Nurse-Performed Point-Of-Care Ultrasound-guided Peripherally Inserted Central Catheter Insertion: A Standardized...

This article presents a standardized, evidence-informed nursing protocol for point-of-care ultrasound-guided peripherally inserted central catheter (PICC) placement in adult patients. Rather than serving as a validation study, this work provides a structured procedural framework that translates current best evidence into a reproducible, step-by-step approach to support safe and consistent bedside practice by trained nurses. The protocol is organized using an operational adaptation of the Indication-Acquisition-Interpretation-Nursing Decision-Making framework to guide both clinical reasoning and technical execution. It details ultrasound system preparation, patient positioning, infection prevention, ultrasound-based vein assessment, real-time ultrasound-guided venipuncture using the modified Seldinger technique, catheter advancement, and post-insertion tip verification strategies. Key technical elements including probe selection, image optimization, catheter-to-vein ratio assessment, and troubleshooting in technically challenging cases are explicitly defined. Nursing decision-making related to catheter maintenance, post-insertion care, and patient education is also integrated. By incorporating ultrasound as an extension of bedside vascular assessment, this protocol aims to reduce mechanical complications, minimize multiple puncture attempts, and improve procedural accuracy. This standardized approach promotes patient safety, reduces variability in clinical practice, and supports the implementation of ultrasound-guided PICC placement as an advanced, evidence-based nursing intervention across diverse healthcare settings.