Locations:
Search IconSearch
July 26, 2023/Nursing/Research

Ultrasound May Help Nurses Successfully Obtain Peripheral Vascular Access on the First Attempt

Study shows ultrasound can be valuable tool for improving patient satisfaction by reducing failed IV insertions

23-NUR-3534832-NN-Rsrch-RiskFactors-Difficult-IV-startsInptnt-CQD-1_650x450

Ultrasound appears to help facilitate peripheral vascular access in hospitalized adult patients, according to a study led by Cleveland Clinic nurse researchers. In assessing factors associated with IV access success in a series of 394 medical-surgical patients at Cleveland Clinic, ultrasound use was an important predictor of first-attempt and overall peripheral IV access success, according to lead investigator Andrew Callahan, BSN, RN, Assistant Nurse Manager. He is scheduled to present the data at the Cleveland Clinic Nursing Research Conference in late April.

Advertisement

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

“We found that ultrasound was more successful than the standard landmark technique in enabling peripheral vascular access,” says Callahan.

Ultrasound was used in 227 of the 394 (57.6%) IV access attempts evaluated in the study. When asked why he wanted to study ultrasound access, Callahan explained: “Landmark techniques are important, but I thought there had to be a better way to insert IVs. I also met an elderly patient with cancer who told me that there were many nurses who assessed her arm veins, attempted to insert an IV and failed; she was frustrated.

“I listened to her story and wondered if we could use ultrasound for every patient. When researching peripheral IV access in adults, I found papers in the peer-reviewed literature that showed the effectiveness of ultrasound guidance for placing IVs. I presented findings from the ultrasound literature review to my manager, who indicated that our research department was thinking about studying difficult IV starts.”

Study participants consisted of medical-surgical patients who required IV access and nurses who attempted IV access on multiple nursing units. Nurses agreed to complete case reports that described their perceptions about more than 30 factors associated with successful IV insertions. Data were also collected from medical records.

Of the cohort assessed, the first-attempt success rate was 20% lower than the overall IV access success rate, which was over 80%. In multivariable modeling, multiple factors were associated with first-attempt and overall IV access success. Of the factors that correlated to first-attempt IV access, two were related to patient veins, four were related to nurses’ experience and perceptions about IV access, and one was associated with patient verbalization of difficult IV access. In addition, vein visibility and palpability were associated with overall IV access success.

Advertisement

“Since use of an ultrasound device was an important predictor of success, the hope is to facilitate nurse autonomy by teaching nurses how to use the imaging modality to reduce the number of IV attempts their patients require. Fewer attempts can decrease supply usage, nursing time and other resources needed to establish IV access,” Callahan says. “Patient satisfaction is also important. When I am using the ultrasound to start peripheral access, patients seem more at ease.”

Since overall success in IV access did not reach 100%, future research findings may be used to justify the creation of a systemwide vascular access team, he adds.

Advertisement

Related Articles

Nurse researchers
May 30, 2025/Nursing/Innovations
Advancing the Nursing Profession Through Science

How nurses are using frontline research to improve patient outcomes and healthcare delivery

Pink stethoscope with NICU label
May 30, 2025/Pediatrics
Why Words Matter in the NICU

How one simple project changed the conversation about care and the patient-parental experience

Helicopter
Anytime, Anywhere: Critical Care On The Go

Transport nurses prepare to manage all patients and acuity levels

Nurse Kristen Vargo
Successfully Transitioning from Nursing Peer to Leader (Podcast)

How to move from working side-by-side with nursing colleagues to leading a team

Nurse Margee Pagnucco
Connecting with Health Organizations Around the World (Podcast)

Nurses play a pivotal role in Cleveland Clinic Connected, a global affiliation program aimed at sharing expertise

Portrait of nurse David Lucas
April 23, 2025/Nursing/Podcast
Specialty Spotlight: Caring for Patients in a Neurological ICU (Podcast)

What it’s like working in neurology critical care and what to consider before entering the specialty

Nurse giving shot
April 21, 2025/Nursing/Clinical Nursing
Modern Healthcare’s Ambulatory Care Nurse

Delivering specialized care and education that improves outcomes

Nurses in OR
April 16, 2025/Nursing/Clinical Nursing
Perioperative Nurses Help Propel Robotic Surgery Programs

As robotics in the OR grows, so does the role of nurses

Ad