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International, Journal of Medical Science and Innovative Research (IJMSIR). "Effectiveness of demonstration versus video assisted teaching on IV cannulation skills among nursing students at selected nursing colleges, Bangalore." International Journal of Medical Science and Innovative Research (IJMSIR) 9, no. 5 (2024): 11–22. https://doi.org/10.5281/zenodo.15430162.
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<strong>Abstract</strong> Introduction: IV cannulation involves inserting a cannula into a vein to directly administer medications or fluids into the bloodstream, requiring precise proficiency from healthcare providers for rapid and reliable circulatory access in medical care and monitoring. Objectives: This study aims to investigates the effectiveness of demonstration versus video-assisted teaching methods on intravenous (IV) cannulation skills among nursing students. Methodology: Quasi experimental study design was adopted and 80 nursing students were recruited by convenient sampling technique, data was collected by using socio demographic variables and observational check list on IV cannulation skills. The data were analyzed by descriptive and inferential statistics. Results: The study revealed significant enhancements in IV cannulation skills among nursing students using both demonstration and video-assisted teaching methods (P<0.05). Initially, 80% of the demonstration group and 90% of the video-assisted teaching group exhibited poor skills. Following the interventions, mean IV cannulation scores improved from 11.52 ± 2.54 to 19.02 ± 1.83 in the demonstration group and 9.98 ± 1.91 to 17.22 ± 2.09 in the video-assisted teaching group. Moreover, 92.5% of the demonstration group and 70% of the video-assisted teaching group achieved proficient IV cannulation skills. Interpretation and conclusion: This study underscores the importance of innovative teaching methodologies in nursing education to optimize IV cannulation procedural skill acquisition and student learning outcomes. Future research may explore further enhancements and adaptations of demonstration and video- assisted teaching in diverse nursing education contexts.
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Mamatha, K., G. Nirmala, and Dr P. Balakrishna. "A Study to Assess the Effectiveness of IV Refresher Course on Pediatric IV Cannulation Among Registered Nurses." International Journal of Science and Healthcare Research 7, no. 2 (2022): 399–403. http://dx.doi.org/10.52403/ijshr.20220456.
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Pediatric intravenous (IV) cannulation is an integral part of modern medicine and is practiced in every health care setting. Children have approximately half the number of usable veins than adults, but they have less accessible veins. Pediatric IV cannulation can be challenging. Nurses performing IV procedures in children should demonstrate skill and knowledge in performing IV applications. Simulation provides effective and efficient knowledge and skills regarding pediatric IV cannulation. So the investigator decided to conduct the study in Apollo DRDO Hospital Hyderabad with a purpose to assess the effectiveness of IV Refresher course on Pediatric IV cannulation among Registered nurses who is working in Pediatric units. A quantitative pre experimental one group pre-test and post test design was selected to assess the effectiveness of IV refresher course on pediatric IV cannulation among the registered nurses. For this study total 30 nurses were selected by using purposive sampling technique. The study was conducted in Apollo DRDO Hospital Hyderabad. Data was collected with the help of Demographic Variables, structured knowledge questionnaires and Modified Intravenous Cannulation Skills Check List, with the permission from Nursing Head and Ethical consideration from Apollo Hospital Jubilee hills. The Results showcased that the pre–test mean Knowledge score was +8.63 and Standard Deviation (SD) ±1.79 whereas the post-test mean Knowledge score of was ±11.9 and Standard Deviation (SD) ±1.54. The calculated paired ‘t’ value was (8.03) which is more than the table value (1.699) at 0.05 level of significance. On job hands on training which helps the Register nurses to develop necessary confidence and competencies in any given procedure. so Nursing staff can be able to practice procedure properly with the patient. The IV refresher course had enabled the nurses to develop skills in Intravenous cannulation for the pediatric patients. Keywords: Simulation, Knowledge, practice, skills on Pediatric IV Cannulation, on-job training, IV refresher course.
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McCarthy, Nichola. "Teach all students phlebotomy, cannulation, ecg and iv skills." Nursing Standard 26, no. 35 (2012): 32. http://dx.doi.org/10.7748/ns2012.05.26.35.32.p8246.
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McCarthy, Nichola. "Teach all students phlebotomy, cannulation, ECG and IV skills." Nursing Standard 26, no. 35 (2012): 32. http://dx.doi.org/10.7748/ns.26.35.32.s42.
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Mohammed Ali, Bashar R., Ibrahim Alwan Al-Ashour, Mohammed Hakim Shamran Al-Hchaim, Mohammed Abdualkareem Aljanabi, and Jinan Fadhel Kadum. "Evaluation of Nurses' Performance Regarding Intravenous Cannulation." Pakistan Journal of Medical and Health Sciences 16, no. 8 (2022): 549–52. http://dx.doi.org/10.53350/pjmhs22168549.
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Objective: aimed to evaluate nurses' performance regarding intravenous cannulation. Methodology: In order to attain the initial stated purpose, descriptive research was conducted for the current study. The research was conducted between February 20 and March 21, 2018. The research was conducted at AL-Najaf City/AL-Najaf AL-Ashraf Health Center Directorate / AL-Sader Medical City & AL-Zahra Teaching Hospital. A non-probability (accidental sample) of (100) male and female nurses working at AL-Sader Medical City and AL-Zahra Teaching Hospital with at least one year of experience. Before assigning them to the research, we received their permission. A tool for assessing the intravenous cannulation skills of nurses was used. The data were collected using the observational checklist approach of the designed questionnaire, which was observed three times using the English version of the questionnaire, and the researchers conducted interviews in the same manner. Validity of the study instrument is conducted through a panel of experts with years of experience in the nursing field. The information was analyzed using inferential statistics, which included the mean of scores, as well as descriptive statistical analysis techniques, which included frequency, percentage, and cumulative percentage. Results: According to the research, al-Sader Medical City and Al-Zahraa Teaching Hospitals in Najaf have poor or insufficient intravenous cannulation nursing abilities. In the two hospitals, it was discovered that, respectively, 94% and 82% of the nursing staff were poor. Conclusion: The research found that most nurses utilize inadequate IV cannulation techniques. The study recommendation advises nurses to join in training sessions to develop their abilities in IV cannulation. Keywords: Evaluation, Nurses' Performance, Intravenous Cannulation.
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Ault, Mark J., Ryoko Tanabe, and Bradley T. Rosen. "Peripheral Intravenous Access Using Ultrasound Guidance: Defining the Learning Curve." Journal of the Association for Vascular Access 20, no. 1 (2015): 32–36. http://dx.doi.org/10.1016/j.java.2014.10.012.
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Abstract Background: The need for peripheral intravenous (IV) access in anatomically challenging patients is becoming a more commonly encountered clinical problem. The significant investment devoted to physician training for ultrasound-guided vascular access has not yet been matched by a similar commitment to nursing. Nurses, paramedics, and physicians are becoming more enthusiastic about peripheral IV access with ultrasound (PIVUS); however, institutional and clinician support has not yet been forthcoming. The learning curve for PIVUS has never been rigorously studied, and may be flatter than previously assumed. Methods: Registered nurses were selected to participate as trainees. Training involved 1:1 sessions consisting of formal orientation to portable ultrasound, mentoring, and practice sessions with a nurse practitioner who has expertise in ultrasound-guided peripheral vascular access; hands-on, supervised practice cannulating vessels on a nonhuman tissue simulator; and supervised attempts on live patients. Results: Seven of 8 trainees completed the training. The average number of patient encounters required to achieve 10 successful IV placements was 25 (range =18–32). The average time required for successful vessel cannulation was 19.57 minutes (range =5–62 minutes). An average of 25 attempts was required to achieve proficiency, and average of 50 cases was required to maintain consistency. Conclusions: In today's practice environment, PIVUS skills are increasingly important. The results of our study demonstrate that, with appropriate hands-on training and supervision, these skills can be effectively taught to registered nurses.
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Lund, Frederike, Jobst-Hendrik Schultz, Imad Maatouk, et al. "Effectiveness of IV Cannulation Skills Laboratory Training and Its Transfer into Clinical Practice: A Randomized, Controlled Trial." PLoS ONE 7, no. 3 (2012): e32831. http://dx.doi.org/10.1371/journal.pone.0032831.
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Ciafre, Lisa, Matthew Bigbee, Holley Stallings, et al. "The prevention of anticancer therapy extravasation events in the oncology clinic infusion patient: A quality improvement study." Journal of Clinical Oncology 38, no. 29_suppl (2020): 192. http://dx.doi.org/10.1200/jco.2020.38.29_suppl.192.
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192 Background: The Allegheny Health Network Cancer Institute (AHNCI) Medical Oncology is comprised of 19 infusion clinics located in the western Pennsylvania region. Safety quality assurance data revealed an extravasation rate of 0.12% for vesicant anticancer therapies. A literature review identified a benchmark for these extravasations to be 0.09% confirming that the AHNCI had an opportunity to improve patient safety. Methods: A multidisciplinary quality team with support from ASCO’s Quality Training Program was developed to decrease extravasation occurrences utilizing problem solving tools and PDSA methodology. A process flow map and cause and effect diagram revealed opportunities in the following categories: People–Lack of formal IV training resulting in care dependent on experiential knowledge only; Process–There is not a standardized process for IV starts; Plant–Supply standardization was non-existent. Offices and staff utilized the catheter of their choice with varying levels of technology for early detection of vein cannulation. The use of catheter stabilizing dressings or devices did not exist. Diagnostic data analysis revealed that a majority of extravasation events occurred peripherally in the forearm with a 24g, 0.75” catheter. Therefore, this quality team’s focus was on the prevention of peripheral extravasations. Gemba walk utilizing an observation tool identified that nurses often made decisions based on personal comfort rather than best practice. Process measures: Process Change #1: Standardize IV Catheters across the network to reduce variation and ensure that the chosen catheter’s manufacture technology includes early vein cannulation technology and to implement IV start kits with a securement dressing. Process Change#2: Educate nurses in vein assessment technique, catheter selection and insertion skill. Results: Allegheny Health Network Cancer Institute was able to decrease extravasation events from 0.12% to 0.02% due to the innovation of this quality improvement team by standardizing supplies and ensuring staff competency with peripheral IV insertion knowledge and skills. Conclusions: Validating a problem through data is essential–we can’t manage what we can’t measure.Validating a problem’s value through evidence is necessary (patient harm). Benchmarking must be supported with a high level of evidence. Eliminating variation improves investigative outcomes. Implementing process measures through best practice evidence and not hypothesis is essential.
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Lone, Mutahira, Ahmad H. Sheikh, Andreea Factor, Niamh Moore, and Muhammad A. Javaid. "Impact of a multimodal anatomy CPD course on intravenous cannulation skills – An Irish radiographers and radiation therapists’ perspective." European Journal of Anatomy 26, no. 1 (2022): 73–86. http://dx.doi.org/10.52083/qpaw2060.
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Radiographers and radiation therapists continually upgrade their knowledge to remain informed and competent in modern radiological imaging techniques. Despite the generally agreed upon significance of anatomy for successful interpretation of imaging modalities, its link with clinical performance of radiographers and radiation therapists has not been highlighted before. The above-stated gap in the literature was addressed by employing an anatomy-based CPD course and investigating its influence on intravenous cannulation and administration skills of 10 radiographers and 4 radiation therapists. The course comprised interactive anatomy tutorials (employing vascular histology e-modules and vascular prosections), lectures and simulation sessions to practice IV cannulation. Likert questionnaires were employed to gauge attitudes and interests, prior to and after the course. At the end of the course, participants perceived anatomy prosections/dissection more useful compared to other learning modalities, including social media, textbooks, e-learning, plastic models and lectures. This corresponded with a significant increase in their perceived level of anatomy knowledge and confidence in identifying structures on prosections, and tracing vessels on radiographs and body surface. Anatomy-based CPD course was valued with regards to their career progression and enhancement of anatomical knowledge. Furthermore, the use of prosections and hands-on practical sessions was highly commended and a desire to attend similar future courses was expressed. Lastly, participants identified factors facilitating or hindering course attendance and offered advice to improve efficacy of future courses. We conclude that an interactive anatomy-based CPD—employing multimodal pedagogies—can be effective in enhancing anatomy knowledge and clinical competence of radiographers and radiation therapists.
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Shaukat, Haroon, Beemnet Neway, Kristen Breslin, et al. "Utility of the DIVA score for experienced emergency department technicians." British Journal of Nursing 29, no. 2 (2020): S35—S40. http://dx.doi.org/10.12968/bjon.2020.29.2.s35.
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Background: The DIVA score is validated for predicting success of the initial attempt at peripheral intravenous insertion by nurses and physicians. A score of 4 or greater is 50% to 60% likely to have a failed first attempt. The study objective was to assess the validity of this score for emergency department technicians. Methods: This study used a prospective convenience sample of 181 children presenting to the emergency department with intravenous access attempt by one of 29 emergency department technicians. DIVA score, total number of attempts, and median time to successful intravenous cannulation were obtained. Results: Comparing patients with a DIVA score <4 to ≥4, first-time IV placement failure rates were lower (9% [95% CI, 3–24] vs. 41% [95% CI, 33–49]) and median time to IV placement was shorter (75 [interquartile range (IQR) 42–157] vs. 254 [IQR 91–806]) seconds. In patients with scores ≥4, emergency department technicians with ≥5 years of experience were significantly more likely to be successful on the first attempt (OR 2.8; 95% CI, 1.03–7.63). For every year of technician experience, the time to catheter placement, adjusted for DIVA score, decreased by 25 minutes (P≤0.05, R2=0.05). Comparing our receiver operating curve to the derivation study, the areas were similar (0.67 vs. 0.65). Conclusions: This study provides preliminary evidence for the validity of the DIVA score when applied to IVs placed by emergency department technicians. For patients with high DIVA scores, ≥5 years of IV experience was associated with higher odds of successful first-time IV placement and shorter time to placement. HIGHLIGHTS The difficult intravenous access (DIVA) score may be generalizable to IVs placed by experienced emergency department technicians (EDTs) Higher odds of first-time success in difficult patients with ≥5 years EDT experience Early identification of difficult access may allow for aid of alternative technology Likely first study to evaluate EDTs IV skills in patients with varying DIVA scores
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Mace, Sharon E. "Prospective, double blind, randomized, controlled trial comparing vapocoolant spray versus placebo spray in adults undergoing intravenous cannulation." Scandinavian Journal of Pain 17, no. 1 (2017): 8–15. http://dx.doi.org/10.1016/j.sjpain.2017.06.002.
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AbstractObjectivesPainful diagnostic and therapeutic procedures are common in the health care setting. Eliminating, or at least, minimizing the pain associated with various procedures should be a priority. Although there are many benefits of providing local/topical anesthesia prior to performing painful procedures, ranging from greater patient/family satisfaction to increased procedural success rates; local/topical anesthetics are frequently not used. Reasons include the need for a needlestick to administer local anesthetics such as lidocaine and the long onset for topical anesthetics. Vapocoolants eliminate the risks associated with needlesticks, avoids the tissue distortion with intradermal local anesthetics, eliminates needlestick pain, have a quick almost instantaneous onset, are easy to apply, require no skills or devices to apply, are convenient, and inexpensive. The aims of this study were to ascertain if peripheral intravenous (PIV) cannulation pain would be significantly decreased by using a vapocoolant (V) versus sterile water placebo (S) spray, as determined by a reduction of at least >1.8 points on numerical rating scale (NRS) after vapocoolant versus placebo spray, the side effects and incidence of side effects from a vapocoolant spray; and whether there were any long term visible skin abnormalities associated with the use of a vapocoolant spray.Materials and methodsProspective, randomized, double-blind controlled trial of 300 adults (ages 18-80) requiring PIV placement in a hospital ED, randomized to S(N = 150)or V(N = 150) prior to PIV. Efficacy outcome was the difference in PIV pain: NRS from 0 (none) to worst (10). Safety outcomes included a skin checklist for local adverse effects (i.e., redness, blanching, edema, ecchymosis, itching, changes in skin pigmentation), vital sign (VS) changes, and before/after photographs of the PIV site.ResultsPatient demographics (age, gender, race), comorbidity, medications, and vital signs; and PIV procedure variables (e.g., IV needle size, location, number of IV attempts, type and experience of healthcare provider performing the IV) were not significantly different for the two groups. Median (interquartile range) PIV pain was 4 (2,7) (S) and 2 (0,4) (V) (P< 0.001). Skin checklist revealed minimal erythema: S 0% (N = 0/150), V: 2.7% (4/150), which resolved within 5min, and no blanching, skin pigmentation changes, itching, edema, or ecchymosis. Photographs at 5-10 min revealed no visible skin changes in any patient (N=300), vapocoolant (N = 150) or placebo groups (N = 150). Complaints (N = 26) were coolness/cold feeling S 8.7% (N = 13), V 7.3% (N = 11), coolness/numbness S 0% (N =0), V 0.7% (N =1), and burning S 0.7% (N =1), V 0 (0%). Patient acceptance of the vapocoolant spray was high: 82% (123/150) of the patients stated they would use the spray in the future, while only 40.7% (61/150) of the placebo group stated they would use the placebo spray in the future.Conclusions and ImplicationsVapocoolant spray significantly decreased peripheral intravenous cannulation pain in adults versus placebo spray and was well tolerated with minor adverse effects that resolved quickly. There were no significant differences in vital signs and no visible skin changes documented by photographs taken within 5-10 min postspray/PIV.
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Elikplim Pomevor, Kokui, and Augustine Adomah-Afari. "Health providers’ perception of quality of care for neonates in health facilities in a municipality in Southern Ghana." International Journal of Health Care Quality Assurance 29, no. 8 (2016): 907–20. http://dx.doi.org/10.1108/ijhcqa-04-2016-0055.
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Purpose The purpose of this paper is to assess available human resources for neonatal care and their skills, in order to explore health providers’ perceptions of quality of neonatal care in health facilities in Ghana. Design/methodology/approach Data were gathered using qualitative interviews with health providers working in the maternity and paediatric wards and midwives; direct observation; and documentary review at a regional hospital, a municipal hospital and four health centres in a municipality in a region in Southern Ghana. Data were analysed using thematic framework through the process of coding in six phases to create and establish meaningful patterns. Findings The study revealed that health providers were concerned about the number of staff available, their competence and also equipment available for them to work more efficiently. Some essential equipment for neonatal care was either not available or was non-functional where it was available, while aseptic procedures were not adhered to. Moreover, personal protective equipment such as facemask, caps, aprons were not used except in the labour wards where staff had to change their footwear before entering. Research limitations/implications Limited number of health providers and facilities used, lack of exploration of parents of neonates’ perspective of quality of neonatal care in this study and other settings, including the teaching hospitals. The authors did not examine issues related to the ineffective use of IV cannulation for neonates by nurses as well as referral of neonates. Additionally, the authors did not explore the perspectives of management of the municipal and regional health directorates or policy makers of the Ministry of Health and Ghana Health Service regarding the shortage of staff, inadequate provision of medical equipment and infrastructure. Practical implications This paper suggests the need for policy makers to redirect their attention to the issues that would improve the quality of neonatal health care in health facilities in Ghana and in countries with similar challenges. Social implications The study found that the majority of nursing staff catering for sick newborns were not trained in neonatal nursing. Babies were found sleeping in separate cots but were mixed with older children. The study suggests that babies should be provided with a separate room and not mixed with older babies. Originality/value There seemed to be no defined policy framework for management of neonatal care in the country’s health care facilities. The study recommends the adoption of paediatric and neonatal care nursing as a specialty in the curricula of health training institutions. In-service trainings should encompass issues related to management of sick babies, care of preterm babies, neonatal resuscitation and intravenouscannulation, among others.
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Welyczko, Nikki. "Peripheral intravenous cannulation: reducing pain and local complications." British Journal of Nursing 29, no. 8 (2020): S12—S19. http://dx.doi.org/10.12968/bjon.2020.29.8.s12.
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Caring for patients with peripheral intravenous cannulas/catheters (PIVCs) is an important part of the nurse's role and insertion of PIVCs has traditionally been a post-registration nursing skill. With the introduction of the Nursing and Midwifery Council Standards of Proficiency for Registered Nurses in 2018, insertion of PIVCs is to be incorporated in pre-registration nursing programmes for all four fields of nursing practice. Although IV cannulation is a commonly performed clinical procedure, it is associated with significant risks and complications, which can cause pain for patients. This article outlines the factors that can cause pain for adult patients requiring a PIVC and recommends that the use of local anaesthetics be more widely considered when inserting a cannula. The identification, prevention and clinical management of commonly occurring painful local complications that can arise post-PIVC insertion are also discussed.
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Davis, Joshua, Timothy Faust, Azeem Tajani, et al. "A randomized study of training with large versus small vessel size on successful ultrasound-guided peripheral venous access." Journal of Vascular Access 18, no. 2 (2017): 163–66. http://dx.doi.org/10.5301/jva.5000645.
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Purpose Our objective was to investigate whether training on phantoms with smaller or larger vessels would improve success rate in novice medical students learning this skill. Methods Medical students who participated in a voluntary, extracurricular ultrasound training day were asked to participate in the study as part of their procedural training. They were given a standardized education and demonstration of how to use ultrasound to place a peripheral intravenous (IV) catheter. They were then randomized to practice three times on homemade phantom models with either a 5-mm or a 2.5-mm diameter simulated vessel. Afterwards, they were observed attempting to place an ultrasound-guided IV on a 5-mm diameter vessel. Successful cannulation rates was the primary outcome. Results Fifty-one students from five institutions were included in the analysis. No significant difference in success rate, time to cannulation, number of sticks, or number of redirects was seen between the group who trained on the phantoms with the smaller vessels versus those who trained on the phantoms with the larger vessel. A trend towards significance was seen for success rate and number of redirects, favoring the group trained on the smaller vessels, but this did not reach significance. Conclusion In our small sample, there was no difference in success rate of novice students trained in ultrasound-guided peripheral IV access using either a smaller or a larger vessel phantom. Future work should focus on elucidating other aspects of training in ultrasound-guided procedures and should attempt a similar study with a larger sample size.
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Naik, Sajad Hussain. "A Study to Assess the Occurrence and Risk Factors of Phlebitis among Peripheral Intravenous Cannulated Patients admitted in Emergency Wards of SKIMS, Soura, Srinagar with a view to develop Phlebitis Prevention Protocol." Trends in Nursing Administration & Education 11, no. 1 (2022): 5–15. http://dx.doi.org/10.24321/2348.2141.202202.
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Introduction: Almost half of the patients who are administered intravenous fluid infusion or blood transfusion via IV cannula insertion develop phlebitis. This study was conducted to assess the occurrence and risk factors of phlebitis among peripheral intravenous cannulated patients admitted in the emergency wards of SKIMS, Soura, Srinagar with a view to develop phlebitis prevention protocol. Methodology: A non-experimental descriptive research design was used for the study. Convenient sampling technique was used for the selection of 250 patients. The prepared tool (semi-structured observation checklist) and phlebitis prevention protocol were validated by experts. Pre-testing and pilot study was conducted on patients other than the study sample. The data collected were analysed using descriptive and inferential statistics.Results: The results of our study showed that phlebitis occurred in more than half of the patients (58%). Among these, grade-1 phlebitis was seen in most of the patients (32.8%) and grade 4 phlebitis was seen in only 0.4%. Most of the patients developed phlebitis within the first 48 hours (26.4%) and 72 hours (20.4%) of cannulation time. There was a significant association of phlebitis with age and gender, site of cannulation, disinfection of cannula site, size/ gauge of cannula, infusion of ionotropic drugs and blood and its products, mode of infusion of IV fluids potassium chloride, and phenytoin, administration of piperacillin/ tazobactam, vancomycin, metronidazole, and imipenem. Conclusion: Staff nurses should be made aware of the various risk factors associated with phlebitis. Appropriate training and education programmes should be implemented.
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O Dochartaigh, Domhnall, Christopher Picard, Warren Ma, et al. "Ultrasound guidance for pediatric vein cannulation: an emergency nurse quality improvement initiative and registry." Canadian Journal of Emergency Nursing 43, no. 2 (2020): 8–9. http://dx.doi.org/10.29173/cjen58.
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Background
 Between 10 and 25 percent of pediatric patients present to the emergency department (ED) with difficult to cannulate veins. Recent RCT evidence suggests that in pediatric patients assessed at being a predicted difficult IV start (by DIVA score of 3 or more), ultrasound guided catheter placement decreased the number of IV attempts, decreased time to successful IV placement, and improved first pass success, patient satisfaction, and catheter dwell time. Our QI project examines the specific learnings around ultrasound guided peripheral IV in pediatric patients and suggests opportunity for non-pediatric specialist hospitals to consider with the overall aim of minimizing IV attempts on all pediatric patients within our EDs.
 Building on a RCT led by Dr Curtis in pediatrics patients conducted at the Stollery from 2012-2014, a standardized ultrasound guided nurse performed procedure was implemented in 2016 at the University of Alberta and Stollery EDs, and expanded to the Royal Alexandra ED in 2017 and the Misericordia ED in 2019. Using the same education package and QI study methodology as previously reported in adult patients this study focused specifically on pediatric patients.
 Methods 
 A quality improvement (QI) registry was utilized to track complications and success of pediatric patients at all sites. The aim was to assess for program success, and improve education, training, and procedural success as required. Staff who had achieved independent practice voluntarily completed a tracking form whenever an ultrasound procedure occurred. Completed forms were assessed on a continual basis for any opportunities for improvement. Qualitative feedback was also obtained from informal interviews, a focus group, and a survey of the trained nurses. Feedback was thematically analyzed and grouped into themes for reporting.
 Results 
 There were no reported pediatric UGIV placed at the MCH and RAH during the study period. At the Stollery 126 cases were reported. Immediate insertion complications were noted in three cases as ‘pain or swelling at site’, and ‘unable to advance catheter’. In the first and second years of data collection the average number of traditional IV attempts prior to UGIV attempt decreased from 3.9 to 2.8; first ultrasound pass success increased from 65% to 86%; overall ultrasound success improved from 85% to 97.6% respectively. Increasing nurse skill was significant with a linear increase of first pass and overall success seen with increasing number of ultrasound starts: From 6-20 starts (54% first pass 64% overall success) through to >150 starts (97% first pass and 100% overall). QI staff feedback included ensure adequate pediatric specific supplies such as longer length small gauge catheters, and a procedural focus of patient, provider, and assistant set up. Location of IV placement was noted to change in a number of cases from hand and A/C to forearm.
 Advice and Lessons Learned 
 
 The key for staff to transition to procedural competance was to ensure initial and ongoing oportunities to place many ultrasound guided IVs (i.e. when time allows in all patients with non-optimal IV placement locations or with non-easy predicted tradititional IV starts)
 Further work is required at non specilaist hospitals with trained staff to increase ultrasound guided use in pedatric patients
 At all particapting sites work continues on unit level QI to minimize the number of IV attempts on all pedatric patients as well as work towards a cohort of available staff that are comforable and competent with ultrasound that can provide 24/7 unit coverage. (with limited numbers of trained staff there is increase burden on these staff to assist others while also completing their own nursing assignment.
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O Dochartaigh, Domhnall, Warren Ma, Christopher Picard, Richard Drew, and Matthew Douma. "Emergency nurse use of ultrasound guidance for vein cannulation: a three site quality improvement initiative and registry." Canadian Journal of Emergency Nursing 43, no. 2 (2020): 6–7. http://dx.doi.org/10.29173/cjen59.
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 Background 
 
 AHS suggests a limit of four attempts at traditional peripheral vascular access, however there are limited current options at many sites for these patients. Between 10 and 25 percent of patients present to the emergency department (ED) with difficult to cannulate veins. In these patients ultrasound guided catheter placement decreases the number of IV attempts, decreases time to successful IV placement, improves patient satisfaction, and in adult patients decreases central line use. Emergency nurses have been shown to successfully employ ultrasound-guided peripheral vascular access. Physician and Nursing clinical practice guidelines place a high recommendation for this practice. Despite the evidence and recommendations, in Canadian EDs, with notable exceptions there remains minimal standard procedural uptake or ED research.
 
 Implementation 
 For difficult peripheral intravenous access a standardized ultrasound guided nurse performed procedure was implemented in 2016 at the University of Alberta (UAH) ED, in 2017 to the Royal Alexandra Hospital (RAH) ED, and in 2018 the Misericordia Community Hospital (MCH) ED. An education module was created that included didactic learning and an exam, approximately one hour of in-person training which included vessel and structure identification and cannulation practice on a gel model until competence was achieved, and finally three successful mentored starts prior to independent practice. Mentorship ensured good technique was followed, provided additional tips to improve practice, and most importantly ensured an IV attempt was on a patient with veins amenable to a novice ultrasound provider attempt (e.g. if a patient was assessed to be a challenging ultrasound start with limited vein options the mentor would place the IV in much the same way as traditional IV placement mentoring). The ultrasound technique taught was a single operator, short access or traverse approach with dynamic tip tracking where the catheter needle tip is continually visualized as the target vessel is cannulated. Catheter placement is confirmed with the catheter tip visualized intraluminal and with an ultrasound visualized saline flush. This study reports on the first 30 nurses trained at the UAH, 12 at the RAH and 6 at the MCH.
 
 Evaluation Methods 
 A quality improvement (QI) registry documented complications and was used to improve education, training, and procedural success. The two QI study objectives were 1) to determine ultrasound program success for all sites by comparing QI results to historic results from other programs 2) to determine if an abbreviated training regimen (shorter than previously documented for adult patients in Canada) can be used to train nurses in EDs with minimal support or pre-existing experience with UGIVC.
 Staff who had achieved independent practice voluntarily completed a tracking form whenever an ultrasound procedure occurred. Completed forms were assessed on a continual basis for any opportunities for improvement. Qualitative feedback was also obtained from informal interviews, a focus group, and a survey of the newly trained nurses. Feedback was thematically analyzed and grouped into themes for reporting. Data and trends from the registry were used to reinforce education to promote greater procedural success. Also identified were questions to add to the tracking form to improve the usefulness of the registry. Ongoing review will identify if these efforts improve practice. Opportunities for system improvements were managed through consultation with all stake holders including nursing management, CNEs, physicians, and bedside nurses. Program evaluation will shape all aspects of the program development.
 
 Results 
 At the UAH, RAH, and MCH respectively; the mean number of failed IV attempts [SD] before UGIV was: 4.2 [2.5]; 3.4 [2.1]; 4.77 [2.9]; while first pass success by novice provider (1-10 UGIV starts) was 76%; 66%; and 62%. Success increased rapidly with the number of starts and plateaued after 100. Complications occurred in 4/374 (1%) starts. Qualitative feedback suggests that provider and patient positioning, and equipment preparation improve individual success; engaged staff and a QI registry improve program success; even in cases with more reported pain, patients prefer UGIV to traditional placement.
 Advice and Lessons Learned 
 Creating an ultrasound guided peripheral IV program and quality registry that supports emergency nurse use of this procedure is possible. First pass and overall catheter success rates and low reported compilications are reassuring.
 
 The quality registry has provided useful data to support practice and suggest modifications to the education and site specific system level supports provided. An example of system feedback is that newly trained staff need to have a clinical assignment that allows the opportnuity to utilize the procedure. Also enough mentors are required to support new staff. A third interesting system issue identifed is the possible effects of the training on traditional difficult IV placement skill and how to best support this.
 Emergency physicians and nurse champions can play a key supportive role to ensure the success of the program.
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Chinene, Bornface, and Osward Bwanga. "Role Development and Extension for Radiographers in Computed Tomography: Literature Review Findings and their Application to Zimbabwe." Medical Journal of Zambia 50, no. 4 (2024): 380–90. http://dx.doi.org/10.55320/mjz.50.4.449.
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Computed Tomography (CT) technology has evolved into a vital diagnostic tool in modern medical practice, leading to the development and extension of the CT radiographer's role. While some countries have made progress in developing and extending radiographers' roles in CT, resource-constrained settings like Zimbabwe have been slower to implement these changes. The purpose of this review is to inform role changes for radiographers in Zimbabwe and similar settings by reviewing the literature on role development and extension for radiographers in CT. The review explores the concepts of role development and extension, emphasizing the necessity for changes in radiographers' roles in CT due to factors such as radiologists shortages, cost containment, quality improvement needs, and technological advancements. It also addresses the opposition to role development and extension, emphasizing the fundamental impetus for these changes should be to provide high-quality and effective patient-centered care. The paper delves into specific areas of role development and extension for radiographers in CT, including intravenous (IV) cannulation and contrast media administration, performing CT colonoscopy examinations, reporting on CT brains, and the significance of research and clinical audit in CT. It underscores the potential benefits of these expanded roles, such as improved patient care, workflow efficiency, and the workload of radiologists, as well as advancements in education, service delivery, and technological innovations. The review underscores the need for further research to ensure evidence-based implementation of role development and extension for radiographers in CT. Embracing these changes and providing the necessary support and training can lead to improved patient care, address skill shortages, and advance the radiography profession in resource-constrained settings like Zimbabwe.
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Sr. Litty SH, Sr Thresiamma NC, and Dr S. Rajina Rani. "KNOWLEDGE AND PRACTICE ON IV CANNULATION AMONG NURSES." IDC International Journal 8, no. 1 (2021). http://dx.doi.org/10.47211/idcij.2021.v08i01.008.
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ABSTRACT Background: PIVC (Peripherally Intravenous Cannulation) is common invasive procedure in all hospital settings and nurses had a vital role in performing PIVC. It is the only fastest way to deliver any medications to the body. For fruitful insertion of cannulation the trainers should have proper knowledge and practical skills to succeed this procedure with minimum complication and positive client outcome with treatment. The objective was to determine the level of knowledge and practice on IV cannulation and its association with selected demographic and clinical variables. Materials and methods: By using convenience sampling technique 54 participants were recruited based on inclusion criteria. The study was conducted in St. John’s Hospital, Idukki. After gaining informed consent, data was collected by using self-structured questionnaire consisting demographic and clinical characteristics, questions regarding knowledge on IV cannulation and observational checklist for identifying practical skills in IV procedure. Results: Data was statistically analysed using SPSS version 20. Samples of 33(68.8%) had average and 10 (20.8%) had poor knowledge on IVC. Regarding practical performance, 27(56.3%) had average, 16 (33.3%) had good skills in IVC. Whereas 5(10.4%) had very poor practical skills on IVC. This study concluded that knowledge and practical skills in IVC should be improved by attending induction classes which can promote standardised care. Key words: Intravenous cannulation, knowledge, practice, staff nurses.
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Bullington, Phillip W., James R. Reed, Derek L. Owens, Janet L. Rothers, Gloanna J. Peek, and Christopher Herring. "Improving healthcare professionals’ ultrasound-guided peripheral vascular access ability utilizing self-assembled ultrasound phantoms: A prospective, observational quality improvement project." Journal of Vascular Access, May 27, 2024. http://dx.doi.org/10.1177/11297298241254633.
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Background: Ultrasound guidance can reduce the number of attempts to gain peripheral IV access while improving the success rate and satisfaction in patients with difficult IV access. Education and simulation are effective tools for improving the skills and knowledge related to ultrasound-guided peripheral IV access. Ultrasound phantom models allow for skill development without the risk of patient harm. Methods: Twenty-nine registered nurses and nurse practitioners were recruited for education and simulation regarding ultrasound-guided peripheral IV (USGPIV) placement. Participants completed a survey evaluating the efficacy of the phantom models in addition to pre- and post-intervention confidence, perceived competence, knowledge surveys, and a Directly Observed Procedural Skills Evaluation (DOPSE). The intervention included an educational PowerPoint and open practice session using the phantom models. Results: Statistically significant improvements were found in participants’ confidence ( p < 0.001; 95% CI: 5.287, 9.499; d = 1.31), perceived competence ( p < 0.001; 95% CI: 1.231, 2.742; d = 1.20), knowledge ( p < 0.001; 95% CI: 1.079, 2.163; d = 1.47), and skills ( p < 0.001; 95% CI: 2.499; 5.501; d = 1.29). Participants improved in maintaining needle visualization ( p < 0.001; 95% CI: 0.272, 0.9; d = 0.79) and decreasing their cannulation attempts (0.045; 95% CI: 0.013, 1.022; d = 0.48). Participants with no and novice experience saw statistically significant improvement across all categories ( p < 0.02) compared to those with intermediate, advanced, or expert experience with ultrasound. 96.5% of participants could perform ultrasound-guided peripheral IV cannulation independently or with indirect supervision following the intervention. Conclusions: At $36.52 per model, the self-assembled ultrasound phantom models provided a cost-effective and sustainable solution to teaching ultrasound-guided peripheral IV cannulations. Education and simulation for ultrasound-guided peripheral vascular access may benefit individuals with no or novice ultrasound experience.
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Srikanth, Damera, Grandhi Srujananjali, Ganni Sandeep, Ghanta Sunil, Ganesh Pampana, and Yerra Sindhuri. "Evaluating the Effectiveness of “B.A.S.I.C.S” Simulation in Undergraduate Dental Students: An Institutional Based Study." Journal of Maxillofacial and Oral Surgery, June 11, 2025. https://doi.org/10.1007/s12663-025-02600-6.
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Abstract Background Simulation training in medical education provides a risk-free environment for practicing clinical skills, enhancing proficiency, and fostering interdisciplinary teamwork. It integrates to modern healthcare training, providing safe environments for students to master clinical skills. The Basics of Anaesthesia, Surgery, and Intensive care in Clinical scenarios (BASICS) program at a Private Dental College focuses on anaesthetic, surgical, and certain procedures which were introduced to bridge academic knowledge and clinical application to enable dental students to develop clinical competencies in emergency procedures. Methods Dental students were segregated into groups and participated in simulation exercises which includes airway management, intubation, catheterization, ryle’s tube placement, intravenous cannulation, operation theatre etiquette, suturing and nasal packing. Training was complemented by theoretical lectures, online tests, hands-on sessions with mannequins, and debriefings. Faculty assessments and real-time feedback were provided, with statistical analysis evaluating improvements in task performance over multiple academic years. Results Over a 7-year period, the simulation-based training program demonstrated significant improvements in task efficiency and reduced durations for key clinical procedures, especially between the fourth-year and internship phases. Clinical tasks such as airway management, urinary catheterization, and IV cannulation showed substantial progress. Task durations notably decreased as students advanced, with reductions observed from third-year students to interns in airway management, urinary catheterization, and IV cannulation. These improvements indicate better skill retention, increased confidence, and greater efficiency. Conclusion The study confirms that simulation-based education facilitates skill acquisition, improves efficiency, and enhances confidence in clinical settings among dental students. The findings support the integration of simulation training within dental curricula to bridge the gap between theoretical knowledge and practical application, contributing to improved patient care.
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Makkink, Andrew William, and Emile Barnard. "Potential overtreatment by paramedic students: A study from three South African higher education institutions." Australasian Journal of Paramedicine 19 (June 15, 2022). http://dx.doi.org/10.33151/ajp.19.977.
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Introduction: Healthcare students are often required to perform predetermined numbers of clinical skills to prove competence. The pressures of meeting predetermined clinical skill numbers may result in students overtreating patients. Overtreatment is not without consequence to the patient. This study aimed to investigate perceptions related to possible overtreatment of patients by emergency medical care students in three South African higher education institutions (HEIs). Methods: This cross-sectional study used a purpose-designed, anonymous online questionnaire to collect data on possible patient overtreatment from emergency medical care student participants at three South African HEIs. Results: Of the participants, 45 self-reported reasonably low incidences of overtreatment of patients. The prescribed skill requirements were deemed appropriate as were practical shift numbers, but there was concern about achieving prescribed skill numbers. Participants generally considered risk versus benefit and clinical mentors generally agreed with student decisions without permitting overtreatment practices. Intravenous (IV) cannulation, oxygen administration and spinal immobilisation were the most common forms of overtreatment with advanced airway management and IV cannulation the most difficult to achieve. Lack of appropriately qualified practitioners and low patient numbers were the most common barriers to achieving required skill numbers. Conclusion: There was concern among participants about not reaching prerequisite skill numbers. Self-reported overtreatment of patients by participants was uncommon. The list of self-reported procedures most often forming part of overtreatment seemed to contradict this. The most common forms of overtreatment were clinical procedures that posed potential risk to the patient. There is a need to further explore overtreatment within healthcare student populations.
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Williams, Jarred P., Melita Macdonald, Peter A. Watts, and Brad F. Peckler. "Comparative Evaluation of Blue Phantom and SCOBY-Based Models for Ultrasound-Guided Intravenous Cannulation Training." Simulation in Healthcare: The Journal of the Society for Simulation in Healthcare, June 9, 2025. https://doi.org/10.1097/sih.0000000000000864.
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Introduction Ultrasound-guided intravenous (USIV) cannulation is a common alternative when IV access cannot otherwise be obtained. Many hospitals teach this skill with the commercial CAE Blue Phantom gelatinous training blocks. However, their cost is a barrier. This has led to experimentation with creative alternatives. Recent studies have trialed SCOBY (Symbiotic Culture of Bacteria and Yeast) in the production of training models for medical procedures. SCOBY is a biofilm-like structure appearing as a thick, rubbery film. We aimed to develop a 2-vessel SCOBY-based model and compare its effectiveness for teaching USIV against the Phantom. Methods Participants, 23 emergency medicine clinicians, performed USIV on each model and completed a pre- and post-procedure questionnaire. Results Seventy-four percent of participants indicated that the SCOBY model more closely resembled the clinical reality of human tissue compared with 13% for the Phantom. SCOBY provided an improved visual appearance, physical touch, feel of the procedure, and appearance of “subdermal tissues” on ultrasound compared to the Phantom. Conclusion These results suggest a promising future for SCOBY as a cost-effective alternative to teaching clinical skills.
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"1st Attempt Success Rate of Ultrasound-Guided Peripheral IV Access of Emergency Medical Services Health Care Providers on the Pre-Hospital Simulation Model." Journal of the Medical Association of Thailand 104, Suppl. 1 (2021): S35—S39. http://dx.doi.org/10.35755/jmedassocthai.2021.s01.12151.
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Background: Ultrasound guided peripheral intravenous access (USGPIV) has derived benefits for the Emergency and Pre-hospital Management. However, no studies have yet been conducted that have focused upon Emergency Medical Services (EMS) personnel in Thailand. Objective: To introduce USGPIV cannulation to the health care providers of Emergency Medical Services and to examine the success rates of the first attempts at PIV cannulation. Materials and Methods: This prospective observational study was conducted with 49 EMS providers in August 2020. All respondents had been participants in a USGPIV workshop. Afterwards, the participants’ skills were evaluated in a Pre-hospital simulation model, which was conducted in a moving ambulance. The data, which was recorded, noted the number of attempts required to successfully obtain USGPIV access, as well as the participants’ opinions about using ultrasound in this procedure. Results: Among the 49 participants, the first attempt success rate was found to be at 57.14%. The participants’ genders, their years of work experience, their experience of performing PIV with real patients, and the categories of the Emergency Medical Services health care providers were determined not to be factors that had contributed to the success rate of the first attempts at USGPIV. Our study demonstrated a “High” level of satisfaction with regard to performing USGPIV with this ultrasound device (4 out of 5). However, the participants noted that some elements of the environment in the ambulance may have affected the success rate of performing this procedure. Conclusion: In this study, the success rate of the first attempts was found to be lower than in other studies. However, in regard to this simulation, implementing this procedure represents the first step towards assisting Thai EMS personnel to perform ultrasound procedures. Keywords: Ultrasound, Peripheral IV cannulation, Emergency medicine, Emergency medical services, Emergency medical personnel
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Nalge, Swapnil, Dakshish Dakshish, Dhwani Gandhi, Divakar Balusamy, and Neelam Prajapati. "A COMPARISON BETWEEN SHOW ONE, DO ONE AND TEACH ONE (SODOTO) AND MODIFIED PEYTONS AS BASIC SURGICAL SKILLS TEACHING METHODS FOR UNDERGRADUATE MEDICAL STUDENTS." INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH, December 1, 2022, 33–36. http://dx.doi.org/10.36106/ijsr/0525470.
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Background: Teaching psychomotor skills to healthcare professionals is an ongoing challenge even today. These skills are utmost important to deliver competent patient care. Traditionally show one, do one and teach one method (SODOTO) is followed in Indian context, which is poorly structured. Thus knowledge is usually gained but skill acquisition is seldom assured. So introduction of modied PEYTONS as basic surgical teaching method may prove to be vital for enhancing competency of the candidate. II. Aim and Objectives: a) To assess efcacy of modied PEYTONS 4 step approach as a teaching tool for third year phase 2 MBBS students. b) To compare Show one, Do One and Teach One (SODOTO) and modied PEYTONS as basic surgical skill teaching method for undergraduate medical students. c) To compare post test scores of SODOTO Vs PEYTONS in simulated environment. III. Methodology: Study was conducted in the simulation laboratory of GMC, Surat. Third phase 2 undergraduate students posted in orthopaedics were divided in group A and B.Group A will be taught by the traditional method of SODOTO in which they will be observing the procedure rst, then assist followed by doing it themselves under guidance, in a week's time. Group B by modied PEYTONS 4 steps approach in which step 1 and 2 will be video assisted self-directed learning that will be sent to them via whatsapp, followed by step 3 and 4 in standard manner for a particular clinical skillset. Post intervention of 7 days assessment will be done by direct observation as per standard checklist. Flip over will be done for another basic surgical skill set for 7 days. Total of 2 surgical basic skill set of skin suturing in a simulated environment and placing an intravenous catheter will be assessed. No statistical IV. Findings: difference was found in the scores obtained by students of conventional Vs PEYTONS method, with the p value of 0.325 suturing skills and 0.22 in IV cannulation. But the feedback was very positive for PEYTONS group. V. Conclusions: PEYTONS four step approach is an interesting and innovative method of learning for students and may have a better memory retention in future and different ways of teaching avoids monotony and boredom.
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Mariam, Sayed Tawfik Mohamed Eltabbakh. "Exploring Parental Acceptance of Medical Student Participation in Pediatric Healthcare: A Pilot Study." MAR Cardiology & Heart Diseases 3, no. 9 (2024). https://doi.org/10.5281/zenodo.10791425.
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<strong><em>Abstract</em></strong> <strong><em>Background </em></strong><em>Healthcare is greatly influenced by how patients view and interact with medical students. With the incorporation of technology developments and therapeutic discoveries, current medical education techniques define the future of global healthcare. Although technology improves education, interaction with patients is still essential for fostering clinical judgment and empathy. According to studies, medical students are more responsible and well-prepared when dealing with actual patients, which boosts their self-assurance and multitasking skills. The general positive response from patients to medical student participation emphasizes the significance of comprehending patients' perspectives in order to provide effective undergraduate medical education.</em> <em> </em><strong><em>Methods</em></strong><em> This study utilized a descriptive, questionnaire-based, observational methodology, conducted at a Hospital in Sharjah, UAE, between June 2022 and October 2022. The Pediatric department was chosen as the target population due to the sensitivity dilemma involved in children's healthcare especially when handled by medical students. The study employed a self-administered questionnaire with five closed-ended questions, distributed online to participating parents after obtaining verbal consent. The questionnaire responses were anonymized using the patient's medical identifier number to ensure confidentiality and minimize bias. </em> <strong><em>Results</em></strong><em> In the study, the majority of 182 (97.3%) interviewed patients' legal guardians were comfortable with medical students retrieving their children's medical history. Additionally, 153 (81.8%) had no objections to physical examinations conducted by students. However, 175 (93.6%) parents preferred examinations to be supervised by a senior doctor. Only 85 (45.5%) parents were willing to allow procedures like IV cannulation and injections by medical students under nurse supervision. 141 (75.4%) participants accepted educational sessions with medical students using patient files and laboratory results for training purposes.</em> <strong><em>Conclusion</em></strong> <em>Based on existing literature and student participation in Pediatric care, this study found positive patient attitudes towards medical student involvement. Patients were more accepting of oral communication and educational sessions, but stricter regarding physical interactions that could cause distress. This perception may limit hands-on clinical experience and learning opportunities. Teaching hospitals should focus on improving patient attitudes towards student involvement in patient care to ensure adequate training for future medical practitioners.</em>