Dychter SS, Gold DA, Carson D, Haller M Intravenous therapy: a review of complications and economic considerations of peripheral access. J Infus Nurs.. 2012; 35:(2)84-91

Galen B, Baron S, Young S, Hall A, Berger-Spivack L, Southern W Reducing peripherally inserted central catheters and midline catheters by training nurses in ultrasound-guided peripheral intravenous catheter placement. BMJ Qual Saf.. 2020; 29:(3)245-249

van Loon FHJ, Buise MP, Claassen JJF, Dierick-van Daele ATM, Bouwman ARA Comparison of ultrasound guidance with palpation and direct visualisation for peripheral vein cannulation in adult patients: a systematic review and meta-analysis. Br J Anaesth.. 2018; 121:(2)358-366

Armenteros-Yeguas V, Garate-Echenique L, Tomas-Lopez MA Prevalence of difficult venous access and associated risk factors in highly complex hospitalised patients. J Clin Nurs.. 2017; 26:(23-24)4267-4275

Gottlieb M, Sundaram T, Holladay D, Nakitende D Ultrasound-guided peripheral intravenous line placement: a narrative review of evidence-based best practices. West J Emerg Med.. 2017; 18:(6)1047-1054

Stuckey C, Curtis MP Development of a nurse-led ultrasound-guided peripheral intravenous program. J Vasc Nurs.. 2019; 37:(4)246-249

Carrico RM, Furmanek S, English C Ultrasound probe use and reprocessing: results from a national survey among U.S. infection preventionists. Am J Infect Control.. 2018; 46:(8)913-920

Rowley S, Clare S Standardizing the critical clinical competency of aseptic, sterile, and clean techniques with a single international standard: Aseptic Non-Touch Technique (ANTT®). JAVA.. 2019; 24:(4)12-17

Marschall J, Mermel LA, Fakih M Strategies to prevent central lineassociated bloodstream infections in acute care hospitals: 2014 update. Infect Control Hosp Epidemiol.. 2014; 35:(7)753-771

Gorski L, Hadaway L, Hagle M Infusion therapy: standards of practice (Supplement 1). J Infus Nurs.. 2016; 39:(1S)S1-S159

, 5th ed. : Infusion Nurses Society; 2016

Paladini A, Chiaretti A, Sellasie KW, Pittiruti M, Vento G Ultrasound-guided placement of long peripheral cannulas in children over the age of 10 years admitted to the emergency department: a pilot study. BMJ Paediatr Open.. 2018; 2:(1)

Panebianco NL Ultrasound-guided vascular access. In: Baker RD, Baker SS, Davis AM Hoboken, NJ: John Wiley & Sons Ltd; 1997

Campagna S, Gonella S, Zerla PA The risk of adverse events related to extended-dwell peripheral intravenous access. Infect Control Hosp Epidemiol.. 2018; 39:(7)875-877

Zhang L, Cao S, Marsh N Infection risks associated with peripheral vascular catheters. J Infect Prev.. 2016; 17:(5)207-213

DeVries M, Valentine M Bloodstream infections from peripheral lines: an underrated risk. Am Nurs Today.. 2016; 11:(1)

Mermel LA Short-term peripheral venous catheter—related bloodstream infections: a systematic review. Clin Infect Dis.. 2017; 65:(10)1757-1762

Thompson J, Garrett JH Transducer disinfection for evaluation and insertion of peripheral and central catheters for vascular access teams and clinicians. JAVA.. 2018; 23:(3)141-146

Mullaney P, Munthali P, Vlachou P, Jenkins D, Rathod A, Entwisle J How clean is your probe? Microbiological assessment of ultrasound transducers in routine clinical use, and cost-effective ways to reduce contamination. Clin Radiol.. 2007; 62:(7)694-698

Chu K, Obaid H, Babyn P, Blondeau J Bacterial contamination of ultrasound probes at a tertiary referral university medical center. Am J Roentgenology.. 2014; 203:(5)928-932

Shokoohi H, Armstrong P, Tansek R Emergency department ultrasound probe infection control: challenges and solutions. Open Access Emerg Med.. 2015; 7:1-9

Carrico RM, Furmanek S, English C Ultrasound probe use and reprocessing: results from a national survey among US infection preventionists. Am J Infect Control.. 2018; 46:(8)913-920

DeVries M, Valentine M, Mancos P Protected clinical indication of peripheral intravenous lines: successful implementation. JAVA.. 2016; 21:(2)89-92

Rickard CM, Webster J, Wallis MC Routine versus clinically indicated replacement of peripheral intravenous catheters: a randomised controlled equivalence trial. Lancet.. 2012; 380:(9847)1066-1074

Stevens C, Milner KA, Trudeau J Routine versus clinically indicated short peripheral catheter replacement: an evidence-based practice project. J Infus Nurs.. 2018; 41:(3)198-204

Oleszkowicz SC, Chittick P, Russo V, Keller P, Sims M, Band J Infections associated with use of ultrasound transmission gel: proposed guidelines to minimize risk. Infect Control Hosp Epidemiol.. 2012; 33:(12)1235-1237

Nyhsen C, Humphreys H, Koerner R Infection prevention and control in ultrasound-best practice recommendations from the ESRUWG. Insights Imaging.. 2017; 8:(6)523-535

Thorn S, Gopalasingam N, Bendtsen TF, Knudsen L, Sloth E A technique for ultrasound-guided blood sampling from a dry and gel-free puncture area. J Vasc Access.. 2016; 17:(3)265-268

Drafz M, Goeller K, Dizon B, Buc D, Moureau N Efforts toward standardization of UGPIV insertion through quantitative clinical product evaluation.: Las Vegas, NV; 2019

Rickard CM, Marsh N, Webster J Dressings and securements for the prevention of peripheral intravenous catheter failure in adults (SAVE): a pragmatic, randomised controlled, superiority trial. Lancet.. 2018; 392:(10145)419-430

Moureau N Impact and safety associated with accidental dislodgement of vascular access devices: a survey of professions, settings, and devices. JAVA.. 2018; 23:(4)203-215

Nyhsen C, Humphreys H, Nicolau C, Mostbeck G, Claudon M Infection prevention and ultrasound probe decontamination practices in Europe: a survey of the European Society of Radiology. Insights Imaging.. 2016; 7:(6)841-847

Moore C, Kollpainter R, Andrews L AIUM practice parameter for the use of ultrasound to guide vascular access procedures. J Ultrasound Med.. 2019; 38:(3)E4-E18

Timsit JF, Rupp M, Bouza E A state of the art review on optimal practices to prevent, recognize, and manage complications associated with intravascular devices in the critically ill. Intensive Care Med.. 2018; 44:(6)742-759

Mimoz O, Lucet J-C, Kerforne T Skin antisepsis with chlorhexidinealcohol versus povidone iodine-alcohol, with and without skin scrubbing, for prevention of intravascular-catheter-related infection (CLEAN): an openlabel, multicentre, randomised, controlled, two-by-two factorial trial. Lancet.. 2015; 386:(10008)2069-2077

Gilbert RE, Mok Q, Dwan K Impregnated central venous catheters for prevention of bloodstream infection in children (the CATCH trial): a randomised controlled trial. Lancet.. 2016; 387:(10029)1732-1742

Survey of ultrasound-guided peripheral intravenous practices: a report of supply usage and variability between clinical roles and departments

22 October 2020
Volume 29 · Issue 19



The purpose of this study was to investigate ultrasound-guided peripheral intravenous (UGPIV) supply usage practices by clinicians working in vascular access, in emergency departments (EDs), or in other roles.


In 2019, a voluntary cross-sectional descriptive survey was conducted via SurveyMonkey. Data collected included demographics, practice-oriented information, procedural activities, and supplies used for UGPIV insertions. Frequency distributions and results of Fisher's exact test and one-way analysis of variance were reported using R v.3.5.2.


A total of 26,649 surveys were distributed with a response rate of 5.5% (n = 1475). Forty-eight percent of respondents (n = 709) indicated that they worked in a vascular access role, 310 (21%) worked in an ED, and 455 (31%) categorized their role as other. Clinically meaningful differences existed in all variables for UGPIV procedures and supplies between departments (P < 0.0001) and in all care settings. Using an investigatorconstructed overall metric of supplies used, important differences were demonstrated between personnel supply use in vascular access roles and other roles (P < 0.0001) and personnel in EDs and other roles (P < 0.0001).


Use of supplies for UGPIV insertions varies by department. The variability in supply usage for UGPIV insertions revealed by this survey suggests a need for clinical education on guideline application and evaluation of compliance with policies to promote standardization of supplies for UGPIV insertion.

Peripheral intravenous (PIV) catheters are the most common devices used to deliver medications, fluids, blood products, and nutrition. Approximately 2 billion PIV catheters are inserted worldwide every year.1

The impact of the aging population, increasing numbers of difficult access patients, and usage of irritating intravenous medication treatments make it increasingly difficult to successfully establish a PIV. Many other factors complicate successful PIV insertion including obesity, IV drug use, and conditions such as diabetes, cancer, and sickle cell disease.2 Ultrasound-guided peripheral cannulation has made it possible to improve PIV access success for patients with known difficult access veins (Supplemental Figure 1, available online).3,4

Estimates for incidence of difficult access are nearly 60% of patients, or 1 of every 2 patients in acute care.5 As a result, ultrasound-guided PIV (UGPIV) insertions are being used to ensure PIV placement success.6,7 As new devices and practices emerge, it is necessary to consider gaps in procedural asepsis, evaluate areas of noncompliance, and apply current guidelines to policies to ensure ongoing safety for patients.

Register now to continue reading

Thank you for visiting British Journal of Nursing and reading some of our peer-reviewed resources for nurses. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to clinical or professional articles

  • Unlimited access to the latest news, blogs and video content