2):432–440.
doi:10.1177/11297298231220537