Implementation of an Ultrasound Guided Peripheral Intravenous (USGPIV) Educational Curriculum in a Pediatric Emergency Department

Background and Objective Studies have demonstrated that as many as 23% of pediatric emergency department (PED) patients meet criteria for difficult intravenous access (DIVA). These patients create challenges as DIVA can take twice as long as conventional peripheral intravenous (PIV) placement. Multiple studies have demonstrated successful PIV placement under US guidance (USGPIV). USGPIV placement can improve patient satisfaction, reduce procedural cost, and lower the risk of complications. The objective of this study was to evaluate a competency-based program for USGPIV placement and track advance practice providers (APPs), charge nurses, and a select group of staff nurses (nurse champions) who completed the course. Methods Our freestanding children’s hospital sees approximately 40,000 patients/year with over 25,000 PIVs being placed. A competency based USGPIV educational program was established in 2022. The program consisted of three structured phases for implementation: 1-pre-course educational session; 2-simulation training session; and 3-clinical use with proof of competency. The outcome measure was the total number of USGPIVs placed by APPs, charge nurses and nurse champions. Results Over a three-year period, APPs, charge nurses, and nurse champions participated in the competency-based training program. Of the APPs trained only 1 of the 6 APPs has maintained competency and is now an instructor. Of the charge nurses attending the course, none completed the clinical competency component due to lack of protected time while on their shift. Finally, recruitment was limited to nurse champions. This proved to improve skill retention and procedural efficiency, as nurse champions were more likely to actively practice and maintain competency. At the completion of Phase 3, a total number of 236 USGPIVs were placed with 167/236 (71%) by nurse champions. Conclusions The goal of this paper was to centralize a competency-based training program for USGPIV placement for healthcare providers. Three key core components were included: 1-pre-course educational session 2-simulation training session and 3-clinical use with proof of competency. By incorporating the core components, the goal was to provide an educational framework to successfully implement an USGPIV competency-based program. This could help aid other organizations to execute a universal and sustainable USGPIV training program at their institution.