Dissertation
Ultrasound IV Training to Manage Difficult Access at a Level One Trauma Center
University of Iowa
Doctor of Nursing Practice (DNP), University of Iowa
Spring 2025
Abstract
**Background:** Peripheral intravenous (PIV) catheter placement is a common nursing procedure, yet patients with difficult intravenous access (DIVA) often require multiple attempts, leading to delays, discomfort, and increased resource utilization. Ultrasound-guided PIV (USGPIV) insertion has demonstrated increased first-attempt success rates and improved patient outcomes. At a large level one trauma center, no preoperative nursing staff were trained in USGPIV placement, relying instead on anesthesia providers for difficult access patients. **Purpose:** The purpose of this project was to develop, implement, and evaluate an ultrasound-guided PIV training program for preoperative nurses in the Day of Surgery Admissions (DOSA) unit at a large academic medical center to improve nursing confidence, competence, and patient care. **Methods:** Five DOSA nurses participated in a structured training program consisting of pre-training modules, simulation-based learning, and supervised patient insertions. Pre- and post-training assessments measured confidence and knowledge. Outcome measures included the number of USGPIV insertions by nurses, pre- and post-training assessment scores, and anesthesia 'rescue' IV placements when nursing attempts were unsuccessful. **Findings:** Post-training assessment scores improved across all measured domains, particularly in ultrasound skills and confidence in PIV placement. A Welch s t-test showed a statistically significant reduction in anesthesia rescue IV placements (p=0.020) during the months an ultrasound was available for nursing use. Additionally, an average of 8.66 USGPIVs were placed monthly by trained nurses. **Discussion:** Implementation of a structured USGPIV training program significantly improved nursing confidence and skill in PIV placement, decreased reliance on anesthesia providers, and reduced the need for rescue IV attempts. Findings support the need for continued expansion of nurse-led USGPIV programs, acquisition of dedicated ultrasound equipment, and integration of ultrasound training into nursing practice for optimal patient care outcomes.
Details
- Title: Subtitle
- Ultrasound IV Training to Manage Difficult Access at a Level One Trauma Center
- Creators
- Michael Bieber - University of Iowa
- Contributors
- Jodi Bloxham (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 Michael Bieber
- Language
- English
- Academic Unit
- College of Nursing; Doctor of Nursing Practice Projects
- Record Identifier
- 9984841038002771
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