Peripheral Intravenous Cannulation Research Articles

Evaluating Nursing Students' Venipuncture and Peripheral Intravenous Cannulation Knowledge, Attitude, and Performance: A Two-Phase Evaluation Study.

Peripheral intravenous cannulation and venipuncture are among the most common invasive procedures in health care and are not without risks or complications. The aim of this study was to evaluate the current training provided to nursing and midwifery undergraduate students. Student knowledge, attitude, practice, and performance regarding these procedural skills were assessed. A knowledge, attitude, and practices survey was disseminated to final year nursing and midwifery students as the first phase of this study. For the second phase of the study, nursing students were video recorded and then observed performing the skill of peripheral intravenous cannulation in a simulated environment. Thirty-eight nursing and midwifery students completed the survey, and 66 nursing students participated in the observation study. Descriptive statistics were performed. The mean knowledge score was 7.2 out of 15.0, (standard deviation [SD] = 2.4), and the mean attitude score was 10.20 out of 18.00 (SD = 4.79). Qualitative data from the survey were categorized to demonstrate specific areas of focus for improving the training. The mean performance score was 16.20 out of 28.00 (SD = 2.98). This study provides valuable input to developing and enhancing evidence-based curricula. It can help educators and supervisors, in both academic and clinical settings, identify areas where clinical performance and education could be enhanced.

Increased risk of complications in lower versus upper limb peripheral intravenous cannulation in children with severe neurological impairment.

Obtaining peripheral intravenous catheter (PIVC) access in children with severe neurological impairment (SNI) is often challenging and commonly associated with complications, including dislodgement, phlebitis and extravasation. In severe cases, extravasation injury may lead to tissue necrosis, ulceration and long-term morbidity. The aim of this study was to determine the relative incidence of PIVC complications secondary to lower limb cannulation, compared to upper limb, in children with SNI. A single centre, retrospective, observational review was conducted. Patients with SNI, admitted at a tertiary paediatric centre over 6months between July and December 2022, were included. One-hundred fifty-five PIVC procedures were conducted in 110 children over the study period. Complications were more common in lower limb PIVCs (12/16, 75%) compared to upper limb (58/139, 42%), p = 0.01. Upper limb cannulation is preferred in children with SNI.

Assessment of the Peripheral Venous Cannulation in a Teaching Hospital: A Prospective Study

ABSTRACT Introduction: In today’s healthcare environment, peripheral venous cannulations are frequently performed procedures. Bloodstream infections could occur as a result of the intrusive operation. Peripheral venous cannulas should be inserted and managed according to specific rules. This study compared these standards to the peripheral venous cannulation procedure and results at a teaching hospital institution. Materials and Methods: This study investigated the procedure and results of peripheral venous cannulation in a teaching center using a prospectively completed audit loop study. The “Royal College of Nursing’s criteria for infusion therapy” is one such set of recommendations. After the first phase of the observations, the audit was conducted. Later, after 4 months based on the recommendations, the personnel received training on a variety of cannulation-related topics and the second set of observations for the cannulations was performed. Both observations were made and compared for significance that was considered at. 05 using the ANOVA. Results: During the first phase of the research, 212 cannulations were made, and 314 were made for the second phase to be audited. In the reaudit compared with the initial audit, there was a statistically substantial surge in documentation, cannula cleansing, glove use, suitable site selection, and hand cleanliness, according to comparative exploration. Moreover, there was a statistically substantial decline in recannulations. Conclusion: Even though peripheral intravenous cannulation is a straightforward process, if done incorrectly, it might have serious side effects. Such techniques’ auditing reveals performance flaws. Reaudit results reveal a noticeable increase in performance and outcome following proper personnel retraining.

Impact of Local Heat Application on Peripheral Intravenous Cannulation Among Patients

Impact of Local Heat Application on Peripheral Intravenous Cannulation Among Patients

Superficial Vein Thrombosis of the Upper Extremity: Not a Benign Entity

Superficial vein thrombosis receives little medical attention, however it is not an uncommonly encountered presentation. While previously thought to be a completely benign entity, more recent studies have demonstrated that it may be associated with concomitant deep vein thrombosis and thromboembolic complications.1 Additionally, superficial vein thrombosis is not always self-limiting, and can be prone to tenacity and recurrence, causing significant incapacitation and impairment of daily functional activities, especially when involving the upper extremities. We present the case of a 31-year-old woman who developed extensive superficial vein thrombosis of the non-dominant upper extremity following a brief period of peripheral intravenous cannulation. Our reasons for highlighting this case are: 1. This presentation is usually undermined, and the thromboembolic complications associated with it are not recognized as a sequelae of this entity. 2. To create awareness about current treatment guidelines in superficial vein thrombosis.

POCUS guided small saphenous vein cannulation: A novel approach for peripheral venous assess in prone position

Peripheral intravenous cannulation (PIVC) is a routine procedure in perioperative, and critical care settings and nearly one-third of the patients may have difficult intravenous access (DIVA). PIVC is challenging in a prone position in an intraoperative setting when there is a need for emergency access. Point of care ultrasonography (POCUS) is becoming the standard for assisting DIVA and improving the success rate. The small saphenous vein (SSV) in the posterolateral side of the mid-calf is a consistent vein in the lower extremity that provides an acceptable diameter and optimal depth for POCUS-guided PIVC in the prone position. A successful SSV cannulation was performed with an 18-G peripheral intravenous catheter under POCUS guidance on a 34-year-old male polytrauma patient in the prone position during the intraoperative period scheduled for D2 spine fixation. The SSV can be a credible option for emergency DIVA in the prone position under POCUS guidance.

Use of Vein Finder to Overcome Factor Affecting Peripheral Intravenous Cannulation, Venipuncture, IV Insertion, and Blood Draws

To find a vein for intravenous insertion is quite difficult in most of the people. This difficulty is due to several factors, such as the demographic and clinical characteristics of the patients (age, sex, height, weight, ethnicity, IV drugs history, and medical history), health professional’s experience, device characteristics, site of insertion, and vein characteristics. Many insertion attempts has to be done due to difficulty in intravenous insertion. This makes the patient uncomfortable and frustrated leading to challenge for the health workers. It is also an expensive affair for the health institutions. Therfore to avoid the above problems medical practitioners should use the Vein Finder to locate the vein for intravenous insertion.

The Effect of Virtual Reality and Hugo Point Massage on the Pain and Anxiety of School-aged Children with Cancer: Crossover Clinical Trial

Background: Venipuncture and peripheral intravenous cannulation are two of the most common invasive procedures in children that generate pain and distress. Previous studies have confirmed the effect of distraction and acupressure on reducing pain and anxiety in children; however, the effectiveness of these two methods has not been compared. Objective: The aim of this study was to compare Virtual Reality and Hugo point massage on the pain and anxiety of children. Methods: This crossover study was conducted in the oncology unit of a children’s hospital. Participants included 30 children aged 6-12 with cancer who were randomly assigned to one of the three groups: (routine, Virtual Reality, and acupressure). All children experienced these three methods. The scores of children’s pain (VAS scale) and anxiety (FAS scale) were measured. Finding: The result showed that the Virtual Reality method significantly reduced pain and anxiety compared to Hugo’s point method (P <0.001). Implications for Nursing: According to the present study, non-pharmacological methods such as Hugo point massage and virtual reality were effective in reducing pain and anxiety in school-aged children. Therefore, nursing managers can encourage nurses to use these methods based on the child's preferences to relieve the pain by providing the necessary facilities and equipment. Furthermore, they can increase nurses' knowledge by introducing new pain management methods in children through workshops. Conclusion: The present study showed that VR and Hugo’s point massage were effective ways to reduce pain and anxiety resulting from intravenous cannulation in school-age children.

A52Probing for Veins: A Cost-Effective, Reproducible Method for Teaching Ultrasound-Guided Peripheral Intravenous Access

Repeated attempts at peripheral intravenous (PIV) access cause increased discomfort and delays in treatment for patients in hospital. The use of ultrasound can improve success in PIV access, benefitting patient experience. Medical professionals are increasingly expected to use ultrasound when landmark techniques fail [1]. We sought to improve confidence using ultrasound for PIV cannulation with low-cost simulation models made from ADAMgel [2] or tofu in multiple teaching sessions. We organized teaching sessions with multiple specialties at St Richard’s Hospital. A total of 48 members of staff have been taught over four sessions. Prior to the teaching session learners were asked to complete a survey identifying previous ultrasound experience and rating confidence using ultrasound for PIV access. The teaching session consisted of an introductory multimedia presentation with a video demonstration, then practical experience. Models consisted of water-filled balloons placed in ADAMgel (Aqueous Dietary Fibre Antifreeze Mix gel) or tofu to simulate human tissue and veins, Models used to deliver teaching sessions. After ADAMgel became available this has been used exclusively due to it being more reusable compared to the tofu modelsA: tofu model with ultrasound image underneath.B: ADAMgel model with ultrasound image underneath The initial survey identified only 29% of staff had previously used ultrasound for PIV access, and half of these (15% overall) had only used it once or twice a year. Using a five-point Likert scale, 74% of respondents rated their confidence in using ultrasound as one or two out of five. All respondents thought they would benefit from further teaching in PIV access. Feedback after teaching sessions was favourable, with 95% of respondents finding the session very useful and 95% also believing it would increase their use of ultrasound in clinical practice. After the session, more than half rated their confidence in ultrasound cannulation as four or five out of five. We have demonstrated that there is a desire from medical staff to increase their competency in ultrasound-guided PIV cannulation. Using low-cost, high-fidelity simulation models with a blended learning method, we can deliver teaching sessions to a large number of medical staff. We hope to continue this teaching in collaboration with our sister sites throughout Sussex to increase confidence with ultrasound-guided PIV cannulation in this region. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.

Evaluation of procedural pain for neonates in a neonatal intensive care unit: a single-centre study

BackgroundTo evaluate the procedural pain experienced by neonates in a neonatal intensive care unit (NICU) setting and determine the corresponding pain grades.MethodsTwo experienced nurses independently used the Neonatal Infant Pain...

Mono- and bi-plane sonographic approach for difficult accesses in the emergency department – A randomized trial

BackgroundThe insertion of peripheral intravenous (PIV) catheters is one of the most performed invasive procedures in acute healthcare settings. However, peripheral difficult vascular access (PDVA) is not uncommon and can lead to delays in administering essential medications. Ultrasound (US) has emerged as a valuable tool for facilitating PIV cannulation. Advancements in technology have introduced a technique known as bi-plane imaging, allowing the simultaneous display of both longitudinal and transverse views of vessels. We aimed to investigate whether the utilization of bi-plane imaging, as opposed to the single-plane approach, would yield superior results for PDVA in the emergency department (ED). MethodsThis study was a single-center randomized controlled trial. We included adult patients admitted to the ED who required PIV cannulation. Patients were randomly assigned to undergo cannulation using either the mono-plane or bi-plane approach, both performed by skilled providers. The primary outcome of the study was to compare the first attempt success rates between the two techniques. ResultsA total of 442 patients were enrolled, with 221 undergoing cannulation attempts using the mono-plane approach. Successful placement of a functioning PIV catheter was achieved in a single attempt for 313 out of 442 patients (70.8%). There was no significant difference in the success rates between the two study groups: 68.3% in the mono-plane group and 73.3% in the bi-plane group (p = 0.395). The median time required for a successful attempt differed between the groups, with 45 s (range 18–600) in the mono-plane group and 35 s (range 20–600) in the bi-plane group (p = 0.03). ConclusionsOur study confirms that US is a highly effective tool for facilitating PIV cannulation in patients with PDVA presenting to the ED. However, our investigation into the use of bi-plane imaging did not reveal a significant improvement when compared to mono-plane imaging.

Outcomes of a Comprehensive Ultrasound Guided Peripheral IV Insertion (USGPIV) Training Program in a Pediatric Emergency Department

IntroductionTimely and reliable peripheral intravenous cannulation is an imperative skill in a pediatric emergency department. Utilization of point-of-care ultrasound guidance has proven to significantly improve first-attempt peripheral intravenous cannulation insertion rates in pediatric patients. We sought to develop, implement, and evaluate an ultrasound-guided peripheral intravenous training program for emergency nurses in a tertiary care pediatric center. MethodsTwelve emergency nurses underwent a training program that consisted of an interactive asynchronous learning module followed by 8 hours of training by a vascular access clinical instructor. Data was collected on each ultrasound-guided peripheral intravenous insertion via survey methodology. ResultsComplete data for a total of 210 ultrasound-guided peripheral intravenous were recorded over the 9-month period. A total of 65.2% (137/210) of patients who received an ultrasound-guided peripheral intravenous had known difficult intravenous access on history. A total of 89.5% (188/210) of patients had a difficult intravenous access of ≥4. The mean difficult intravenous access score for the patients in which ultrasound-guided peripheral intravenous insertions were attempted was 4.78 (95% confidence interval, 4.55-5.01). A total of 193 of 210 (91.9%) of ultrasound-guided peripheral intravenous were attained successfully. On the first attempt, 86.5% (167/193) ultrasound-guided peripheral intravenous were attained, and 98.96% (191/193) were attained within the first 2 attempts. ConclusionWe found that implementing a comprehensive ultrasound-guided peripheral intravenous training program for emergency nurses in a pediatric tertiary care center led to a high first-pass success rate in attaining peripheral intravenous cannulations. It also facilitates vascular access in patients with known difficult intravenous access. Consideration should be made to implementing point-of-care ultrasound intravenous training programs to improve pediatric vascular access in the emergency department, particularly in patients with known difficult intravenous access.

Video-Based versus On-Site Neonatal Pain Assessment in Neonatal Intensive Care Units: The Impact of Video-Based Neonatal Pain Assessment in Real-World Scenario on Pain Diagnosis and Its Artificial Intelligence Application.

Neonatal pain assessment (NPA) represents a huge global problem of essential importance, as a timely and accurate assessment of neonatal pain is indispensable for implementing pain management. To investigate the consistency of pain scores derived through video-based NPA (VB-NPA) and on-site NPA (OS-NPA), providing the scientific foundation and feasibility of adopting VB-NPA results in a real-world scenario as the gold standard for neonatal pain in clinical studies and labels for artificial intelligence (AI)-based NPA (AI-NPA) applications. A total of 598 neonates were recruited from a pediatric hospital in China. This observational study recorded 598 neonates who underwent one of 10 painful procedures, including arterial blood sampling, heel blood sampling, fingertip blood sampling, intravenous injection, subcutaneous injection, peripheral intravenous cannulation, nasopharyngeal suctioning, retention enema, adhesive removal, and wound dressing. Two experienced nurses performed OS-NPA and VB-NPA at a 10-day interval through double-blind scoring using the Neonatal Infant Pain Scale to evaluate the pain level of the neonates. Intra-rater and inter-rater reliability were calculated and analyzed, and a paired samples t-test was used to explore the bias and consistency of the assessors' pain scores derived through OS-NPA and VB-NPA. The impact of different label sources was evaluated using three state-of-the-art AI methods trained with labels given by OS-NPA and VB-NPA, respectively. The intra-rater reliability of the same assessor was 0.976-0.983 across different times, as measured by the intraclass correlation coefficient. The inter-rater reliability was 0.983 for single measures and 0.992 for average measures. No significant differences were observed between the OS-NPA scores and the assessment of an independent VB-NPA assessor. The different label sources only caused a limited accuracy loss of 0.022-0.044 for the three AI methods. VB-NPA in a real-world scenario is an effective way to assess neonatal pain due to its high intra-rater and inter-rater reliability compared to OS-NPA and could be used for the labeling of large-scale NPA video databases for clinical studies and AI training.

The effectiveness of warm application on accessibility of peripheral intravenous cannulation among patient’s receiving chemotherapy: A quasi experimental study

The effectiveness of warm application on accessibility of peripheral intravenous cannulation among patient’s receiving chemotherapy: A quasi experimental study

Assessment of Readiness Toward Flipped Learning Among Novice Nursing Students on Fundamental Nursing Care in Puducherry, South India.

Background This study aimed to assess the readiness towardflipped learning (FL)among novice nursing students in fundamental nursing care in Puducherry, South India. Methodology A cross-sectional descriptive study was conducted among 176 first-year B.Sc. Nursing students from threeprivate nursing colleges by purposive sampling technique. In theory and practical classes, the students were taught fundamental nursing procedures such as oral medication, intramuscular injection, peripheral intravenous cannulation, and nasogastric tube feeding as FL. The study was conducted from November 2021 to March 2022. The responses were collected using the Nursing Students'Readiness for Flipped Classroom(NSR-FC) scale with four domains such as personal, technological, environmental, and pedagogical readiness. Pearson correlation and chi-square tests were used to analyze data by incorporating IBM SPSS Statistics for Windows, Version 25.0 (IBM Corp.,Armonk, NY, USA). Results Among 176 nursing students, 73.9% were aged between 17 and 19 years, the majority (76.7%) were females, and 98% of them used mobile phones to access online FL content. Of the novice nursing students, 69.88% agreed, 27.84% strongly agreed, and 2.27% were in a neutral state for readiness to adopt FL in their nursing curriculum with a mean (standard deviation, SD) value of 77.02 (6.27). Among the four domains of readiness, a positive correlation was found between personal with technological readiness (P= 0.001; r=0.446)and pedagogical with personal readiness (P= 0.003; r= 0.223).Statistically, a significant association was found between students' readiness towardFL with the occupation of the head of the family, gadgets used to access the FL materials, and Wi-Fi/internet availability in the institutions with a P-value <0.05. Conclusions The study showed highly positive readiness for FL among nursing students in nursing subjects. It can be leveraged with educational institutions' environmental and technological support by properly utilizing mobile devices, computer laboratories, and access to the internet/Wi-Fi for students from their entry level to enhance FL.

Evaluation of a Point-of-care ultrasound (POCUS) workshop for peripheral intravenous cannulation

BackgroundPoint-of-care ultrasound (POCUS) is increasingly used as a non-invasive vascular access assessment method by clinicians from multiple disciplines worldwide, prior and during vascular access cannulations. While POCUS is a relatively new method to establish a vascular access in patients with complex vascular conditions, it is also essential to train and educate individuals who are novices in the techniques of cannulation so that they become proficient in performing this task subsequently on patients safely and successfully. A simulated environment may be a helpful tool to help healthcare providers establish skills in using POCUS safely and may also help them to successfully establish vascular access in patients. With this project, we sought to determine if participants of a simulated POCUS workshop for vascular access can use this technique successfully in their individual clinical environment after their attendance of a half-day workshop.MethodsA mixed-methods longitudinal study design was chosen to evaluate a point-of-care ultrasound workshop for peripheral intravenous cannula insertion. The workshops used simulation models for cannulation in combination with multiple ultrasound devices from various manufacturers to expose participants to a broader variety of POCUS devices as they may also vary in different clinical areas. Participants self-assessed their cannulation skills using questionnaires on a 10-point rating scale prior to and directly after the workshop.ResultsA total of 85 Individuals participated in eleven half-day workshops through 2021 and 2022. Workshop participants claimed that attending the workshop had significantly enhanced their clinical skill of using ultrasound for the purpose of cannulating a venous vessel. The level of confidence in using this technique had increased in all participants directly after conclusion of the workshop.ConclusionsGlobally, clinicians are increasingly using POCUS to establish vascular access in patients, and it is necessary that they receive sufficient and adequately structured and formal training to successfully apply this technique in their clinical practice. Offering a workshop which uses simulation models in combination with various POCUS devices to demonstrate this technique in a hands-on approach has proven to be useful to establish this newly learned skill in clinicians.

NENA Position Statement: Ultrasound Guidance for Peripheral Intravenous Cannulation

Ultrasound guidance can increase peripheral vein cannulation success by nurses in the Emergency Department (ED). Unfortunately, ED nurses are not routinely trained to use ultrasonography for peripheral vein cannulation and may not have access to the required equipment.

Effectiveness of structured self-evaluation of video recorded performance on peripheral intravenous catheter insertion: a randomised control trial study protocol

BackgroundClinical psychomotor skills training is a core component of undergraduate nursing education. Performing technical skills competently involves the use of cognitive and motor function. The training of these technical skills is typically carried out in clinical simulation laboratories. Peripheral intravenous catheter/cannula insertion is an example of a technical skill. It is the most common invasive procedure performed in the healthcare environment. Owing to unacceptable clinical risk and complications to patients, it is imperative that practitioners performing these skills are trained effectively to provide patients with best practice and high-quality care. Technologies identified as innovative teaching methods to help train students in this skill and in the skill of venepuncture include virtual reality, hypermedia and simulators. However, little high-quality evidence exists to confirm such educational approaches are effective.Methods/designThis study is a single-centre, non-blinded, two-group, pre-test and post-test randomised control trial. The randomised control trial will investigate whether a formal structured self-evaluation of videoed performance (experimental group) has an impact on nursing students’ peripheral intravenous cannulation knowledge, performance and confidence. The control group will also be videoed performing the skill but they will not view or self-evaluate their videoed performance. The peripheral intravenous cannulation procedures will be carried out in a clinical simulation laboratory using a task trainer. The data collection tools will be completed online using survey forms. Students will be randomised into the experimental group or into the control group using simple random sampling. The primary outcome measures the nursing students’ knowledge level of the skill of peripheral intravenous cannulation insertion. Secondary outcomes evaluate procedural competence and self-reported confidence and practices in the clinical environment.DiscussionThis randomised control trial will investigate whether this pedagogical approach, using video modelling and self-evaluation, will positively influence students’ knowledge, confidence and performance in the skill of peripheral intravenous cannulation. Evaluating such teaching strategies using stringent methodologies may be impactful in influencing the training provided to healthcare practitioners.Trial registrationThe randomised control trial detailed in this article is an educational research study and so does not fall under the ICMJE definition of a clinical trial as “any research project that prospectively assigns people or a group of people to an intervention, with or without concurrent comparison or control groups, to study the relationship between a health-related intervention and a health outcome”.

Peripheral intravenous cannulation in infants and children

Peripheral intravenous cannulation in infants and children

Use of procedural ultrasound for the insertion of peripheral intravenous catheters: A nationwide survey in acute care departments in Belgium.

Assessment of ultrasound use for peripheral intravenous cannulation among acute care nurses and physicians. Over a population of 17,437, the calculated sample size of respondents required was 376. A total of 388 health professionals; 249 (64.2%) physicians and 139 (35.8%) nurses completed the entire questionnaire. 166 (45.2%) used ultrasound for intravenous cannulation. A statistically significant difference favored physicians' ultrasound use (p<0.001). Respondents with less than 10 years of clinical practice used ultrasound significantly more (p<0.001). The main reported obstacle among users was the lack of time. This survey revealed the gap between the current recommendations for ultrasound use for peripheral intravenous cannulation and the actual practices. Efforts should be made to develop specific training using ultrasound.