Nemours/Alfred I. duPont Hospital for Children, Wilmington, Delaware (Mss Russell, Mullaney, and Campbell, and Drs Sabado and Haut); Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (Mss Mullaney and Campbell); Thomas Jefferson University, Philadelphia, Pennsylvania (Dr Sabado).
Christina Russell, BSN, RN, HTCP, HNB-BC, is currently the healing touch coordinator for the Department of Integrative Medicine at Nemours/Alfred I. duPont Hospital for Children. She served as nurse manager for the intravenous (IV) therapy team during this quality improvement (QI) project. Ms Russell is also a registered yoga teacher.
J Infus Nurs. 2021;44(4):204-215. doi: 10.1097/NAN.0000000000000427.
Ultrasound guidance is an effective technique for obtaining short peripheral catheter (SPC) access but requires training and practice for proficiency. The aim of this quality improvement initiative was to develop and assess a formal training program to increase the confidence and competency of intravenous (IV) therapy nurses in the placement of ultrasound-guided SPCs. IV therapy nurses completed a didactic and hands-on training course where they practiced ultrasound-guided SPC placement techniques on a poultry phantom during simulation, followed by performing ultrasound-guided SPC insertion on patients proctored by an interventional radiology physician. Data collection included preintervention and postintervention confidence self-assessment, frequency tracker, Difficult Intravenous Access (DIVA) scale scores, and total number of ultrasound-guided SPCs placed by the nurses. Ultrasound-guided SPC placement increased significantly after the training program. The IV therapy nurses placed 29 ultrasound-guided SPCs in 2017, 391 ultrasound-guided SPCs in 2018, and 711 ultrasound-guided SPCs in 2019. Mean DIVA scores rose from 4.54 in May 2018 to 5.17 in July 2018, indicating success in placing SPCs in more difficult patients. Implementation of an ultrasound-guided SPC placement program using poultry phantom simulation is a recommended nursing resource for increasing competency in ultrasound-guided SPC placement in pediatric patients.
超声引导是获得短外周导管（SPC）通路的有效技术，但需要经过培训和实践才能熟练掌握。本质量改进计划的目的是开发和评估一个正式的培训计划，以提高静脉（IV）治疗护士在超声引导下 SPC 置管的信心和能力。IV 治疗护士完成了一个理论和实践培训课程，在模拟过程中使用家禽模型练习超声引导下 SPC 放置技术，然后在介入放射科医生的监督下对患者进行超声引导下 SPC 插入。数据收集包括干预前和干预后信心自我评估、频率跟踪器、Difficult Intravenous Access（DIVA）量表评分以及护士放置的超声引导 SPC 总数。培训计划后，超声引导下 SPC 放置显著增加。2017 年 IV 治疗护士共放置 29 个超声引导 SPC，2018 年放置 391 个，2019 年放置 711 个。2018 年 5 月 DIVA 评分平均为 4.54，2018 年 7 月升至 5.17，表明在更困难的患者中成功放置 SPC。使用家禽模型模拟实施超声引导 SPC 放置计划是增加儿科患者超声引导 SPC 放置能力的推荐护理资源。
