Academic Journal
Training, technology, and escalation in IV access: A national survey of clinician experience with difficult venous access.
| Τίτλος: | Training, technology, and escalation in IV access: A national survey of clinician experience with difficult venous access. |
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| Συγγραφείς: | Bahl A; Department of Emergency Medicine, Corewell Health William Beaumont University Hospital, Royal Oak, MI, USA., Mielke N; Department of Medicine, Creighton University School of Medicine, Omaha, NE, USA. |
| Πηγή: | The journal of vascular access [J Vasc Access] 2026 Jul; Vol. 27 (4), pp. 1766-1772. Date of Electronic Publication: 2026 Feb 26. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Sage Publications Country of Publication: United States NLM ID: 100940729 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1724-6032 (Electronic) Linking ISSN: 11297298 NLM ISO Abbreviation: J Vasc Access Subsets: MEDLINE |
| Imprint Name(s): | Publication: 2018- : Thousand Oaks, CA : Sage Publications Original Publication: Milano ; Birmingham : Wichtig, c2000- |
| Ιατρικοί όροι (MeSH): | Catheterization, Peripheral*/adverse effects , Catheterization, Peripheral*/trends , Catheterization, Peripheral*/instrumentation , Ultrasonography, Interventional*/trends , Practice Patterns, Physicians'*/trends , Practice Patterns, Nurses'*/trends , Inservice Training*, Nursing Staff, Hospital/education ; Nursing Staff, Hospital/trends ; Humans ; Clinical Competence ; Health Care Surveys ; Health Knowledge, Attitudes, Practice ; Attitude of Health Personnel ; Vascular Access Devices ; United States ; Male ; Punctures ; Female ; Adult |
| Περίληψη: | Background: Peripheral vascular access device (PVAD) insertion is a frequent and critical procedure in hospitalized patients; yet success rates vary and complications are commonplace. Ultrasound (US) guidance can improve outcomes in difficult venous access (DIVA), but adoption and training among bedside clinicians remain inconsistent. We surveyed clinicians to assess current practices, training, and confidence in PVAD placement, including the use of US. Methods: Between July 9 and September 2, 2025, a total of 321 completed surveys were analyzed. Respondents included bedside clinicians (n = 247) and non-bedside clinicians (n = 74). Survey items captured demographics, clinical roles, PVAD practices, US availability, training, and self-reported confidence. Results: Among respondents, vascular access nurses (55.5%) and staff nurses (21.5%) predominated, with most working in medical/surgical units (72.6%). Frequent encounters with patients requiring >2 PVAD attempts were reported by 38.9%. Most respondents reported policies or informal norms mandating multiple insertion attempts before escalation, with two attempts most common (59.5%). US was available in 83.0% of units, but staff nurses had lower access (59.4% vs 92.1% for vascular access nurses) and lower personal use (37.7% vs 90.4%). Confidence in US-guided insertion was markedly lower among staff nurses (26.1% very confident) versus vascular access nurses (85.4%), as was formal training (23.2% vs 47.2%). Conclusions: Despite widespread US availability, many staff nurses lack access, training, and confidence in US-guided PVAD placement. Policies emphasizing multiple insertion attempts before escalation persist, and potentially contribute to patient harm. Structured, competency-based training programs are needed to improve skill acquisition, procedural success, and patient outcomes across bedside clinicians. |
| Competing Interests: | Declaration of conflicting interestsThe authors declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: AB is a paid consultant for Lineus Medical, Becton Dickinson, Skydance Vascular, CIVCO. AB has research grant support from Becton Dickinson, B. Braun. AB and NM are co-founders of Operation STICK. |
| Contributed Indexing: | Keywords: Difficult venous access; education; interventional; nursing; peripheral intravenous catheter; peripheral vascular access device; training; ultrasound; vascular access devices |
| Entry Date(s): | Date Created: 20260227 Date Completed: 20260720 Latest Revision: 20260720 |
| Update Code: | 20260720 |
| DOI: | 10.1177/11297298261424635 |
| PMID: | 41749447 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1724-6032 |
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| DOI: | 10.1177/11297298261424635 |