Various medical or anatomical conditions can lead to difficult intravenous access (DIVA) in the emergency department. It was hypothesized that developing an emergency nurse-training program could reduce IV attempts in the emergency department, improving throughput and patient care.
Emergency nurses completed a 4-hour ultrasound-guided intravenous (USGIV) access course and achieved competency after 10 successful supervised USGIV insertions on patients. Data were collected from a nurse-completed USGIV log and the electronic medical record. Experience levels, rates of completion, rates of success, and the effects on attempts of IV access were analyzed.
Thirty-four emergency nurses enrolled in the study over 9 months, and 12 (35%) developed competency. Successful cannulation rates improved from 81% for procedure attempts 1 to 10, to 96% for attempts 21 to 30. Overall IV attempts by nurses and physicians (n = 24,471) decreased by 2%, P = 0.013. DIVA IV attempts (n = 1,366) decreased by 7%, P = 0.003.
USGIV training programs can decrease total number of IV attempts. A simplified and economical USGIV training program for emergency nurses can be successful and may be dependent on emergency nurse experience levels and initiative.
Contribution to Emergency Nursing Practice
- •This research evaluates the outcomes of an ultrasound-guided intravenous (USGIV) training program for newly trained emergency nurses on an emergency department’s ability to deliver cost-effective and efficacious care by reducing attempts at IV access in the emergency department.
- •A simplified and economical USGIV program is described, and potential rates of completion and nurses most likely to succeed are identified.
- •USGIV placement is a skill that can be mastered by emergency nurses of all skill levels, including novice emergency nurses.
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Sarah Feinsmith, Member, Illinois ENA, is Education Coordinator, Emergency Department, Northwestern Memorial Hospital, Chicago, IL.
Ryan Huebinger is Emergency Medicine Resident, McGaw Medical Center, Chicago, IL.
Emily Baran is Director of Ultrasound Education, Assistant Residency Program Director and Assistant Professor of Emergency Medicine, Northwestern Medicine, Chicago, IL.
Michael Pitts is Operations Project Manager, Project One, Emergency Department/Observation Unit, Northwestern Memorial Hospital, Chicago, IL.
Sheila Haas is Research Consultant, Northwestern Memorial Hospital, Chicago, IL.
Published online: November 08, 2017
Earn Up To 7.0 Hours. See page 217.
© 2017 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.