Implementing advanced skills to ease pain

By Capt. Nicole D. Kline, RN, Eisenhower Army Medical CenterOctober 1, 2019

Implementing advanced skills to ease pain
(Photo Credit: U.S. Army) VIEW ORIGINAL

Capt. Nicole D. Kline, RN


Eisenhower Army Medical Center

It's 0330 and a patient is having their labs drawn … or at least the staff is trying. They have been for past 45 minutes, and this was their fourth attempt. Frustration is working itself through the staff, patient and patient's family. Surely, there has to be a better way.

Technology and continuously advancing their repertoire of skills provide our nurses with tools to enhance the delivery of five star patient care. Despite up to date competencies, skills, and training, patients' pre-existing conditions, body type, age and other factors can lend themselves to veins that elude traditional or blind intra-venous cannulation. Unfortunately, these particular patients frequently have to endure multiple venipuncture attempts during their hospital visit.

Using cutting edge technology, namely the utilization of portable ultrasound to guide the needle and catheter on its journey into a vein, several Nurses are curbing the frustration, pain and cost of obtaining IV access. These portable ultrasound machines are quite prevalent throughout the hospital and available in almost all areas where patients need to have IV access initiated or labs drawn.

9MSP conducted a pilot study over a four-week period. Data was obtained for 328 IV access and lab draws, where traditional "blind" attempts, which use touch and sight to locate and access veins, were compared against those using portable ultrasound. The ultrasound-guided attempts resulted in a 97.7 percent success rate on the first attempt which is more than 30 percent greater than the blind stick method.

These numbers are not unique, as several studies from across the United States support similar outcomes when using ultrasound machines. Furthermore, many medical centers and medical degree programs have incorporated ultrasound IV access as standard practice.

These successful percentages prompted the nurses and medics of Eisenhower Army Medical Center to take action. There are only a handful of nurses and medics to date who have the training and demonstrated proficiency necessary to provide this option to patients. They have proven to be assets to their coworkers and patients.

In the past, patients who were "hard sticks" would openly discuss losing faith in their health care team and dread seeing any nurse with a needle. Using the ultrasound, patients can breathe a sigh of relief knowing that multiple IV attempts will rarely be necessary. Overall impressions and feedback from patients are motivating.

Additionally, less compromised skin integrity directly correlates to lower infection rates and are strongly supported by CDC guidelines. Ultrasound IVs protect patients not only during IV placement but also by decreasing the overall risk for infection as fewer attempts are necessary to achieve access.

Implementing and encouraging the use of this technology not only improves patient care and safety, but also promotes patient satisfaction, ensuring delivery of the 5-Star care EAMC promises its patients.

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-- Editor's note: 1st Lt. Claudiu Ene, Andrea Chavous, 1st Lt. Molly Martin, and Sgt. Anasheh Aslanian contributed to this article.