Adhikari Srikar, Schmier Charles, Marx Jared
Department of Emergency Medicine, University of Arizona Medical Center, Tucson, AZ - USA.
Department of Emergency Medicine, Southern Arizona VA Healthcare System, Tucson, AZ - USA.
J Vasc Access. 2015 Nov-Dec;16(6):515-20. doi: 10.5301/jva.5000436. Epub 2015 Jun 20.
The objective of this study is to assess Emergency Department (ED) nurses' confidence, comfort level, and competency in performing ultrasound-guided vascular access after a focused ultrasound simulation training session.
A cross-sectional study at an academic medical center. A simulation-based ultrasound training module was used to train ED nurses in ultrasound-guided intravenous (IV) access. The training module consisted of didactics followed by hands-on practice on human models and Blue Phantom ultrasound training block model. All subjects completed a questionnaire after completing the training module.
A total of 40 nurses were enrolled. All subjects successfully demonstrated competency during the training session by identifying upper extremity sonographic vascular anatomy on a human model and performing real-time ultrasound-guided IV access on Blue Phantom ultrasound training block model. On a scale of 1-10, the average confidence level in performing the ultrasound-guided vascular access was 6.9 [95% confidence interval (95% CI) 6.3-7.46], with 98% (95% CI, 92-102%) reporting no difficulty in recognizing upper limb vascular anatomy on ultrasound. Ninety-two percent (95% CI, 84-100%) agreed that focused training in ultrasound-guided IV access was adequate to learn the procedure.
After a focused simulation training session, ED nurses had a high level of comfort using ultrasound for vascular access. Despite having a moderate degree of confidence, ED nurses were accurate in identifying vascular anatomy and performing ultrasound-guided vascular access.
本研究的目的是评估在经过聚焦超声模拟培训课程后，急诊科护士在进行超声引导下血管穿刺时的信心、舒适度和能力。
在一家学术医疗中心进行的横断面研究。使用基于模拟的超声培训模块对急诊科护士进行超声引导下静脉穿刺培训。培训模块包括理论教学，随后在人体模型和蓝色幻影超声训练模块模型上进行实践操作。所有受试者在完成培训模块后填写一份问卷。
共招募了40名护士。所有受试者在培训过程中均成功展示了能力，能够在人体模型上识别上肢超声血管解剖结构，并在蓝色幻影超声训练模块模型上进行实时超声引导下的静脉穿刺。在1至10的评分量表上，进行超声引导下血管穿刺的平均信心水平为6.9[95%置信区间（95%CI）6.3 - 7.46]，98%（95%CI，92 - 102%）报告在超声上识别上肢血管解剖结构没有困难。92%（95%CI，84 - 100%）的人认为聚焦于超声引导下静脉穿刺的培训足以学会该操作。
经过聚焦模拟培训课程后，急诊科护士在使用超声进行血管穿刺时具有较高的舒适度。尽管信心程度中等，但急诊科护士在识别血管解剖结构和进行超声引导下血管穿刺方面是准确的。
