Performance of peripheral catheters inserted with ultrasound guidance versus landmark technique after a simulation-based mastery learning intervention

Sarah E. Feinsmith, Ashley E. Amick, Joseph M. Feinglass, Jordan Sell, Evan M. Davis, Timothy R. Spencer*, Lydia Koepke, Jeffrey Pastoral, Diane Bronstein Wayne, Jeffrey H. Barsuk

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Problem: Ultrasound-guided peripheral intravenous catheter (USGPIV) insertion is an effective method to gain vascular access in patients with difficult intravenous access (DIVA). While USGPIV success rates are reported to be high, some studies have reported a concerning incidence of USGPIV premature failures. Aims: The purpose of this study was to compare differences in USGPIV and landmark peripheral intravenous catheter (PIV) utilization and failure following a hospital-wide USGPIV training program for nurses. Methods: The authors performed a retrospective, electronic medical record review of all USGPIVs and PIVs inserted at a tertiary, urban, academic medical center from September 1, 2018, through September 30, 2019. The primary outcome was differences between USGPIV and PIV time to failure. Results: A total of 43,470 short peripheral intravenous catheters (PIVCs) were inserted in 23,713 patients. Of these, 7972 (16.8%) were USGPIV. At 30 days of follow-up, for PIVCs with an indication for removal documented, USGPIVs had higher Kaplan–Meier survival probabilities than PIVs (p < 0.001). Conclusions: The use of simulation-based mastery associated with USGPIVs, demonstrated lower failure rates than standard PIVs after 2 days and USGPIVs exhibited improved survival rates in patients with DIVA. These findings suggest that rigorous simulation-based insertion training demonstrates improved USGPIV survival when compared to traditional PIVCs. SBML is an extremely useful tool to ensure appropriately trained clinicians acquire the necessary knowledge and skillset to improve USGPIV outcomes.

Original languageEnglish (US)
JournalJournal of Vascular Access
DOIs
StateAccepted/In press - 2021

Keywords

  • device failure
  • difficult intravenous access
  • outcomes
  • simulation
  • Ultrasound
  • venous access

ASJC Scopus subject areas

  • Surgery
  • Nephrology

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