Outcomes of a simplified ultrasound-guided intravenous program for emergency nurses
Sarah Feinsmith, BSN, RN, CEN; Ryan Huebinger; Michael Pitts, MS, RN, CEN; Emily Baran, MD, RDMS, FACEP; Andrew Ketterer, MD, MA; Sheila Haas, PhD, RN, FAAN
- Sigma Affiliation
Visits vs Downloads
Visitors - World Map
Top Visiting Countries
Top Visiting Cities
Visits (last 6 months)
Downloads (last 6 months)
Popular Works for Feinsmith, Sarah by View
Popular Works for Feinsmith, Sarah by Download
Session E presented Friday, September 15, 2017
Purpose: The purpose of this study was to produce an applicable and economical model of Ultrasound-Guided Intravenous access (USGIV) training and competency for emergency nurses and examine emergency nurse skill acquisition and the impact of this program on all Emergency Department (ED) patients requiring IV access.
Design: The study design was a translational research, quality improvement, prospective single arm pre-post study.
Setting: The study took place at an urban, academic teaching hospital and Level I Trauma Center with over 86,000 Emergency Department visits annually.
Participants/ Subjects: The study was offered to all emergency nurses regardless of skill and experience levels. Thirty-four emergency nurse volunteers with experience levels from 1 year to 30 years enrolled in this IRB approved study over the 7 months it was offered.
Methods: Emergency nurses completed a 4-hour, continuing education (CE) approved USGIV taught by ED resident physicians. Emergency nurses were deemed competent after successful completion of 10 supervised USGIV insertions on patients. Data was collected from a nurse completed USGIV log identifying date, successfulness, procedure time and difficulty levels on a 1-5 Likert scale, IV attempts from the electronic medical record (EMR), post training questionnaires and focus groups. This study analyzes emergency experience levels, course completion rates, USGIV procedure times, difficulty levels, success rates, utilization and the effects on overall IV attempts in the emergency department.
Results/Outcomes: Thirty-four emergency nurses with experience levels of under 1 year to 30 years enrolled in the study, logging 280 USGIV attempts over 7 months. Twelve (35%) of the emergency nurses who attended the training class developed competency in the procedure. The greatest number of successful participants came from the 3-10 years of experience group. Successful cannulation rates were 81% in attempts 1-10, 84% for attempts 11-20, and 96% for attempts 21-30. USGIV procedure times and successfulness varied from 4.74 ± 1.75 minutes and 100% successful when appraised as “very easy” to 15.53 ± 8.18 minutes and 55% successful when assessed as “very difficult.” All patient IV attempts pre and post intervention were examined using two tailed T test (n=24471). The mean number of IV attempts per IV site decreased by 2%, P=0.013. DIVA patients with ≥ 2 failed IV attempts experienced a 7% decrease in IV attempts, P=0.003. Patients with an USGIV placed by an emergency nurse experienced a 28.02% reduction in IV attempts compared to physician placed USGIVs (P=< 0.0001). Qualitative data from focus groups and surveys will be described in a follow-up paper.
Implications: An emergency nurse USGIV training program can decrease total number of IV attempts, especially for DIVA patients, and decrease cost of IV supplies. A simplified and economical USGIV training program for emergency nurses can be successful and completion outcomes are dependent on level of prior nursing experience and individual emergency nurse motivation. Training environment with high demand for IV placement would benefit rapid skill acquisition. A randomized controlled study could more accurately assess emergency nurse versus physician skill in placing USGIVs.
|Review Type||Abstract Review Only: Reviewed by Event Host|
|Keywords||ultrasound-guided intravenous access;
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
All permission requests should be directed accordingly and not to the Sigma Repository.
All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Showing items related by title, author, creator and subjects.
Ultrasound Guided vs. Standard Direct Visualization of Peripheral Intravenous Access in Kilimanjaro Region Emergency Department Stene, Edward C.; Smallheer, Benjamin A.; Jaffa, Elias J.The use of ultrasound is becoming more portable and affordable for healthcare providers. However, there is scant literature on ultrasound use for PIV access outside of developed countries.
Zielinski, Michael II (2017-12-05)Poster presentation Session A presented Thursday, September 14, 2017 Purpose: An Evidence-Based Practice (EBP) change project was designed to educate nurses in the ED on how to recognize, de-escalate, and mitigate violence ...
Outcomes of an Innovative Evidence-Based Project: Building a Difficult Access Team in an Emergency Department Baptiste, Diana Lyn; Maliszewski, Barbara; Whalen, Madeleine; Gardner, Heather; Sheinfeld, Rebecca (2017-07-06)Background/Introduction: Emergency departments across the nation face challenges of longer lengths of stay due to increased volumes and patient acuity. Intravenous (IV) access is vital to emergency care, and a large ...
Shipley, Sarah; Wallis, Frankie; Lovelace, Michael R.; Jones, Tamicka S.; Hardy, SherichiaPoster presentationSession J presented Wednesday, October 2, 11:30 am-12:30 pmPurpose: Opioid use in the United States is on the rise as evidenced by coining of the term the Opioid Epidemic. Effort has been put into ...
Tobiano, Georgia; Marshall, Andrea; Jenkinson, Kim; Ryan, ChristineEmergency department to inpatient unit handover is complex and risky for nurses. Researchers identified the most common barriers to effective emergency department to inpatient unit handover including, "knowledge" and "role ...