The Role of Vascular Nurses and Advanced Practice Providers in Patient Selection and Perioperative Care
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University of Toledo, Ohio
During Sunday’s Nurses and Technologists Symposium at ISET 2025, Karen Bauer, DNP, CWS, FAAWC, the president of the Society for Vascular Nursing and director of Wound and Vascular Services at the University of Toledo in Ohio, presented a session on the critical role that vascular nurses and advanced practice providers (APPs) play in patient selection, perioperative care, and overall vascular disease management. She emphasized the need for interdisciplinary collaboration, enhanced access to vascular care, and strategies to optimize patient outcomes through the expertise of trained vascular nurses and APPs.
Vascular nurses and APPs fill gaps in vascular care, improving patient outcomes while addressing physician shortages and time constraints, Dr. Bauer said. They function as clinical liaisons, patient educators, perioperative managers, and risk factor interventionists. Unfortunately, APPs in vascular care remain underutilized, with only 6% of APP training related to vascular topics.
Dr Bauer outlined the challenges in managing patients with vascular disease, including the fact that these patients are often multimorbid and frail, and require careful risk factor modification (RFM) and coordinated care. Education is also a challenge; a lack of time and financial investment in vascular nursing and APP programs leads to missed opportunities. Another challenge is that one-third of patients with peripheral arterial disease do not receive guideline-directed medical therapy (GDMT), smoking cessation support, or appropriate lifestyle modifications.
Vascular nurses and APPs can enhance access to vascular care, she explained, as timely triage and evaluation by vascular nurses and APPs reduce delays in care for critical conditions such as chronic limb-threatening ischemia (CLTI). Specialized vascular training enables APPs to provide comprehensive pre- and post-operative care, improve efficiency in clinic visits, and optimize procedural planning.
Dr Bauer reviewed the ways that vascular nurses and APPs can provide preoperative, intraoperative, and postoperative care for these patients. Preoperative care roles that these nurses can play include coordinating lab tests, medications, and imaging; providing patient education and consent management; and aiding in surgical planning such as IV access, equipment, and logistical coordination. RN First Assistants (RNFAs) with a vascular focus, specialized knowledge of vascular devices, and wound care expertise can provide intraoperative support for these patients. Postoperative management roles include immediate recovery monitoring, medication reconciliation and discharge planning, patient and family education, and outpatient follow-up coordination.
Vascular nurses and APPs can also provide specialized interventions and expanding responsibilities, she said. Endovenous therapy and vein procedures are increasingly performed by APPs, with APP-led procedures growing by 62% annually. Wound care is a key area where these nurses improve patient outcomes.
Dr Bauer emphasized the importance of improving care coordination and standardizing vascular nursing by increasing mentorship and certification programs for vascular APPs and nurses, having standardized clinical protocols for perioperative care, and integrating APPs into vascular care teams to increase consultation time per patient.
