Patient Satisfaction with Nurse Placed Ultrasound Guided Peripheral IV

Abstract

Objective: Ultrasound (US) guidance for procedures is a well-established adjunct that improves the quality of patient care. Specifically, we assess the impact of nurse performed ultrasound-guided peripheral IV (USGPIV) placement on patient satisfaction with the procedure. Methods: We performed a randomized, prospective controlled study. 10 emergency department (ED) nurses were trained on USGPIVs which included a didactic and supervised placement of 10 US-guided IVs on live subjects. Another cohort of 10 ED nurses received a didactic on using traditional techniques to obtain IVs on difficult vascular access patients. Adult patients were enrolled based on strict inclusion criteria which identified them as having difficult vascular access. Once enrolled, the subjects were randomized into either the US-guided arm or the standard of care (SOC) arm, where the designated study trained nurses carried out peripheral IV placement. If the study nurse failed at IV placement, then a rescue IV was attempted by a non-study provider. The study was stopped once an IV was successfully placed. The patient was given a brief verbal survey to rate their experience from 1-10 (1 was poor and 10 was excellent) regarding the IV technique used by the study nurse. Results: 124 subjects were enrolled and randomized. 62 patients remained in the US-guided study arm and 53 patients in the SOC arm (2 were excluded due to lack of study nurse availability, and 7 patients were lost to followup). The median patient satisfaction in the US-guided group was 10 versus 8 for the SOC arm (p=0.04) Conclusion: Our study demonstrated that patient satisfaction is enhanced when nurses utilize the US-guided approach compared to the SOC palpation technique to establish an IV in difficult access patients. We recommend that nursing staff incorporate this method to IV access in difficult patients to enhance the quality of their patient care experience.