Authors: (including presenting author): :
KO ML(1), Chan CYM(1), Yeung KYP(1), Sin CK(1), Wu HM(1)
Ho LH(2), Lai HL(2), Lam TL(2), Wong KY(2), Fung SC(2)
Affiliation: :
(1) Accident and Emergency Department, Tseung Kwan O Hospital, (2) Accident and Emergency Department, United Christian Hospital
Keyword 1: :
Educational Program
Keyword 3: :
Intravenous Catheterization
Keyword 4: :
Emergency Department
Introduction: :
Difficult vascular access is a common challenge in the Emergency Department (ED), particularly in patients with difficult vascular anatomy for various reasons, including obesity, chronic illness, and intravascular drug abuse. Traditional catheterization techniques can be ineffective in these cases, leading to delays in treatment, increased patient discomfort, and higher complication rates. Ultrasound-guided peripheral intravenous catheterization (USG-PIVC) enables real-time visualization of veins and guide cannulation. There is ample evidence to demonstrate ultrasound is effective in improving success rates, and reducing complications. However, there is no structured educational program in place to support clinical practice, resulting in many emergency nurses lacking confidence in using this technique, hinders its widespread adoption. In EDs of Hong Kong, enhancing nurses' skills in ultrasound-guided peripheral intravenous catheterization is crucial for improving patient care. Implementing a focused educational program will empower nurses, promote the effective use of ultrasound technology, and ultimately lead to better outcomes for patients with difficult vascular access.
Objectives: :
1. To develop an education program to introduce the principle of USG-PIVC to emergency nurses 2. To enhance the knowledge and confidence of emergency nurses in using USG-PIVC on patients with difficult vascular access in ED
Methodology: :
A structured program was implemented using the PDCA (Plan-Do-Check-Act) cycle and Kirkpatrick’s evaluation model. Forty-seven emergency nurses from two hospitals participated in a 30-minute tutorial (covering anatomy, techniques, and indications) followed by hands-on simulation with ultrasound phantoms. Pre- and post-tests measured knowledge gains, while Likert-scale surveys assessed confidence levels.
Result & Outcome: :
As result, post-training, correct identification of USG-PIVC sites improved from 30% to 75%, and confidence in procedural skills increased from 1.87 to 3.74 (5-point scale). Despite these gains, 92% of participants perceived the technique as challenging, underscoring the need for extended practice. To concluded, the educational program successfully enhanced nurses' understanding of USG-PIVC, though the persistent perception of complexity suggests a need for more comprehensive theoretical instruction and conceptual reinforcement. Future iterations should focus on deepening cognitive mastery before clinical application, potentially through extended didactic sessions and case-based learning approaches.
