Transforming Intravenous Access: A Unified, Nurse-Led IVAS Service
Betsi Cadwaladr University Health Board
Introduction:
BCUHB identified a need for a coordinated, nurse-led Intravenous Access Service (IVAS) due to fragmented provision, delayed access, and high complication rates in vascular access. Up to 90% of inpatients require IV access, but failure rates, delays, and a lack of advanced options outside oncology were impacting care quality, safety, and efficiency.
Methods:
A multidisciplinary team co-designed the service using the National IV Access Society (NIVAS) white paper and aligned with BCUHB’s “Living Healthier, Staying Well” strategy and Welsh Government policy. Using Plan-Do-Study-Act (PDSA) cycles, the team piloted and refined the service at Ysbyty Glan Clwyd, establishing electronic referral systems, a Central Venous Access Champions programme, training in ultrasound use, and Wales’ first nurse-led ported line service.
Outcomes:
- Emergency IV access delays reduced from 2.7 days to same-day
- No delays for PICC lines
- 100% positive patient feedback
- Standardised assessment and tracking for all patients
- Estimated £400,000 annual savings through reduced reliance on theatres and radiology
- Improved patient flow, earlier discharges, fewer complications, and enhanced staff morale
Learnings:
Strong stakeholder engagement, co-design, and digital integration were critical. Clear governance and data collection ensured accountability and informed improvements. Earlier economic modelling could have accelerated support for the programme.
What next?
Plans include securing long-term funding, expanding to paediatrics, and extending central line training. The team aims to share learning nationally and continue improving based on data and feedback. The scalable, sustainable IVAS model offers a blueprint for delivering high-quality, equitable vascular access across Wales.
