Other Titles
Success Rate of Ultrasound-Guided IV Intervention in Difficult Intravenous Access Patients [Poster Title]
Abstract
Background: Traditional visualization, palpation, and landmarking peripheral veins for IV access are not helpful in patients with difficult veins. However, multiple studies and publications on difficult intravenous access (DIVA) of hospitalized patients have shown that using ultrasound to guide the cannulation of a peripheral vein improves the success rate in the first attempt to establish IV access in DIVA patients.
Purpose: This evidence-based practice (EBP) change project aims to train critical care nurses on the use of ultrasound in patients with difficult IV access and to increase first attempts on DIVA patients with the use of ultrasound.
Methods: The translational Science Model used was the i-PARIHS. This EBP project occurred in a community hospital's eight-bed critical care unit (CCU). 20 CCU nurses participated in the project, which included full-time, part-time, and per diem nurses. Float nurses and agency nurses were excluded from the project. The practice change intervention is ultrasound-guided peripheral intravenous (USGPIV) access. Participating nurses received education on the basics of ultrasound and its function for IV cannulation and simulation training on the use of ultrasound using phantom veins to access veins with varying depths. There were 29 patients identified as DIVA. Nurses received one-on-one formative evaluations during the intervention implementation. Data collection of ultrasound use and the number of IV attempts per patient were entered into REDCap for the summative evaluation on week 11. Statistical tests using frequencies and percentages and a one-sample test of proportion were used for data analysis. The total project implementation timeframe was 10 weeks.
Results: Data was first summarized using frequencies and percentages, then a one-sample test of proportion was used to determine if the proportion of DIVA patients for whom intravenous access was attempted using the ultrasound on the first attempt was 80%. A one-sample test of proportion revealed that the proportion of patients who were known to have DIVA for whom the first attempt at IV access was using the ultrasound was not significantly different from 80% (p=0.880).
Conclusions: The evidence-based practice USGPIV intervention revealed an 80% and above success rate at the first attempt. The result of the EBP intervention is significant to the body of scientific knowledge as it demonstrated improved peripheral IV skills among the CCU nurses.
Notes
References:
Bahl, A., Alsbrooks, K., Zazyczny, K. A., Johnson, S., & Hoerauf, K. (2024). An improved definition and SAFE rule for predicting difficult intravascular access (DIVA) in hospitalized adults. Journal of Infusion Nursing, 47(2), 9607. https://doi.org/10.1097/NAN.0000000000000535
Bagley, K. (2022). Development and implementation of an ultrasound-guided peripheral intravenous catheter education program for critical care nurses. Dimensions of Critical Care Nursing, 41(4), 182–189. https://doi.org/10.1097/DCC.0000000000000528
Campos, C., Lopez, M., Irwin-Nieto, V., Richards, R., Deen, M. R., & Lalata, A. (2023). Foundation for implementing a comprehensive vascular access excellence initiative organization-wide to improve vascular access device insertion and standardize care: Best practice for an acute care hospital. British Journal of Nursing (Mark Allen Publishing), 32(19), S26–S37. https://doi.org/10.12968/bjon.2023.32.19.S26
Hoskins, M. J., Nolan, B. C., Evans, K. L., & Phillips, B. (2023). Educating health professionals in ultrasound-guided peripheral intravenous cannulation: A systematic review of teaching methods, competence assessment, and patient outcomes. Medicine (Baltimore), 102(16), e33624–e33624. https://doi.org/10.1097/MD.0000000000033624
Huang, D., Winter, L., Macauley, E., Alterman, T., Renouard, B., Wilson, J. L., & Leon, L. N. (2023). Difficult intravenous access requiring ultrasound in the emergency department: Associations with delays in care and areas for quality improvement. Cureus, 15(9), e44960. https://doi.org/10.7759/cureus.44960
Hunter, S. C., Kim, B., & Kitson, A. L. (2023). Mobilizing implementation of i-PARIHS (Mi-PARIHS): development of a facilitation planning tool to accompany the Integrated Promoting Action on Research Implementation in Health Services Framework. Implementation Science Communications, 4(1), 2–2. https ://doi.org/10.1186/s43058-022-00379-y
REDCap (2024). REDCap: Software. https://www.project-redcap.org/software/
Salleras-Duran, L., Fuentes-Pumarola, C., Fontova-Almató, A., Roqueta-Vall-Llosera, M., Cámara-Liebana, D., & Ballester-Ferrando, D. (2024). Pain and satisfaction perceptions of ultrasound-guided versus conventional peripheral intravenous catheterization: A randomized controlled trial. Pain Management Nursing, 25(1), e37–e44. https://doi.org/10.1016/j.pmn.2023.07.010
Tian, Y., Zhong, Z., Dougarem, D., & Sun, L. (2024). The ultrasound-guided versus standard technique for peripheral intravenous catheter placement by nurses: A systematic review and meta-analysis. Heliyon, 10(9), e30582–e30582. https://doi.org/10.1016/j.heliyon.2024.e30582
Tran, Q. K., Flanagan, K., Fairchild, M., Yardi, I., & Pourmand, A. (2022). Nurses and efficacy of ultrasound-guided versus traditional venous access: A systemic review and meta-analysis. Journal of Emergency Nursing, 48(2), 145-158.e1. https://doi.org/10.1016/j.jen.2021.12.003
Sigma Membership
Omicron Delta
Type
Poster
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Translational Research/Evidence-based Practice
Keywords:
Implementation Science, Simulation, Teaching and Learning Strategies, IV Access, Difficult Intravenous Access, Ultrasound-Guided Peripheral Intravenous Access
Recommended Citation
Mulvaney, Evelyn Almera Factora, "Success Rate of Ultrasound-Guided Intravenous Intervention in Difficult Intravenous Access Patients" (2025). Biennial Convention (CONV). 39.
https://www.sigmarepository.org/convention/2025/posters_2025/39
Conference Name
48th Biennial Convention
Conference Host
Sigma Theta Tau International
Conference Location
Indianapolis, Indiana, USA
Conference Year
2025
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2025-11-27
Success Rate of Ultrasound-Guided Intravenous Intervention in Difficult Intravenous Access Patients
Indianapolis, Indiana, USA
Background: Traditional visualization, palpation, and landmarking peripheral veins for IV access are not helpful in patients with difficult veins. However, multiple studies and publications on difficult intravenous access (DIVA) of hospitalized patients have shown that using ultrasound to guide the cannulation of a peripheral vein improves the success rate in the first attempt to establish IV access in DIVA patients.
Purpose: This evidence-based practice (EBP) change project aims to train critical care nurses on the use of ultrasound in patients with difficult IV access and to increase first attempts on DIVA patients with the use of ultrasound.
Methods: The translational Science Model used was the i-PARIHS. This EBP project occurred in a community hospital's eight-bed critical care unit (CCU). 20 CCU nurses participated in the project, which included full-time, part-time, and per diem nurses. Float nurses and agency nurses were excluded from the project. The practice change intervention is ultrasound-guided peripheral intravenous (USGPIV) access. Participating nurses received education on the basics of ultrasound and its function for IV cannulation and simulation training on the use of ultrasound using phantom veins to access veins with varying depths. There were 29 patients identified as DIVA. Nurses received one-on-one formative evaluations during the intervention implementation. Data collection of ultrasound use and the number of IV attempts per patient were entered into REDCap for the summative evaluation on week 11. Statistical tests using frequencies and percentages and a one-sample test of proportion were used for data analysis. The total project implementation timeframe was 10 weeks.
Results: Data was first summarized using frequencies and percentages, then a one-sample test of proportion was used to determine if the proportion of DIVA patients for whom intravenous access was attempted using the ultrasound on the first attempt was 80%. A one-sample test of proportion revealed that the proportion of patients who were known to have DIVA for whom the first attempt at IV access was using the ultrasound was not significantly different from 80% (p=0.880).
Conclusions: The evidence-based practice USGPIV intervention revealed an 80% and above success rate at the first attempt. The result of the EBP intervention is significant to the body of scientific knowledge as it demonstrated improved peripheral IV skills among the CCU nurses.
Description
Patients with difficult intravenous access (DIVA) can be challenging, even for the most experienced nurse. DIVA patients are subjected to multiple intravenous attempts that cause pain and discomfort and delays in receiving treatment. Technology, such as ultrasound to assist with IV cannulation, has improved the first-attempt success rate. Hence, early identification of DIVA and the use of ultrasound-guided peripheral intravenous (USGPIV) intervention enhance the care of DIVA patients.