Ultrasound Guided Peripheral Venous Access

Abstract

Certified Registered Nurse Anesthetists (CRNAs) currently practice in all settings where anesthesia is delivered. Establishing intravenous (IV) access is one of the first steps to providing a safe and effective anesthetic, thus the ability to do this quickly and efficiently is a crucial skill for CRNAs. IV access can be difficult to obtain, especially in patients with unpalpable vasculature or a history of difficult venous access. One alternative to standard IV insertion methods is the utilization of ultrasonography for peripheral IV placement. Currently, many healthcare institutions lack structured ultrasound (U/S) training programs for CRNAs. A multi-modal education program for the use of U/S for peripheral IV placement was designed and implemented at the Fall 2021 Michigan Association of Nurse Anesthetists (MANA) conference. The course included a didactic education component, as well as a hands-on component using task trainers. Twenty-one CRNAs participated, with each one completing both a pre-education and post-education knowledge assessment, in addition to a hands-on skill check- off to demonstrate competency. Scores improved by an average of 1.61 (SD = 1.16) after education thus demonstrating a significant improvement, t(20) = 6.39, p < .001. Additionally, 100% of CRNAs were able to demonstrate competence in peripheral IV placement with ultrasound on a task trainer following education and practice. Therefore, multi-modal education in the use of ultrasound for peripheral IV placement is effective in increasing CRNAs’ knowledge and competence in this skill.