Effect of Ultrasound-Guided Placement of Difficult-to-Place Peripheral Venous Catheters: A Prospective Study of a Training Program for Nurse Anesthetists

TY - JOUR

T1 - Effect of Ultrasound-Guided Placement of Difficult-to-Place Peripheral Venous Catheters

T2 - A Prospective Study of a Training Program for Nurse Anesthetists

AU - Partovi-Deilami, Kohyar

AU - Nielsen, Jesper K.

AU - Møller, Ann M.

AU - Nesheim, Sara-Sophie S.

AU - Jørgensen, Vibeke L.

PY - 2016

Y1 - 2016

N2 - Patients with difficult intravenous access (DIVA) often experience discomfort because of failed attempts to place peripheral venous catheters (PVCs); however, ultrasound guidance may improve this problem with catheter placement. The aim of this study was to evaluate the use of ultrasound when operated by nurse anesthetists for these patients. This prospective observational study with a pre/post design focused on inpatients with DIVA referred for PVC placement, a service provided by nurse anesthetists in most Scandinavian hospitals. The rate of success, procedure time, number of skin punctures, discomfort, catheter size, location, and incidence of central venous catheter placement are reported before and after implementation of a training program and a mobile service using ultrasound to place difficult-to-place PVCs. The success rate increased from 0% (0 of 33 patients) to 83% (58 of 70 patients) with ultrasound. Procedure time was reduced from 20 to 10 minutes, discomfort was unchanged, and the median number of skin punctures decreased from 3 to 2. The incidence of central venous catheter placement dropped from 34% to 7%. Implementation of a training program and a mobile service in which nurse anesthetists performed ultrasound-guided PVC placement improved the success rate and quality of care in patients with DIVA.

AB - Patients with difficult intravenous access (DIVA) often experience discomfort because of failed attempts to place peripheral venous catheters (PVCs); however, ultrasound guidance may improve this problem with catheter placement. The aim of this study was to evaluate the use of ultrasound when operated by nurse anesthetists for these patients. This prospective observational study with a pre/post design focused on inpatients with DIVA referred for PVC placement, a service provided by nurse anesthetists in most Scandinavian hospitals. The rate of success, procedure time, number of skin punctures, discomfort, catheter size, location, and incidence of central venous catheter placement are reported before and after implementation of a training program and a mobile service using ultrasound to place difficult-to-place PVCs. The success rate increased from 0% (0 of 33 patients) to 83% (58 of 70 patients) with ultrasound. Procedure time was reduced from 20 to 10 minutes, discomfort was unchanged, and the median number of skin punctures decreased from 3 to 2. The incidence of central venous catheter placement dropped from 34% to 7%. Implementation of a training program and a mobile service in which nurse anesthetists performed ultrasound-guided PVC placement improved the success rate and quality of care in patients with DIVA.

KW - Administration, Intravenous

KW - Catheterization, Peripheral

KW - Education, Nursing

KW - Humans

KW - Nurse Anesthetists

KW - Prospective Studies

KW - Ultrasonography, Interventional

KW - Journal Article

M3 - Journal article

C2 - 27311149

SN - 0094-6354

VL - 84

SP - 86

EP - 92

JO - A A N A Journal

JF - A A N A Journal

IS - 2

ER -