Dissertation
Improving Intravenous Catheterization in the Emergency Department
University of Iowa
Doctor of Nursing Practice (DNP), University of Iowa
Spring 2025
Abstract
Background: Peripheral intravenous (IV) catheterization is among the most common procedures performed by nurses in clinical settings. Despite its routine nature, IV insertions can be challenging in patients with difficult intravenous access (DIVA), defined as two or more failed IV attempts. Patients with DIVA often experience treatment delays, increased pain, and heightened anxiety. Evidence suggests that ultrasound-guided IV (USGPIV) placement significantly improves first-attempt success rates (Tian et al., 2024). Purpose: To improve first-attempt IV insertion success rates in the emergency department (ED) by implementing an educational intervention and best-practice guidelines for nurse-performed USGPIV insertions. Methods: The Iowa Model of Evidence-Based Practice guided this project s design and implementation. The project took place in a 22-bed community hospital ED from May 2024 to January 2025. All ED nurses received baseline education and were invited to complete a retrospective pre/post survey assessing confidence in identifying DIVA patients. A cohort of five ED nurses received additional training in USGPIV insertion, including didactic content, simulation, and supervised hands-on practice. Competency was defined as ten successful USGPIV insertions. Data on ultrasound utilization and IV insertion attempts were extracted from the electronic health record and analyzed. Findings: Post-education survey results indicated a statistically significant increase in nurse confidence identifying DIVA patients in the ED (p = 0.007). Five nurses completed USGPIV training and demonstrated skill competency, performing a total of 247 USGPIV placements. Following the intervention, there was a statistically significant increase in the ED's first-attempt IV insertion success rates (p < 0.01).Discussion: This project achieved its goal of increasing first-attempt IV insertion success rates to over 90% in the ED. These findings highlight the value of empowering nurses with evidence-based tools and skills to improve clinical IV insertion workflows.
Details
- Title: Subtitle
- Improving Intravenous Catheterization in the Emergency Department
- Creators
- Austin Witt - University of Iowa
- Contributors
- Kathleen Fear (Chair) - University of Iowa
- Resource Type
- Dissertation
- Project Type
- Poster
- Degree Awarded
- Doctor of Nursing Practice (DNP), University of Iowa
- Degree in
- Nurse Anesthesia
- Date degree season
- Spring 2025
- Publisher
- University of Iowa
- Number of pages
- 1 page
- Copyright
- Copyright 2025 Austin Witt
- Language
- English
- Academic Unit
- College of Nursing; Doctor of Nursing Practice Projects
- Record Identifier
- 9984841528802771
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