McKinney Amanda, Steanson Kimberly, Lebar Kiersten
Dell Children's Medical Center, Austin, Texas (Dr McKinney); Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee (Dr Steanson); and Jefferson Health Systems, Philadelphia, Pennsylvania (Dr Lebar).
Adv Neonatal Care. 2023 Feb 1;23(1):17-22. doi: 10.1097/ANC.0000000000000969. Epub 2022 Feb 15.
Ultrasound-guided imagery to obtain peripheral intravenous (USGIV) access is a technique that can be used to increase successful peripheral intravenous catheter insertion rates. Improving rates of USGIV use will subsequently decrease central venous catheter use and thus decrease the time to treatment initiation, reduce costs, and improve patient satisfaction.
Current available programs teach nurses USGIV use for the adult population, mainly with a focus on the emergency department. To address this gap in knowledge, a USGIV program aimed at the specific needs of the neonatal intensive care unit (NICU) nurse was developed and implemented.
Twelve NICU nurses were trained in USGIV access during a 4-hour combination didactic and simulation-based program. Participants took a pretest survey assessing baseline knowledge and confidence levels related to USGIV access. After didactic lecture, participants worked at stations focused on USGIV access. An 80% benchmark for each participant was set for successful USGIV attempts during simulation. Participants' knowledge and confidence levels were reassessed at the end of the program.
Posttest scores increased by an average of 25%, demonstrating increased knowledge. The pre- to posttest confidence scores increased by a minimum of 1.6 points (based on a 5-point Likert scale). All participants (n = 12) successfully demonstrated proficiency by achieving at least 80% of attempted USGIV access on a mannequin.
This project demonstrated that USGIV catheter can be employed in neonatal patients by training NICU nurses in USGIV techniques.
超声引导下获取外周静脉通路（USGIV）是一种可用于提高外周静脉导管插入成功率的技术。提高USGIV的使用比例将相应减少中心静脉导管的使用，从而缩短开始治疗的时间、降低成本并提高患者满意度。
目前现有的培训项目主要针对成人，教导护士如何使用USGIV，且主要集中在急诊科。为了填补这一知识空白，开发并实施了一个针对新生儿重症监护病房（NICU）护士特定需求的USGIV培训项目。
12名NICU护士参加了一个为期4小时的理论与模拟相结合的USGIV通路培训项目。参与者进行了一项预测试调查，以评估与USGIV通路相关的基线知识和信心水平。在理论讲座之后，参与者在专注于USGIV通路的站点进行操作。为每位参与者在模拟过程中成功进行USGIV尝试设定了80%的基准。在项目结束时重新评估参与者的知识和信心水平。
后测分数平均提高了25%，表明知识有所增加。前后测的信心分数至少提高了1.6分（基于5点李克特量表）。所有参与者（n = 12）在模拟人上成功进行至少80%的USGIV尝试，从而证明了其熟练程度。
该项目表明，通过对NICU护士进行USGIV技术培训，USGIV导管可用于新生儿患者。
