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Peripheral IV catheter checklist improves clinician competence, skill
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A newly developed short peripheral IV catheter insertion skills checklist has yielded positive results in the improvement of clinician skill in a simulated environment, according to a study published in The Journal of the Association for Vascular Access.
According to a press release from B. Braun Medical, peripheral IV catheter insertion (PIVC) procedural failures are often linked to clinical performance variability. These failures include multiple insertion attempts, patient discomfort and frequent catheter failure.
“Accurately measuring the PIVC skill of clinical staff is an integral, but missing part of the PIVC procedure quality improvement process required to complete a PIVC insertion procedure needs assessment, uncover clinical variation, intervene with appropriate training and monitor and report on the clinical quality and cost of care outcomes,” Nowai L. Keleekai, PhD, RN, from Overlook Medical Center in Summit, New Jersey, and colleagues wrote in the study.
Adverse events from PIVC increase discomfort in patients, delay therapy and increase the cost of health care through extended treatment, as well as length of stay at the hospital.
To fill the need for a checklist that can measure PIVC insertion performance accurately and reliably, researchers modified an original 30-step version of the PIVC Insertion Skills Checklist, which had been used as PIVC training for nurses and educators since 2009.
The modified PIVC training program was reviewed by a panel of three vascular access experts who had no other involvement in the study. The three experts participated in a 3-hour classroom-based training program that included checklist instruction, deliberate practice with feedback and a debriefing process. To qualify as a rater, experts needed at least a 90% minimum passing grade.
The three experts came to a unanimous agreement that the checklist captured all steps necessary to perform start performing PIVC.
The use of the checklist resulted in appropriately high internal consistency (Cronbach’s alpha = 0.84) and was able to be used reliably when combined with the rater training program (intraclass coefficient, 0.99; 95% CI, 0.99-0.99).
According to the researchers, this is the first time a PIVC checklist that includes validity and reliability evidence has been published.
“Providing psychometric evidence related to the checklist gives users a quantitative way to judge its performance and compare its use over many clinical and research applications,” the researchers wrote. “Creating a valid, reliable and generalizable checklist to measure PIVC insertion skill is a key step in assessing baseline competence and skill mastery.” – by Dave Quaile
Disclosure: The researchers report no relevant financial disclosures.
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