Ultrasound-Guided Workflow for Peripheral Venous Access Selection, Maintenance, and Dynamic Catheter Adjustment in...

Peripheral venous access is the most frequently performed invasive procedure in hospitalized patients; however, conventional experience-based management is subjective and associated with higher complication rates and lower nursing efficiency. This single-center retrospective before-and-after study evaluated a reproducible ultrasound-guided workflow for peripheral venous access selection, maintenance, and dynamic catheter adjustment. A total of 113 hospitalized patients receiving intravenous infusion therapy between May 1, 2024, and August 31, 2025, were included. The control group (n = 61) received traditional nursing care, whereas the observation group (n = 52) received an ultrasound-guided integrated nursing model incorporating vascular assessment, predefined access-selection criteria, closed-loop maintenance, and protocol-based dynamic adjustment. Outcomes included puncture performance, catheter dwell time and utilization, complications, nursing efficiency, health economic outcomes, and patient satisfaction. Outcome data were extracted from routine clinical records, and blinded outcome assessment was not feasible because group allocation was determined by the implementation period. Baseline characteristics were comparable between groups (P > 0.05). Compared with the control group, the observation group demonstrated a higher access-selection matching rate (86.5%; unadjusted P = 0.026), improved first-attempt puncture success (88.5% vs. 73.8%; unadjusted P = 0.049), lower puncture pain (VAS 1.65 ± 0.84; P < 0.001), longer catheter dwell time (P < 0.001), fewer venous accesses per treatment course (1.04 ± 0.19 vs. 1.64 ± 0.66; P < 0.001), lower overall complication rates (11.5% vs. 29.5%; unadjusted P = 0.020), faster complication detection and management (P ≤ 0.001), reduced daily nursing time (14.73 ± 4.56 vs. 27.64 ± 7.44 min; P < 0.001), lower direct venous access-related medical costs, and improved patient satisfaction, while hospital stay remained unchanged (P = 0.935). These findings indicate that integrating vascular ultrasound throughout the peripheral venous access pathway provides a standardized workflow that improves clinical outcomes, enhances nursing efficiency, and reduces medical risk.