Nurses and Efficacy of Ultrasound-Guided Versus Traditional Venous Access: A Systemic Review and Meta-Analysis

Ultrasound-guided venous cannulation is an increasingly popular tool for peripheral intravenous catheter placement among nursing providers as opposed to standard of care landmark-based placement methods. This systematic review and meta-analysis assessed the use of ultrasound-guided versus landmark-based catheter cannulation among nursing providers across existing literature.

PubMed, Scopus, and Embase were searched for eligible studies from their beginning to June 11, 2021. Outcomes were the rate of first successful placement, procedure length, and number of total attempts. Bias and study quality were assessed using the Cochrane's Risk of Bias and the Newcastle-Ottawa Scale tools, respectively. Random-effects meta-analysis and assessed heterogeneity via Q-statistics and I² values were used.

The meta-analysis included 7 randomized clinical studies and 527 patients; 276 (52%) underwent ultrasound-guided cannulation and were associated with 2 times higher likelihood (odds ratio, 2.08; 95% confidence interval, 1.43-3.0; P < .001; I² < 0.001; 95% confidence interval, 0-18) of first successful placement by nurse clinicians. Ultrasound-guided venous cannulation by nurses was associated with similar number of attempts, procedure length, and patients' satisfaction, compared with standard-of-care cannulation.

This study demonstrated the advantage of nurses' ultrasound-guided venous cannulation over landmark-based cannulation methods for first successful placement, although other outcomes were not significantly different between methods. Additional multisite studies with adequately powered sample sizes are necessary to confirm these findings.