Doctor of Nursing Practice, Mount St. Joseph University , 2020, Department of Nursing
Medical surgical nurses vary in their ability to insert and assess peripheral IVs. Literature supports general lack of education in this area. The use of a blended online learning module and live simulation has been found to increase peripheral IV insertion confidence and competence (Schuster Stahl, Murray, & Glover, 2016; Schuster, Stahl, Murray, Keleekai & Glover, 2016). Internal application of a blended curriculum model for nurses indicates improved first attempt IV insertion success. Three online modules focusing on the standards of care of peripheral IV insertion, infection prevention and documentation, as well as phlebitis assessment for IVs previously inserted were completed followed by a simulation IV competence session. Student volunteers served as the patients with a practice forearm attached to the arm for cannulation. This live interaction aided in simulating a real IV insertion and assessment experience and required the learners to interact with the patient in describing the procedure.
The Peripheral Intravenous Cather Insertion Confidence Assessment (validated tool) was completed by participants (n=38) pre intervention, immediately post intervention and 30 days post intervention. A Mann-Whitney U test was completed and determined that nurses' confidence was significantly higher immediately following the intervention compared to pre intervention (p=0.003) and the increase was sustained 30 days after the intervention (p<0.001). While placing an IV in simulation, the observer measured competence by verifying 28 steps required, with a 76% success rate for all 28 steps. 24% missed one step with the majority being failure to label the dressing with date, time and initials. Nurses' self-reported first attempt peripheral IV success increased significantly from the pre intervention survey to the 30-day post intervention survey (p=0.00004). While significant, additional dissemination with hospital wide application is recommended.
Committee: Nancy Hinzman Dr (Committee Chair)
Subjects: Nursing