UGPIV Survey Significance to Guideline Application and Patient Safety
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Infection Prevention in Vascular Access Special
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It is the standard of care for the majority of patients admitted to acute care to receive an intravenous ( IV ) catheter for the delivery of solutions and medications in their treatment plan . More and more patients with chronic diseases , obesity , and other conditions that deplete vein accessibility are designated as difficult access requiring ultrasound guidance to successfully place these catheters ( van Loon 2018 ). The use of ultrasound for the peripheral intravenous catheter insertion procedure adds a level of complexity and risk that can impact patient safety .
Aseptic technique and control of pathogenic microorganisms is a foundational practice for maintaining patient safety and avoiding infectious complications . Variations in skin antiseptic disinfection , use of ultrasound transducer / probes requiring disinfection , and gel all play a part in level of risk associated with ultrasound guided peripheral catheter insertion ( UGPIV ) and need to prevent inadvertent bacteria entry into the bloodstream . Research and guideline application to UGPIV practices help to ensure patient safety for the procedure . The type of supplies used in this procedure reflects adherence to policies and steps to control the transfer of microorganisms during this invasive procedure . A recent study addressed concerns associated with inconsistent guideline application from department to department and clinician to clinician ( Moureau and Gilbert 2020 ).
The following Tables 1 and 2 report the responses of clinicians in this recent UGPIV survey of supply usage practices . The respondents were grouped into those with a primary function performing vascular access and infusion therapy procedures , clinicians in emergency departments , and other for a total of 1,475 entries . The clinicians were asked about supplies for UGPIV
PIctured is ultrasound-guided peripheral intravenous catheter insertion . Images courtesy of PICC Excellence
insertions for usage frequency of sterile IV start kits or designated UGPIV kits ; probe protection with transparent dressing , sterile covers or specific dressings ; skin antisepsis , sterile or clean gloves ; type of gel used and ability to clean the skin of gel at the conclusion of the procedure .
Within the responses the most significant variable was with the selection of “ Sometimes used ” reflecting inconsistency in supplies used in these catheter insertions , especially for probe protection and gel . Variable usage of sterile probe covers , transparent dressings , and other UGPIV specific gel separating dressings indicated lack of available supplies or lack of policy adherence to the required level of patient and probe protection . Guidelines and practice recommendations from organizations such as the American College of Emergency Physicians ( ACEP ) and the American Institute of Ultrasound
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More and more patients with chronic diseases , obesity , and other conditions that deplete vein accessibility are designated as difficult access requiring ultrasound guidance to successfully place these catheters ( van Loon 2018 ).