Effectiveness of a Brief Teaching Scenario in a Phantom-Based Learning Model for Students to Achieve Ultrasound-Guided Vascular Access—a Prospective Study

Improving healthcare professionals' ultrasound-guided peripheral vascular access ability utilizing self-assembled ultrasound phantoms: A prospective, observational quality improvement project

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.

Measuring the Compression Force Required for Vascular Shortening in Ultrasonic Vascular Models

Background Vascular compression is important for deep vein thrombosis screening. However, pressure analysis of ultrasound vessel models has not been performed. Therefore, we compared the human popliteal vein and several ultrasound vessel models at 50% compression. Methodology Four major ultrasound vascular models used in Japan and the popliteal vein of one subject constituted our measurement targets. Using a pressure-sensitive measuring device, the compressive force required to shorten the vessel diameter by 50% was determined. Results The compression force that shortened the popliteal vein by 50% was measured to be 191 ± 65 g. The blue phantom, ultrasound CV Pad II, ultrasound training block, and UGP-GEL required compression force of 701 ± 8 g, 265 ± 12 g, 697 ± 20 g, and 745 ± 15 g, respectively. The compression force for the ultrasound training block was 2.6 times higher than that for the ultrasound CV Pad II. The gel material around the vessels was the same; however, different vascular tubes required 2.6 times higher compression force. Conclusions This study showed that the objective numerical values of the compressive force were required to compress an ultrasound vascular model. Reproduction of the compressibility of veins required either removing the vascular structure or using thin tubing material.