An Emergency Department Nurse-Driven Ultrasound-Guided Peripheral Intravenous Line Program

Abstract

Background: Ultrasound-guided peripheral intravenous (USGPIV) technology is being utilized more frequently in emergency department settings. Traditionally, physicians have performed this procedure to gain vascular access in patients for whom standard intravenous line procedures are unsuccessful. Nurses at Wexner Medical Center at The Ohio State University have shown that a nurse-driven ultrasound program can be successfully implemented in an emergency department. Methods: Standardized training for registered nurses includes a 4-hour didactic and hands-on course and 24 hours of 1-on-1 individualized instruction with a nurse champion. Emphasis is placed on avoiding the larger upper arm veins. Results: A peripheral intravenous line database has been maintained since the beginning of the program in 2009. This database shows a significant percentage of admitted patients received USGPIV service. In 2010, USGPIVs were successfully placed 90% to 98% of the time. Conclusions: Utilizing UGSPIV can expedite treatment and disposition in an emergency department. Ultimately, throughput and wait time for an emergency department bed can thus be similarly affected, positively affecting customer service.