Viability of Ultrasound Guided Peripheral IV Insertion: Characteristics of Patients and Outcomes

Purpose:
The purpose of this study is to determine the viability of ultrasound guided peripheral IV insertion in the in-patient settings. Descriptive characterisitics were compared to success rate, catheter dwell times and central line use in order to determine outcomes.

Significance:
IV access is a routine nursing practice in healthcare settings that may result in complications, pain and need for central lines when traditional methods fail. Incorporating current technology into nursing practice may reduce complications and improve patient outcomes.

Strategy and Implementation:
This is a quantitative, quasi-experimental study. IRB approval was obtained. Key personnel were educated on the use of an ultrasound machine to assess peripheral vasculature and how to use it to visualize peripheral IV insertion. Subjects where referred by RNs' who believes patient to be difficult for IV access or had failed IV access attempts. Participants are then educated through verbal discussion regarding the purpose of the ultrasound and the procedure. Assessment for potential sites using the ultrasound was then performed. IV insertion with ultrasound guidance is then attempted choosing the appropriate catheter size and length. The insertion success rate, catheters dwell time and the need for central line was tracked.

Evaluation:
Success was measured through successful IV insertion, catheter dwell times and decreased requirement for central lines. The overall insertion success rate was 92.8%. There is a small negative relationship with significant association(p=0.007) between central line use and successful insertion.

Implications for Practice:
Ultrasound is an extremely versatile assessment tool that can serve many purposes in a variety of settings. By improving IV insertion techniques with the assistance of ultrasound we may prevent central line use, decrease complications and improve the care we provide.