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  • Reducing peripherally inserted central catheters and midline catheters by training nurses in ultrasound-guided peripheral intravenous catheter placement

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Quality improvement report
Reducing peripherally inserted central catheters and midline catheters by training nurses in ultrasound-guided peripheral intravenous catheter placement
  1. Benjamin Galen1,
  2. Sarah Baron1,
  3. Sandra Young2,
  4. Alleyne Hall2,
  5. Linda Berger-Spivack2,
  6. William Southern1
  1. 1 Department of Internal Medicine, Division of Hospital Medicine, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York, United States
  2. 2 Deparment of Nursing, Montefiore Medical Center, Bronx, New York, United States
  1. Correspondence to Dr Benjamin Galen, Department of Internal Medicine, Division of Hospital Medicine, Montefiore Medical Center, Bronx, NY 10461, United States; bgalen{at}montefiore.org

Abstract

Background Training nurses in ultrasound-guided peripheral intravenous catheter placement might reduce the use of more invasive venous access devices (peripherally inserted central catheters (PICC) and midline catheters).

Methods We implemented an abbreviated training in ultrasound-guided peripheral intravenous catheter placement for nurses on an inpatient medical unit and provided a portable ultrasound device for 10 months.

Results Nurses on this unit placed 99 ultrasound-guided peripheral intravenous catheters with a high level of success. During the implementation period, PICC and midline catheter placement decreased from a mean 4.8 to 2.5 per month, meeting criteria for special cause variation. In the postimplementation period, the average catheter use reverted to 4.3 per month on the intervention unit. A comparison inpatient medical unit without training or access to a portable ultrasound device experienced no significant change in PICC and midline catheter use throughout the study period (mean of 6.0 per month).

Conclusions These results suggest that an abbreviated training in ultrasound-guided peripheral intravenous catheter placement for nurses on an inpatient medical unit is sufficient to reduce PICC and midline catheters.

  • Nurses
  • Patient safety
  • Quality improvement
  • Statistical process control
  • Hospital medicine

https://doi.org/10.1136/bmjqs-2019-009923

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    Footnotes

    • Twitter @DrGalenMD

    • Contributors All authors contributed to study design, implementation and manuscript revisions.

    • Funding This study was supported by a grant from the Hospitals Insurance Company / FOJP

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.