Practice Improvement| Volume 44, ISSUE 1, P33-36, January 2018

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Development and Implementation of an Ultrasound-Guided Peripheral Intravenous Catheter Program for Emergency Nurses

Published:August 09, 2017DOI:



      Emergency medical care often necessitates placement of peripheral intravenous (PIV) catheters. When traditional methods for obtaining PIV access are not successful, ultrasound guidance is a rescue technique for peripheral vascular placement that improves the quality of patient care.


      The aim of this training program was to develop a process where emergency nurses would be competent to perform ultrasound guided PIV to improve the quality of patient care delivered while reducing throughput time. Administrative program development required creating a nursing practice statement, procedure guideline, operational plan, and competency validation. A training program comprising both didactic and hands-on training was developed and provided by emergency medicine physicians with formal ultrasound fellowship training.


      In determining whether the training program was adequate in preparing the student to place an ultrasound-guided PIV, 92.9% of students “agreed” or “strongly agreed.” In having confidence in their ability to obtain an ultrasound guided PIV catheter placement, 35.7% of respondents “agreed” and 64.3% “strongly agreed.” In finding it difficult to be successful in achieving ultrasound guided PIV catheter placement, 71.4% of students “strongly disagreed” and 14.3% “disagreed.” All students (100%) felt it was a feasible task to train nurses to successfully place ultrasound-guided PIV catheters and 71.4% of students strongly support continuing to provide this training program and competency validation.


      Establishment of an effective didactic and hands-on training program resulted in emergency department nurses becoming competent in placement of ultrasound guided PIV catheters to provide optimal patient care.
      Contribution to Emergency Nursing Practice
      • Increasing rates of success and decreasing time for placement of vascular access are critical for optimal patient management in the emergency department.
      • When obtaining peripheral intravenous access in the traditional manner has failed, ultrasound guidance is an effective and safe alternative available to emergency nurses.
      • Development of an educational program, including both didactic and hands-on training, can achieve successful competency for emergency nurses in establishing ultrasound-guided peripheral intravenous access.

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      Courtney Edwards, Member, ENA, Dallas County Chapter, is Trauma Outreach Education, Injury Prevention, & Research Manager, The Rees-Jones Trauma Center at Parkland, Parkland Health & Hospital System, Dallas, TX.


      Jodi Jones is Assistant Professor, UT Southwestern Medical Center, Emergency Medicine Faculty Physician, Parkland Health & Hospital System, Dallas, TX.