Remotely supervised ultrasound-guided peripheral intravenous cannulation training: A prospective cohort study examining success rates and patient experience

Nathan Peters; Joel Thomas; Christine Woods; Claire Rickard; Nicole Marsh

doi:10.1002/ajum.12318

Remotely supervised ultrasound-guided peripheral intravenous cannulation training: A prospective cohort study examining success rates and patient experience

Australas J Ultrasound Med. 2022 Sep 16;25(4):176-185. doi: 10.1002/ajum.12318. eCollection 2022 Nov.

Authors

Nathan Peters^{1

2

3}, Joel Thomas^{1

2}, Christine Woods^{1

2}, Claire Rickard^{2

4

5

6}, Nicole Marsh^{4

5

6}

Affiliations

¹ Department of Anaesthesia and Perioperative Medicine Royal Brisbane and Women's Hospital Brisbane Queensland Australia.
² University of Queensland Brisbane Queensland Australia.
³ Department of Surgery University of Melbourne Melbourne Victoria Australia.
⁴ School of Nursing and Midwifery Griffith University Brisbane Queensland Australia.
⁵ Alliance for Vascular Access Teaching and Research Group Griffith University Brisbane Queensland Australia.
⁶ Metro North Hospitals and Health Service Brisbane Queensland Australia.

Abstract

Introduction: Ultrasound-guided peripheral intravenous cannulation (USGPIVC) benefits patients with difficult intravenous access (DIVA) through visualising otherwise non-visible and non-palpable veins. Supervised live-case training is an important component of learning this skill, but supervisor availability can present a barrier limiting or delaying staff completing their training.

Aims: The aim of this study was to determine the first-attempt success rate of newly trained USGPIVC inserters using remote supervision and timely written feedback based on app-based screen recordings taken during insertion. Secondary aims were overall procedural success, and inserter and patient experiences.

Methods: This study is an observational cohort study carried out between October and December 2021. Fourteen newly trained junior medical officers (JMOs) were eligible to utilise USGPIVC on a minimum of five consenting patients while simultaneously recording the ultrasound screen during insertion to capture their technique. Feedback was generated following expert review of these recordings against a standardised feedback tool.

Results: Average first-attempt success was 71% (n = 72) in the 102 patients recruited. The average time for JMOs to receive feedback was 30 h, and 13 JMOs (93%) felt well supported and completed the remote training pathway. The majority of patients were female (n = 59; 58%), were aged 41-80 years (n = 75; 74%) and had ≥2 risk factors for DIVA (n = 57; 56%).

Conclusions: First-attempt success rates were similar when comparing remote supervision used in this study to direct supervision used by other studies.This finding supports incorporating remote supervision into training guidelines for USGPIVC as an alternative method of supervision, particularly when supervisor availability is limited.

Keywords: catheterisation; difficult vascular access; education; peripheral; ultrasound guidance.