A medical procedure traditionally performed by anaesthetists in operating theatres is now being administered by nurse practitioners at the patient’s bedside, significantly reducing the time patients spend in the hospital and with improving their patient journey.
The procedure involves the insertion of a midline – a flexible tube around 15-25cm long – into a large vein in the upper arm using ultrasound guidance. This tube allows for intravenous infusions, such as antibiotics, and can remain in place longer, enabling treatment at home or in a community setting.
Previously, midlines were inserted under anaesthetists’ supervision in a theatre.
Bedside procedure
However, a team of nurse practitioners and advanced clinical practitioners at North Tees and Hartlepool NHS Foundation Trust has now been trained to perform this procedure at the bedside.
Nanette Parkin, senior clinical matron at the University Hospital of North Tees, explained: “For patients requiring long-term treatment, this innovation can reduce their hospital stay, allowing them to recover at home with support from community-based clinical teams.”
The new midline service was developed by trust colleagues who saw an opportunity to help patients safely return home sooner. Training, led by consultants and senior staff, ensures the highest standards of care in midline insertion.
Long term vision
Karen Kelsey, senior clinical matron, added: “Our long-term vision is for this to become integral to all our practitioner’s roles to support the medical teams in delivering this aspect of care.
“We’re currently in discussions to support delivering this training to the community teams so that some patients won’t even need to be admitted to the hospital for midline insertion. This will save patients’ time, free up hospital appointments for others and ultimately improve the delivery of patient care.”