Comparative Effectiveness, Efficiency, and ED Nurse Preference Between Two Methods of Visualization for Midline Catheter Insertion: A Pilot Study

Overview

Journal SAGE Open Nurs

Publisher Sage Publications

Specialty Nursing

Date 2023 Jan 16

PMID 36643785

Authors

Kimberly Alsbrooks

Klaus Hoerauf

Affiliations

Soon will be listed here.

Abstract

Introduction: Rapid and reliable peripheral IV access is essential for many patients admitted to the emergency department (ED) to ensure administration of life-saving medications, and successful intravenous cannulation can significantly affect patient care.

Objective: The objective of this study was to assess the impact of a continuous needle tracking system on the accuracy, speed, and quality of ultrasound-guided peripheral venous catheter insertions.

Methods: A convenient sample study based on the study setting using simulated tissue was conducted with 49 US-based ED nurses to compare the insertion of a midline catheter using traditional ultrasound guidance versus an advanced needle-tracking technology along with ultrasound guidance. The purpose of this evaluation was to assess the impact of continuous needle tracking system. Informed consent was obtained from all individual participants involved in this study. All participants were made aware that the results may be published. There was no IRB approval for this study. All sources were properly disclosed within the text.

Results: The addition of the advanced needle-tracking technology significantly reduced total insertion attempts, insertion time, backwall penetrations, and redirects (probes to hit the target vein), while improving image clarity and confidence for participants.

Conclusion: The innovative needle-tracking system evaluated in this pilot study has the potential to improve emergent difficult vascular access. EDs should assess the value of this technology to potentially improve the management of difficult intravenous access patients in their settings.

References

. AIUM practice guideline for the use of ultrasound to guide vascular access procedures. J Ultrasound Med. 2012; 32(1):191-215. DOI: 10.7863/jum.2013.32.1.191. View

Lapostolle F, Catineau J, Garrigue B, Monmarteau V, Houssaye T, Vecci I . Prospective evaluation of peripheral venous access difficulty in emergency care. Intensive Care Med. 2007; 33(8):1452-7. DOI: 10.1007/s00134-007-0634-y. View

Fields J, Piela N, Au A, Ku B . Risk factors associated with difficult venous access in adult ED patients. Am J Emerg Med. 2014; 32(10):1179-82. DOI: 10.1016/j.ajem.2014.07.008. View

Costantino T, Parikh A, Satz W, Fojtik J . Ultrasonography-guided peripheral intravenous access versus traditional approaches in patients with difficult intravenous access. Ann Emerg Med. 2005; 46(5):456-61. DOI: 10.1016/j.annemergmed.2004.12.026. View

. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013; 310(20):2191-4. DOI: 10.1001/jama.2013.281053. View

Lamperti M, Bodenham A, Pittiruti M, Blaivas M, Augoustides J, Elbarbary M . International evidence-based recommendations on ultrasound-guided vascular access. Intensive Care Med. 2012; 38(7):1105-17. DOI: 10.1007/s00134-012-2597-x. View

van Loon F, Buise M, Claassen J, Dierick-van Daele A, Bouwman A . Comparison of ultrasound guidance with palpation and direct visualisation for peripheral vein cannulation in adult patients: a systematic review and meta-analysis. Br J Anaesth. 2018; 121(2):358-366. DOI: 10.1016/j.bja.2018.04.047. View

Piredda M, Biagioli V, Barrella B, Carpisassi I, Ghinelli R, Giannarelli D . Factors affecting difficult peripheral intravenous cannulation in adults: a prospective observational study. J Clin Nurs. 2016; 26(7-8):1074-1084. DOI: 10.1111/jocn.13444. View

van Loon F, van Hooff L, de Boer H, Koopman S, Buise M, Korsten H . The Modified A-DIVA Scale as a Predictive Tool for Prospective Identification of Adult Patients at Risk of a Difficult Intravenous Access: A Multicenter Validation Study. J Clin Med. 2019; 8(2). PMC: 6406455. DOI: 10.3390/jcm8020144. View

10.

Vezzani A, Manca T, Vercelli A, Braghieri A, Magnacavallo A . Ultrasonography as a guide during vascular access procedures and in the diagnosis of complications. J Ultrasound. 2014; 16(4):161-70. PMC: 3846948. DOI: 10.1007/s40477-013-0046-5. View

11.

Abolfotouh M, Salam M, Bani-Mustafa A, White D, Balkhy H . Prospective study of incidence and predictors of peripheral intravenous catheter-induced complications. Ther Clin Risk Manag. 2014; 10:993-1001. PMC: 4266329. DOI: 10.2147/TCRM.S74685. View

12.

Franco-Sadud R, Schnobrich D, Mathews B, Candotti C, Abdel-Ghani S, Perez M . Recommendations on the Use of Ultrasound Guidance for Central and Peripheral Vascular Access in Adults: A Position Statement of the Society of Hospital Medicine. J Hosp Med. 2019; 14(9):E1-E22. PMC: 10193861. DOI: 10.12788/jhm.3287. View

13.

Gorski L, Hadaway L, Hagle M, Broadhurst D, Clare S, Kleidon T . Infusion Therapy Standards of Practice, 8th Edition. J Infus Nurs. 2021; 44(1S Suppl 1):S1-S224. DOI: 10.1097/NAN.0000000000000396. View

14.

Privitera D, Mazzone A, Pierotti F, Airoldi C, Galazzi A, Geraneo A . Ultrasound-guided peripheral intravenous catheters insertion in patient with difficult vascular access: Short axis/out-of-plane versus long axis/in-plane, a randomized controlled trial. J Vasc Access. 2021; 23(4):589-597. DOI: 10.1177/11297298211006996. View

15.

Scoppettuolo G, Pittiruti M, Pitoni S, Dolcetti L, Emoli A, Mitidieri A . Ultrasound-guided "short" midline catheters for difficult venous access in the emergency department: a retrospective analysis. Int J Emerg Med. 2016; 9(1):3. PMC: 4742453. DOI: 10.1186/s12245-016-0100-0. View

16.

Witting M . IV access difficulty: incidence and delays in an urban emergency department. J Emerg Med. 2011; 42(4):483-7. DOI: 10.1016/j.jemermed.2011.07.030. View

17.

Chapman G, Johnson D, Bodenham A . Visualisation of needle position using ultrasonography. Anaesthesia. 2006; 61(2):148-58. DOI: 10.1111/j.1365-2044.2005.04475.x. View

18.

Hawes M . A proactive approach to combating venous depletion in the hospital setting. J Infus Nurs. 2007; 30(1):33-44. DOI: 10.1097/00129804-200701000-00006. View