Improving Nurses’ Peripheral Intravenous Catheter Insertion Efficiency and Confidence Using Ultrasound Guidance

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Date
2024
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Abstract

Background: A review of current hospital practices related to PIV insertion in a large tertiary community medical center identified practice variability and lacking policies compared to current evidence-based practices and standards of care. Together with other stakeholders, hospital practice guidelines and an ultrasound-guided PIV training program in alignment with current evidence-based practice standards of care were developed and implemented to improve nurses’ PIV insertion skills efficiency, confidence, and self-efficacy.

Methods: The project design was a quality improvement project that included both process and educational interventions. Quantitative methods were utilized to measure nurses’ responses before and after implementation. The Learning Self-Efficacy Scale (L-SES) and level of confidence survey were used for data collection. Paired t-test was used to measure mean scores for frequency of PIV insertion attempts, average time in minutes for PIV insertion, nurses’ level of confidence, and learning self-efficacy.

Results: The implementation of ultrasound-guided PIV catheter insertion training and the establishment of practice guidelines significantly improved nurses' confidence and efficiency in performing PIV insertions. The training significantly improved cognitive and several psychomotor skills and self-efficacy among nurses. Eight out of ten nurses stated the use of ultrasound guidance made PIV insertions more efficient.

Discussion: A multi-pronged approach involving several stakeholders established clear practice guidelines and provided a training program in alignment with the standards of care to improve acute care nurses’ PIV insertion skills efficiency, confidence, and self-efficacy.

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DNP project
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