Dissertation
Optimizing Intravenous Access in an Adult Cardiovascular Intensive Care Unit
University of Iowa
Doctor of Nursing Practice (DNP), University of Iowa
Spring 2026
Abstract
Background: Difficult intravenous access (DIVA) is common in critically ill patients and is associated with delays in care, complications, and decreased patient satisfaction. Ultrasound-guided peripheral intravenous catheter (USGPIV) placement improves success rates; however, structured training in this skill was not available for nurses in the cardiovascular intensive care unit (CVICU) at the project site. Purpose: To optimize PIV access for critically ill patients with DIVA in the CVICU. Methods: Four CVICU charge nurses completed a two-hour training session that followed a simulation-based mastery learning (SBML) curriculum. Knowledge and attitudes were assessed pre-intervention, immediately post-intervention, and at one month. Unit-level data on PIV attempts and vascular access team (VAT) consults were collected for two weeks pre-intervention and eight weeks post-intervention. Findings: Attitudes improved immediately following training and remained elevated at one month. Mean knowledge scores increased from 63% at baseline to 78% post-intervention and 75% at one month. Mean weekly PIV attempts decreased from 43 to 39 (9.3% decrease), while VAT consults increased from 4.5 to 5.6 per week (24% increase). Discussion: SBML USGPIV training improved nurse knowledge and attitudes and was associated with a modest reduction in unit PIV attempts. Increased VAT consults may reflect improved recognition of DIVA and appropriate care escalation. Expanded training and longer evaluation periods may better demonstrate sustained unit-level impact.
Details
- Title: Subtitle
- Optimizing Intravenous Access in an Adult Cardiovascular Intensive Care Unit
- Creators
- Alissa Abel - University of Iowa
- Contributors
- Cormac O'Sullivan (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 2026
- Publisher
- University of Iowa
- Number of pages
- 1 page
- Copyright
- Copyright © 2026 Alissa Abel
- Language
- English
- Academic Unit
- College of Nursing; Doctor of Nursing Practice Projects
- Record Identifier
- 9985217822702771
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