Improving Healthcare Professionals’ Ultrasound-Guided Peripheral Vascular Access Ability Utilizing Homemade Ultrasound Phantoms

Purpose: The primary objective of this quality improvement project was to improve healthcare workers' confidence, competence, knowledge, and skills in placing ultrasound-guided peripheral intravenous catheters using homemade ultrasound phantom models.Background: Ultrasound guidance can reduce the number of attempts to gain peripheral IV access while improving the success rate and satisfaction in patients with difficult IV access. Education and simulation is an effective tool for improving the skills and knowledge related to ultrasound-guided peripheral IV access. Ultrasound phantom models allow for skill development without the risk of patient harm. Methods: Twenty-nine registered nurses and nurse practitioners were recruited for education and simulation regarding ultrasound-guided peripheral IV placement. Participants completed pre- and post-intervention confidence, perceived competence, and knowledge surveys in addition to a Directly Observed Procedural Skills Evaluation (DOPSE). The intervention included an educational PowerPoint and open practice session using the phantom models. Participants provided demographic information and completed a survey evaluating the efficacy of the phantom models. Results: Statistically significant improvements were found in participants’ confidence (p<.001; 95% CI: 5.287, 9.499; d=1.31), perceived competence (p<.001; 95% CI: 1.231, 2.742; d=1.20), knowledge (p<.001; CI: 1.079, 2.163; d=1.47), and skills (p<.001; CI: 2.499; 5.501; d=1.29). Participants improved in maintaining needle visualization (p<.001; 95% CI: 0.272, 0.9; d=0.79) and decreasing their cannulation attempts (.045; CI: .013, 1.022; d=0.48). Participants with no and novice experience saw statistically significant improvement across all categories (p<.02) compared to those with intermediate, advanced, or expert experience. Participants with 4-6 years of nursing experience found improvement across all categories, while those with > 15 years improved in confidence, perceived competence, and skills. 96.5% of participants could perform ultrasound-guided peripheral IV cannulation independently or with indirect supervision following the intervention. Conclusions: At a cost of $36.52 per model, the homemade ultrasound phantom models provided a cost-effective solution to teaching ultrasound-guided peripheral IV cannulations. Education and simulation for ultrasound-guided peripheral vascular access may benefit individuals with no or novice ultrasound experience. Years of nursing experience may influence but not reliably predict participant improvement, with 4-6 years showing the most significant improvement, followed by those with > 15 years.

Name thesis:degree_name

D.N.P.

Level thesis:degree_level

doctoral

Discipline thesis:degree_discipline

Graduate College

Grantor dc:publisher

The University of Arizona.

Year dc:date.issued

2023

Author dc:creator

• Bullington, Phillip Wade

Advisor dc:contributor.advisor

• Herring, Christopher

Committee members dc:contributor.committeemember

• Reed, James R.
• Owens, Derek L.

• healthcare
• peripheral vascular access
• phantom
• simulation
• ultrasound
• vascular access

Statement dc:rights

• Copyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction, presentation (such as public display or performance) of protected items is prohibited except with permission of the author.

Licence dc:rights.uri

• http://rightsstatements.org/vocab/InC/1.0/

Language dc:language.iso

en

Handle dc:identifier.uri

http://hdl.handle.net/10150/668238

OAI identifier oai:identifier

oai:repository.arizona.edu:10150/668238