Improving venous access by using a near-infrared vein-finder device and ultrasound skill building: a quality...

Venous access by venipuncture and cannulation is a crucial procedure in day-to-day patient care in clinical settings. Performing this procedure on difficult veins can be time-consuming and burdensome for healthcare providers and painful and uncomfortable for patients. This quality improvement project aimed to optimise venous access by using a near-infrared (NIR) vein-finder device and provide ultrasound practical skills training to facilitate venous access.

The first plan-do-study-act (PDSA) cycle introduced an NIR device to hospital wards after collecting baseline data on success rate, number of attempts, procedure duration and need for help or escalation. These data were submitted by ward staff voluntarily for any venipuncture or cannulation procedure, followed by data analyses and plans for a second cycle. The second PDSA cycle involved organising a practical training session for the use of an ultrasound device for venous access. Participants voluntarily used their newly acquired ultrasound skills for difficult veins after multiple failed attempts without a device and submitted a Google form with questions about the above-mentioned success indicators.

In the first cycle, improvements were observed in all chosen quality indicators but were only statistically significant for the overall success rate (venipuncture and cannulations combined), the overall number of attempts and the overall duration of venous access procedures as well as for number of attempts and procedure duration for venipuncture individually. For the second PDSA cycle, after attending the ultrasound training session, participants reported an 80.95% overall success rate of venous access for difficult veins that were inaccessible before the ultrasound device was used. It also significantly reduced the number of attempts needed to get venous access when compared with attempts before using the ultrasound device.

Based on our findings, we recommend providing an NIR vein-finder device and ultrasound training to improve venous access in hospital settings and encourage further research to evaluate their effectiveness.