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Keywords

Critical care nurse education, Ultrasound peripheral intravenous ICU nurse training

 

Authors

  1. Bagley, Kimberly DNP, RN, AGPCNP-BC, AGACNP-BC, CCRN

Abstract

Background: Ultrasound-guided (US-guided) peripheral intravenous (PIV) insertion is a skill used by specially trained nurses for patients with difficult vascular access. It can result in potential complications such as occlusive thrombus, phlebitis, infiltration, and pain. Complications can be prevented or minimized with clinical training to achieve competency. Current research shows that the most effective approach to US-guided PIV training consists of a comprehensive structured educational program that includes didactic, hands-on training and skills application.

 

Objectives: This study aimed to develop and implement a US-guided PIV education program for critical care nurses.

 

Methods: Structured education was developed using a step-wise method. Critical care nurse practitioners in the intensive care unit (ICU) developed training materials including hands-on training, ultrasound reference material, and supervised skills application. Afterward, US-guided PIV-trained critical care nurses were enabled to train other nurses in the ICU.

 

Results: The total number of US-guided PIV-trained registered nurses in the ICU increased from 5.8% to 26% of staff, but represents only 20% of those trained at current staffing levels. The percentage of US-guided PIV-trained nightshift/weekend staff increased from 3.9% to 24%, but represents 14% at current staffing levels. One hundred five US-guided PIVs showed a 97% success rate of US-guided PIV placement during an 11-month timeframe, similar to success rates published in the literature that ranged from 86% to 100%. There was 1.9% complication rate for occlusive thrombus, which is below published rates ranging up to 10%.

 

Discussion: Critical care nurse practitioners in the ICU collaborated with vascular nursing and hospital clinical education to successfully develop and implement a US-guided PIV training program to meet patient needs within a growing community facility. The results of the training program yielded similar success and complication rates as those reported in the literature. Ongoing training is essential for program sustainability.

 

Conclusions: Critical care nurse practitioners training registered nurses in US-guided PIV placement is an effective approach to training. Critical care nurses trained in US-guided PIV insertion can safely and effectively train other critical care nurses in US-guided PIV insertion.