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Survey of ultrasound-guided peripheral intravenous practices: a report of supply usage and variability between clinical roles and departments

22 October 2020
Association for Vascular Access
02 October 2020
Volume 29 · Issue 19

Abstract

Background

The purpose of this study was to investigate ultrasound-guided peripheral intravenous (UGPIV) supply usage practices by clinicians working in vascular access, in emergency departments (EDs), or in other roles.

Methodology

In 2019, a voluntary cross-sectional descriptive survey was conducted via SurveyMonkey. Data collected included demographics, practice-oriented information, procedural activities, and supplies used for UGPIV insertions. Frequency distributions and results of Fisher's exact test and one-way analysis of variance were reported using R v.3.5.2.

Results

A total of 26,649 surveys were distributed with a response rate of 5.5% (n = 1475). Forty-eight percent of respondents (n = 709) indicated that they worked in a vascular access role, 310 (21%) worked in an ED, and 455 (31%) categorized their role as other. Clinically meaningful differences existed in all variables for UGPIV procedures and supplies between departments (P < 0.0001) and in all care settings. Using an investigatorconstructed overall metric of supplies used, important differences were demonstrated between personnel supply use in vascular access roles and other roles (P < 0.0001) and personnel in EDs and other roles (P < 0.0001).

Conclusions

Use of supplies for UGPIV insertions varies by department. The variability in supply usage for UGPIV insertions revealed by this survey suggests a need for clinical education on guideline application and evaluation of compliance with policies to promote standardization of supplies for UGPIV insertion.

Peripheral intravenous (PIV) catheters are the most common devices used to deliver medications, fluids, blood products, and nutrition. Approximately 2 billion PIV catheters are inserted worldwide every year.1

The impact of the aging population, increasing numbers of difficult access patients, and usage of irritating intravenous medication treatments make it increasingly difficult to successfully establish a PIV. Many other factors complicate successful PIV insertion including obesity, IV drug use, and conditions such as diabetes, cancer, and sickle cell disease.2 Ultrasound-guided peripheral cannulation has made it possible to improve PIV access success for patients with known difficult access veins (Supplemental Figure 1, available online).3,4

Estimates for incidence of difficult access are nearly 60% of patients, or 1 of every 2 patients in acute care.5 As a result, ultrasound-guided PIV (UGPIV) insertions are being used to ensure PIV placement success.6,7 As new devices and practices emerge, it is necessary to consider gaps in procedural asepsis, evaluate areas of noncompliance, and apply current guidelines to policies to ensure ongoing safety for patients.

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Ultrasound
Infection
Intravenous
Surveys and questionnaires
Vascular access devices