P030 - Use of Near-infrared Vein Visualization Technology to Improve Peripheral Intravenous Assessment and Catheter Placement in an Emergency Department

Purpose - What was the goal of the study?: To evaluate the impact of a quality improvement initiative that utilized education and near-infrared (NIR) technology to improve peripheral intravenous catheter (PIVC) placement in an emergency department in the Southwestern USA. Staff were educated on NIR-guided PIV assessment and equipped with NIR devices.

Background - What was the problem? Why was it important?: Nearly 90% of inpatients will require a PIVC and these are often placed by staff in the emergency department (ED). [1, 2] On average, 1.37-2.35 attempts are required to place PIVCs. [3, 4] Reducing PIVC attempts could contribute to cost savings and improve patient care. [2,4-7] A study conducted at an 867-bed, Level 1 trauma center with approximately 105,000 patients entering the ED annually, reported cost savings of $3,376 per bed per year, or $2.9 million annually related to fewer PIVC attempts, improved PIVC dwell time and greater patient satisfaction. [6] NIR vein visualization technology has been shown to improve PIV assessment for cannulation, decrease the overall procedure time, and decrease the number of required attempts. [8-10] Yet, adoption of this beneficial technology is limited, especially in the ED setting. This session will present findings of a survey administered to nurses (n=24) to evaluate escalation of care, perceived patient satisfaction, number of PIVC attempts, and usability of NIR devices. The survey was administered 6-months after the implementation of education and technology for ED staff.

Results - What were the findings?: Almost half of nurse respondents (n=11, 46%) had less than 2 years’ experience placing PIVCs while 38% (n=9) had 5 years’ experience or more. In terms of usability of the AV500 device (AccuVein Inc., Medford, NY), 83% reported good to excellent usability and 96% agreed that the device was easy to use. Most nurse respondents preferred NIR-guided assessment to traditional techniques (n=20, 83%). Of those who had not yet used NIR (n=15), most agreed that they would expect to have less attempts to gain access (93%) and less calls for additional resources (80%). Most also agreed that using NIR vein visualization technology could improve patient satisfaction (80%) while less than half agreed they would expect to see a reduction in care escalation (44%). Of those who had used NIR technology (n=8), all reported less attempts to gain access (100%), a reduction in escalation of care (100%), and less calls for additional resources (100%). Most nurse respondents who had used NIR technology also reported improved patient satisfaction (80%).

Conclusions - What do the final outcomes mean?: This quality improvement initiative highlighted the impact of NIR vein visualization technology on care efficiency and patient satisfaction in the ED. Through this project, we found that NIR vein visualization technology can improve staff perception of patient satisfaction, decrease the number of PIVC placement attempts and reduce the need to escalate care or use additional staff resources. Considering nursing staff time is extremely limited, NIR vein visualization technology has the potential to greatly enhance PIVC placement and care in the ED, while improving efficiency, staff resilience and reducing cost.