Documenting factors like the number of insertion attempts , PIV failure rates , and infections will make it easier to quickly identify issues that need to be addressed , whether they arise with an individual clinician or are a team-wide problem .”
or a multisite healthcare system .
prevention and patient safety analyst at ECRI . Such experts include members of groups such as HICPAC , who are involved in creating national guidelines and educational requirements that will ultimately be reflected in the recommendations of other professional organizations .
“ It ’ s about people from different professions with different perspectives working together to have these important conversations ,” says Davis . “ After more than 25 years of working in healthcare , I ’ m seeing more organizations form strategic partnerships with the overarching goal of improving patient safety , and I ’ m hopeful we ’ ll continue moving in this direction of increased collaboration .”
This multidisciplinary collaboration needs to happen even within individual institutions . ECRI recommends that facilities establish a point-of-care ultrasound committee made up of key stakeholders from various departments , including nursing , emergency medicine , radiology , risk analysis , and others . The committee should be responsible for establishing ultrasound policies and ensuring they are applied consistently across the entire organization , whether it is a single building
Protecting Patients Through Quality Education and Monitoring Outcomes
In addition , clinicians need high-quality , comprehensive education and hands-on training in the use of ultrasound for the placement of vascular access devices in accordance with their facility ’ s policies .
According to an AVA position paper , such education and training activities should encompass basic knowledge of anatomy , ultrasound physics , and imaging techniques . It should also encompass hands-on competence in aseptic technique , including the use of sterile probe covers , application of gel , and correct disinfection of the transducer . 23
“ In a skilled clinician ’ s hands , the use of ultrasound technology can offer patients a safer , more reliable solution for achieving PIV access ,” says Thompson . “ But this requires proper training . Ultrasound is not a modality where you can just wing it without seriously compromising patient safety .”
Even after initial training , Moureau says there should be ongoing competency assessments to evaluate the skill of the inserter , as well as their compliance with the institution ’ s policies . A key component of such ongoing assessment requires monitoring outcomes through data collection . Documenting factors like the number of insertion attempts , PIV failure rates , and infections will make it easier to quickly identify issues that need to be addressed , whether they arise with an individual clinician or are a team-wide problem .
“ We know we can improve UGPIV patient safety with standardized procedures , quality training , and monitoring compliance ,” says Moureau . “ The time has come to decide what these best practices are and implement them consistently across all departments .”
Jaclyn Landon is a freelance medical writer who specializes in vascular access and women ’ s health technologies .
References :
1 . Tuffaha HW , et al . Cost-Effectiveness Analysis of Clinically Indicated Versus Routine Replacement of Peripheral Intravenous Catheters . Appl Health Econ Health Policy . 2014 ; 12 ( 1 ): 51-58 .
2 . Rickard CM , Ray-Barruel G . Peripheral intravenous catheter assessment : beyond phlebitis . Lancet Hemaetol . 2017 ; 4 ( 9 ): e402-e403 , September 2017 .
3 . Dychter SS , et al . Intravenous Therapy : A Review of Complications and Economic Considerations of Peripheral Access . JIN . 2012 ; 35 ( 2 ): 84-91 .
4 . Gottlieb M , Sundaram T , Holladay D , Nakitende D . Ultrasound-guided peripheral intravenous line placement : a narrative review of evidence-based best practices . West J Emerg Med . 2017 ; 18 ( 6 ): 1047 – 1054 ; doi : 10.5811 / westjem . 2017.7.34610 .
5 . Moureau N , Gilbert GE . Survey of ultrasound-guided peripheral intravenous practices : a report of supply usage and variability between clinical roles and departments . J Assoc Vasc Access . 2020 ; 25 ( 3 ): 1 – 11 ; doi : 10.2309 / java-d-20-00021 .
6 . Stone P , Meyer B , Aucoin J . Ultrasound-guided peripheral I . V . access : Guidelines for practice . American Nurse Today . 2013 . Accessed June 6 , 2018 .
7 . AIUM practice guideline for the use of ultrasound to guide vascular access procedures . J Ultrasound Med . 2013 ; 32 ( 1 ): 191 – 215 ; doi : 10.7863 / jum . 2013.32.1.191 .
8 . Sykes A , et al . An investigation of the microbiological contamination of ultrasound equipment . British Journal of Infection . 2006 Aug ; 7 ( 4 ): 16-20 .
9 . Mullaney PJ , Munthali P , Vlachou P , Jenkins D , Rathod A , Entwisle J . How clean is your probe ? Microbiological assessment of ultrasound transducers in routine clinical use , and cost-effective ways to reduce contamination . Clinical radiology . 2007 Jul 31 ; 62 ( 7 ): 694-8 .
10 . Ohara T , Itoh Y , Itoh K . Ultrasound instruments as possible vectors of staphylococcal infection . J Hospital Infection . 1998 ; 40:73-77 .
11 . 2020 Top 10 Health Technology Hazards [ executive brief , online ]. Plymouth Meeting , PA : ECRI , 2020 . Available at : https :// www . ecri . org / landing-2020-top-tenhealth-technology-hazards . Accessed Sept . 16 , 2020 .
12 . Rozich JD , Howard RJ , Justeson JM , Macken PD , Lindsay ME , Resar RK . Standardization as a mechanism to improve safety in healthcare . Jt Comm J Qual Saf . 2004 ; 30 ( 1 ): 5 – 14 ; doi : 10.1016 / s1549-3741 ( 04 ) 30001-8 .
13 . Top Patient Safety Concerns 2020 [ executive brief , online ]. Plymouth Meeting , PA : ECRI , 2020 . Available at : https :// www . ecri . org / landing-top-10-patient-safetyconcerns-2020 . Accessed Sept . 16 , 2020 .
14 . Ultrasound Guidance for Vascular Access Procedures by Qualified Vascular Access Specialists or Other Applicable Healthcare Clinicians [ position paper , online ]. Herriman , UT : Association for Vascular Access , 2019 . Available at : https :// cdn . ymaws . com / www . avainfo . org / resource / resmgr / files / position _ statements / ultrasound _ in _ vascular _ acces . pdf . Accessed Sept . 30 , 2020 .
15 . Bolton D . Improving peripheral cannulation practice at an NHS Trust . Br J Nurs . 2010 ; 19 ( 1346 ): 8 – 50 .
16 . The Use of Visualization Technology for the Insertion of Peripheral Intravenous Catheters [ position paper , online ]. Herriman , UT : Association for Vascular Access , 2019 . Available at : https :// cdn . ymaws . com / www . avainfo . org / resource / resmgr / files / position _ statements / visualization _ for _ peripheral . pdf . Accessed Sept . 30 , 2020 .
17 . Standardizing the Critical Clinical Competency of Aseptic , Sterile , and Clean Techniques with a Single International Standard : Aseptic Non-Touch Technique ( ANTT ) [ guidance document , online ]. Herriman , UT : Association for Vascular Access , 2019 . Available at : https :// cdn . ymaws . com / www . avainfo . org / resource / resmgr / files / position _ statements / ANTT . pdf . Accessed Sept . 30 , 2020 .
18 . Moureau N , Gilbert GE . Survey of ultrasound-guided peripheral intravenous practices : a report of supply usage and variability between clinical roles and departments . J Assoc Vasc Access . 2020 ; 25 ( 3 ): 1 – 11 ; doi : 10.2309 / java-d-20-00021 .
19 . Bernatchez S . Care of Peripheral Venous Catheter Sites : Advantages of Transparent Film Dressings Over Tape and Gauze viewed at http :// www . avajournal . com / article / S1552-8855 ( 14 ) 00161-5 / fulltext ? cc = y = Published December 2014 , Volume 19 Issue 4 . Accessed Sept . 30 , 2020 .
20 . Bolton D . Improving peripheral cannulation practice at an NHS Trust . Br J Nurs . 2010 ; 19 ( 1346 ): 8-50 .
22 . Carrico RM , Furmanek S , English C . Ultrasound probe use and reprocessing : results from a national survey among U . S . infection preventionists . Am J Infect Control . 2018 ; 46 ( 8 ): 913 – 920 ; doi : 10.1016 / j . ajic . 2018.03.025 .
23 . Ultrasound Guidance for Vascular Access Procedures by Qualified Vascular Access Specialists or Other Applicable Healthcare Clinicians [ position paper , online ]. Herriman , UT : Association for Vascular Access , 2019 . Available at : https :// cdn . ymaws . com / www . avainfo . org / resource / resmgr / files / position _ statements / ultrasound _ in _ vascular _ acces . pdf . Accessed Sept . 30 , 2020 .