We are training staff to place US guided PIVs. We are having them go through a online course; work with a vein mannequin; be proctored for 10 insertions. Then to do 50 insertions indepedently within two months. Once this is accomplished they can in turn train others.
I am questioning the need to do 50 insertions to make you proficent. I feel this is a high number to do within two month time frame.
Please let me how you train your staff.
Thank you,
Debra - Major Medical Center
Hi Debra,
I am currently doing a dissertation on this subject. After a review of the literature there are many successful training programs discussed. Most of the literature claims a safe nurse between 5 - 10 and a proficient nurse from 20-30. Very few programs, if any, require a high amount in a specified time. That may or may not be achievable in every setting.
I can tell you from training hundreds of nurses, most people become very proficient around 15 to 20. The nurse's talent and ability of fine motor skills will determine if they "get it" in 5-6 sticks or 10-15. (Even more important than their ability is their attitude...do they want to be there? is most important).
The push to 50 however will help sustainability long term. I also typically ask them to "race to 50." It is less likely they will fade away if they can obtain a high amount of insertions in a short amount of time.
I will be posting much more information on this topic later this year.
Good luck,
Kevin Arnold, MSN, BBA, BS, BSN, RN
Web Manager, www.iv-therapy.net
Eager to read Kevin's work and I think you should publish it There are no magic number of any procedure that will ensure any level of practice. Those numbers simply are not found in the literature. Each person is different in their learning process. As Kevin said, their willingness is critical. So competency has 4 components - knowledge, crticial thinking, psychomotor skills, and willingness to accept accountability for the outcomes of their decisions and actions. The competent level may be reached with 5-10 but the proficient level (using Benner's definitions) requires time and number of insertions encountering many different patients and their needs. The more they do the better they will be.
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
The missing factor here in this discussion is the patient. There can't be a clear number of sticks to determine expert status. With the average patient being 30lbs heavier since 1980's, the peripheral IV will continue to be a challenge. We know that the average dwell time is 46 hours so it becomes a mute point. Why exhaust all those resorces for an access that will probably only last 46 hours. Finacially it makes little sense and patients do not want to be stuck. Think of the alternatives, longer dwell time and one stick lines...Midline anyone?