Ultrasound-Guided Peripheral Intravenous Catheter Insertion: The Nurse’s Manual

2020 ◽  
Vol 40 (5) ◽  
pp. 38-46
Author(s):  
Lauren Morata ◽  
Mark Bowers

Peripheral intravenous catheter placement is a skill that is used daily in the hospital. However, many nurses face the challenge of cannulating increasingly complex and difficult-to-access vasculature. Although emergency department clinicians have been using ultrasound to facilitate this procedure for the last 18 years, ultrasound-guided peripheral intravenous catheter placement has not been as rapidly adopted in the critical and acute care nursing realms. Given the benefits of this procedure, including increased patient satisfaction and reduced use of central catheters, its use should be encouraged among all acute care clinicians. The aim of this article is to provide the bedside nurse with a basic understanding of the techniques involved in placing ultrasound-guided peripheral intravenous catheters in patients with difficult venous access.

2019 ◽  
Vol 29 (3) ◽  
pp. 245-249 ◽  
Author(s):  
Benjamin Galen ◽  
Sarah Baron ◽  
Sandra Young ◽  
Alleyne Hall ◽  
Linda Berger-Spivack ◽  
...  

BackgroundTraining nurses in ultrasound-guided peripheral intravenous catheter placement might reduce the use of more invasive venous access devices (peripherally inserted central catheters (PICC) and midline catheters).MethodsWe implemented an abbreviated training in ultrasound-guided peripheral intravenous catheter placement for nurses on an inpatient medical unit and provided a portable ultrasound device for 10 months.ResultsNurses on this unit placed 99 ultrasound-guided peripheral intravenous catheters with a high level of success. During the implementation period, PICC and midline catheter placement decreased from a mean 4.8 to 2.5 per month, meeting criteria for special cause variation. In the postimplementation period, the average catheter use reverted to 4.3 per month on the intervention unit. A comparison inpatient medical unit without training or access to a portable ultrasound device experienced no significant change in PICC and midline catheter use throughout the study period (mean of 6.0 per month).ConclusionsThese results suggest that an abbreviated training in ultrasound-guided peripheral intravenous catheter placement for nurses on an inpatient medical unit is sufficient to reduce PICC and midline catheters.


2016 ◽  
Vol 3 (2) ◽  
Author(s):  
Eloise D. Austin ◽  
Sean B. Sullivan ◽  
Susan Whittier ◽  
Franklin D. Lowy ◽  
Anne-Catrin Uhlemann

Abstract Few studies have focused on the risks of peripheral intravenous catheters (PIVs) as sources for Staphylococcus aureus bacteremia (SAB), a life-threatening complication. We identified 34 PIV-related infections (7.6%) in a cohort of 445 patients with SAB. Peripheral intravenous catheter-related SAB was associated with significantly longer bacteremia duration and thrombophlebitis at old PIV sites rather than current PIVs.


2021 ◽  
Vol 6 (3) ◽  
pp. e406
Author(s):  
Vikas N. O’Reilly-Shah ◽  
Amber Franz ◽  
Cornelius B. Groenewald ◽  
Michael Collins ◽  
Lance S. Patak

2020 ◽  
pp. 112972982092982
Author(s):  
James Thomas Cottrell ◽  
Todd Chang ◽  
Jennifer Baird ◽  
Joanna Barreras ◽  
Marsha A Elkhunovich

Objective: To compare the dwell times of ultrasound-guided and non-ultrasound-guided short peripheral intravenous catheters in hospitalized children. Methods: This was a retrospective analysis of data from 256 ultrasound-guided and 287 traditional peripheral intravenous catheters placed in hospitalized children between 1 September2016 and 31 October 2016 at a free-standing children’s hospital with a 10-member vascular access team. A two-sample independent t test and Kaplan–Meier estimator were used to assess differences in dwell times between the ultrasound-guided peripheral intravenous catheters and non-ultrasound-guided peripheral intravenous catheters. Child age, peripheral intravenous catheter location, and subjective difficulty of placement were also analyzed. Results: There was a significant difference in mean hours of dwell time for ultrasound-guided versus non-ultrasound-guided peripheral intravenous catheters (96.06 vs 59.39, p < 0.001). Mean increase in dwell time was 36.68 h (95% CI: [24.14–49.22]). Median dwell times (50% probability of survival) for ultrasound-guided and non-ultrasound-guided peripheral intravenous catheters were 118 h (95% CI: [95–137]) and 71 h (95% CI: [61–79]), respectively. None of the additional covariates were significant predictors of dwell time. Conclusion: Peripheral intravenous catheters placed using ultrasound-guided methods had a significantly longer dwell time than those placed using non-ultrasound-guided methods in a cohort of hospitalized pediatric patients. This is in line with the findings in the adult literature and may suggest a need to increase the use of ultrasound-guided method for peripheral intravenous catheter placement in pediatric practice.


2020 ◽  
pp. 112972982093713
Author(s):  
Carly Blick ◽  
Alexandra Vinograd ◽  
Jamie Chung ◽  
Elizabeth Nguyen ◽  
Mary Kate F Abbadessa ◽  
...  

Objectives: To evaluate if nurses can reliably perform ultrasound-guided peripheral intravenous catheter placement in children with a high success rate after an initial training period. A secondary aim was to analyze complication rates of ultrasound-guided peripheral intravenous catheters. Methods: A database recorded all ultrasound-guided peripheral intravenous catheter encounters in the emergency department from November 2013 to April 2019 including the emergency department nurse attempting placement, number of attempts, and whether it was successful. Patient electronic medical records were reviewed for the time of and reason for intravenous removal. The probabilities of first-attempt successful intravenous placement and complication at successive encounters after an initial training period were calculated. These probabilities were plotted versus encounter number to graph best-fit logarithmic regressions. Results: A total of 83 nurses completed a standardized training program in ultrasound-guided peripheral intravenous catheter placement including 10 supervised ultrasound-guided peripheral intravenous catheter placements. In total, 87% (3513/4053) of the ultrasound-guided peripheral intravenous catheter placed after the training program were successful on the first attempt. The probability of successfully placing an ultrasound-guided peripheral intravenous catheter increased as nurses had more experience placing ultrasound-guided peripheral intravenous catheters (R2 = 0.18) and was 83% at 10 encounters. Twenty-five percent (904/3646) of ultrasound-guided peripheral intravenous catheters had complications, and there was no statistically significant relationship between the number of encounters per nurse and complication rates (R2 < 0.001). Conclusion: Nurses can reliably place ultrasound-guided peripheral intravenous catheters at a high success rate after an initial training period. First-attempt success rates were high and increased from 67% to 83% for the first 10 unsupervised encounters after training and remained high. The complication rate was low and did not change as nurses gained more experience.


2016 ◽  
Vol 17 (4) ◽  
pp. 366-370 ◽  
Author(s):  
Lori A. Stolz ◽  
Anthony R. Cappa ◽  
Michael R. Minckler ◽  
Uwe Stolz ◽  
Ryan G. Wyatt ◽  
...  

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