UGPIV Practices: Are they jeopardizing patient safety?

A new continuing education program details how a lack of standardized policies related to ultrasound-guided peripheral IV (UGPIV) catheter insertions can negatively impact patient safety. The webinar also suggests UGPIV performance improvement initiatives that “can help to create a culture of safety across the healthcare continuum,” according to presenter Nancy Moureau, RN, PhD, an internationally recognized expert and consultant in vascular access and CEO of PICC Excellence.

The on-demand webcast, Patient Safety and Ultrasound-Guided Peripheral IV Placement: The Need for Standardized Practices, offers 1 contact hour of continuing education for nurses. It is sponsored by Parker Laboratories.

“While the use of ultrasound guidance to improve success during PIV catheter placements is becoming more common, suboptimal aseptic technique and variations in supply usage poses a very serious risk to patients,” said Dr. Moureau. “To increase safety during UGPIV insertions, healthcare organizations should adopt a multidisciplinary approach to standardize policies and procedures based on current evidence and recommendations, while at the same identifying opportunities for pragmatic, incremental improvements.”

In the 60-minute webcast, Dr. Moureau provides an overview of common safety concerns and presents methods to improve patient safety through the application of standardized policies, training and competency assessment for UGPIV procedures. In addition, she discusses current guidelines and recommendations for application of aseptic technique, device disinfection, probe protection and gel usage.

Dr. Moureau also discusses her recent survey of vascular access and emergency department clinicians, published in the September issue of Journal of the Association for Vascular Access, which revealed significant levels of variation in UGPIV practices and supply use across hospitals and alternate care settings. The survey results confirmed that variations in UGPIV practices occur in a number of areas, including the handling of contamination sources, ultrasound probe protection, and gel use and cleanup. 

To work towards greater standardization, Dr. Moureau says facilities should assess their existing ultrasound use and practices, with emphasis on ultrasound disinfection practices, use of sterile probe covers and sterile gel, and other core infection control recommendations. 

PIV insertion is the most commonly performed invasive medical procedure among hospitalized patients. Over 70 percent of acute care patients require IV access at some point during their stay, and up to 60 percent of those patients may be considered to have difficult vascular access (DiVA). These patients frequently require ultrasound guidance in order to successfully achieve peripheral access and receive necessary treatments. 

The use of ultrasound may increase the risk of contamination during PIV insertions if certain guidelines are not followed to maintain a sterile insertion site and use the appropriate supplies (gel and transducer protection). According to Dr. Moureau, a specialty gel-free insertion dressing that separates the transducer and gel from the insertion site (UltraDrape, Parker Labs) may address and even mitigate many of these issues while reducing the cost of performing UGPIV insertions.

Dr. Moureau’s program is the latest in a series of continuing education webinars on infection prevention in vascular access from Healthcare Hygiene Magazine. The publication also recently issued a special edition on vascular access-related infection prevention imperatives, which featured an article on the importance of improving UGPIV patient safety

“We know we can improve UGPIV patient safety with standardized procedures, quality training, and monitoring compliance,” Dr. Moureau says in the article. “The time has come to decide what these best practices are and implement them consistently across all departments.”

Why IV Lines Fail: A Crazy Little Thing Called Dislodgement

With something like 300 million peripheral IV lines sold in U.S. each year – and a failure rate that’s often cited as being 50% – researchers continue to try to understand a problem that’s a daily headache in vascular access and infusion therapy.

4-1Common causes of line failure are dislodgement, infection, thrombosis, phlebitis and occlusion. Peripherally inserted central catheters (PICCs) and central venous catheters (CVCs) tend to be better secured than peripheral IVs, but they are also subject to high failure rates.

“Intravenous catheter dislodgement is a significant and avoidable problem,” said vascular access consultant Leigh Ann Bowe-Geddes, BSN, RN, CRNI, VA-BC, a well known vascular access clinical consultant and former president of the Association for Vascular Access. Continue reading “Why IV Lines Fail: A Crazy Little Thing Called Dislodgement”