Looking for something beyond anecdotal and research based on best practice regarding USGIV placement by staff not involved with VAT...ie ED, ICU...ect. VAT are facing challenges with support staff placing/attempting USGIV in upper arms with less than stellar results. Most research Im pulling encourages selecting these upper arm veins to drastically improve success rates but doesnt address the challenges of VAT following up post failure. Ranging from poor imaging due to bruising, infiltration, decreased patient satisfaction, or worst case-inability to place midline/picc and refer to IR for tunneled catheter. Throw into the mix, limb restricted patients entering into system, can be frustrating. "Common sense" and theorectical logic is not gaining traction. Heels are dug in wanting evidence and research as VAT steer policy to keeping all attempts below antecubital fossa or passing on challenging attempts. Even stepping in to these units has been offered but still in limbo. Look forward to some input.