Introduction: the placement of peripheral intravenous catheters in patients with difficult venous access (DVA) leads to high rates of failure even
for experienced operators. The use of ultrasound guidance (US-guided peripheral access, USPA) has shown an increase in the success of cannulation
attempts compared with "blind" methods. This study evaluated the ability of learning and the effectiveness in performing the USPA technique in
patients DVA by nurses with little professional experience and inexperienced in ultrasound.
Materials and methods: three novice nurses and a Nursing student (NOV Group) performed a prospective cross-sectional study, supervised by
an experienced tutor. The research protocol was also applied by operators with expertise in USPA (EXP group).
Results: fifty-nine DVA patients were included (mean age: 78.5). Forty-eight (81.4%) procedures were performed by NOV and 11 (18.6%) by
EXP. Forty-one USPA (69.5%) were successfully completed (NOV: 66.7% EXP: 81.8%, p=0.48). In group NOV, most of the USPA procedures
(39; 81.3%) were performed by the student (success: 69.2%). There were no significant immediate complications.
Discussion: in a population of very elderly patients with extremely poor peripheral venous access, the support of ultrasound guidance has allowed
access to veins definitely not accessible using the "blind" methods, often deep and/or of a very small gauge, with an overall ultrasound-guided
approach success of 86.4%, when including the procedures completed by the tutor. The studies that have evaluated the USPA technique in DVA
patients by more experienced operators but with no experience in ultrasound-guided methods reported a success rate of 63-84%.
Conclusions: novice nurses or still in training and nurses with no previous experience in operating ultrasound can effectively learn and perform
USPA procedure in DVA patients, without immediate complications. It is important to encourage the acquisition of ultrasound operational expertise
for clinical nurses, starting from the basic training course.
