Ultrasound-Guided Peripheral Intravenous Catheter Insertion
As more and more patients in the world are receiving medical treatment via intravenous infusions, the task of establishing a reliable form of vascular access becomes more challenging. With the advent of improved technology of ultrasound and vein visualization technology clinicians are embracing the ability to find veins and effectively guide needles into the veins in real time. All levels of clinicians, nurses, doctors, junior doctors, and medical students are using visualization technologies, with and without prior training, and with much variability in the supplies used for the ultrasound guided peripheral catheter insertion (UGPIV) procedures.
Understanding variations in practice and how they might affect patient risk and safety was the focus of a recent survey with more than 1400 respondents. Questions measured usage of supplies for the insertion of peripheral catheters that incorporated ultrasound guidance. The supplies evaluated in the survey included intravenous start kits, transducer/probe covers and dressings, skin antisepsis, gloves, and types of gel used for procedures. Results reported comparison of types of supplies used and those considered important; departmental variations in supplies used between vascular access specialist, emergency department and other clinicians. Results were then applied to current recommendations to evaluate effective application of the guidelines.
Much variation was noted in each department and between the specialties suggesting the need for improvement in guideline application, standardization of UGPIV policies, and measurement of compliance within all inserters. The results of the survey clearly demonstrate the need for heightened attention to this invasive procedure with opportunities for performance improvement leading to standardization in UGPIV insertions. Patient safety concerns, along with the need for heightened attention to the aseptic technique used during UGPIV insertion procedures, make the results of this survey pertinent. Complete results are pending for upcoming publication in the Journal of the Association for Vascular Access (https://meridian.allenpress.com/java) Fall 2020 edition.
Nancy Moureau, PhD, RN, CRNI, CPUI, VA-BC
PICC Excellence, Inc
Celebrating the year of the nurse 2020
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