vascular access infection prevention
Clinical Voices of COVID and Survey of Ultrasound- Guided Peripheral Catheter Policies and Training
Patients admitted to acute-care facilities require intravenous access for the delivery of medical treatment today . As the most common invasive procedure performed in acute care today , approximately 340 million peripheral intravenous catheters ( PIVC ) are sold each year for the purpose of access for intravenous infusions . While our population continues to increase , the number of peripheral catheters and the skill required for successful insertion will continue to increase . Estimates of more than one out of every two to three patients is classified as having difficult access requiring visualization technologies to enhance success . Solutions for managing greater patient difficulty with achieving intravenous access has led to escalation in the use of ultrasound-guided peripheral catheter insertions ( UGPIV ).
Currently , UGPIV insertion procedures performed in the United States are projected at approximately 12 million per year . Use of this type of visualization technology has reduced the number of failed attempts allowing clinicians improved success , faster intravenous access , and extended dwell time with the insertion of longer catheters . With the increase in these point of care procedures groups such as ERCI have expressed concerns over the training necessary to ensure safety with every patient .
In a recent survey , clinicians were asked about UGPIV procedures , their training , policies , and experiences with COVID-19 at each of their facilities . Clinical areas represented in the survey respondents included vascular access specialists , emergency departments , acute care and alternate care . The objective of the survey was to gain a greater understanding of the UGPIV policies for qualification and training received for UGPIV procedures , and feedback from the clinicians on the impact of the COVID-19 pandemic on UG- PIV practices . Secondary outcomes were to record free-form text responses of the
Word cloud associated with survey respondents ’ comments . Courtesy of the author .
experiences of working nurses during the COVID-19 pandemic on aspects of aseptic technique , disinfection , management of protection and UGPIV insertions .
Training
Education and training positively contribute to increased patient safety and are needed before performing new invasive procedures on patients . Davis ( 2016 ) noted that vascular access device insertions are high-volume and high-risk invasive procedures requiring clinicians with specialized training and expertise to ensure positive outcomes . The survey asked clinicians , Prior to performing ultrasound guided peripheral catheter insertions did you receive training ? The majority ( 82 percent ) said yes , they did receive training prior to performing insertions . In a separate question , the group indicated they learned UGPIV insertions by themselves ( 14 percent ), while 86 percent listed various types of training for on the job , online education , lecture , and hands-on simulation . According to Spencer ( 2020 ), such education and training activities should encompass basic knowledge of anatomy , ultrasound physics , and imaging techniques .
In the comments section of the survey , one respondent addressed education and training by noting , “ We have great support and good training of performing ultrasound-guided PIVC and PICC insertion but luckily I did not need to perform one to any of those patients .” Another respondent said , “ I took extra education available in community and online with my own funding . Hospital education and training is lacking , and I feel most nurses learn primarily by trial and error . There is no IV team in my hospital .” Another respondent observed , “ We are now also training non-PICC RNs and X-ray / ED techs to perform USPIV with mandatory classroom and online training followed by ‘ monitored ’ placement of USPIV prior
www . healthcarehygienemagazine . com • october 2021
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