Rethinking Vascular Access in the Emergency Department

Abstract

Many studies have concluded that implementing a vascular access program in inpatient units can reduce central line rates. However, there are limited studies on the effects of implementing these programs within the emergency department, where efforts to reduce central line rates should begin. This quality improvement project examined the effects of an ultrasound-guided peripheral access program in the emergency department has on inpatient central line rates. An ultrasound-guided peripheral IV access program was implemented at a community hospital with an annual volume of 40,000 patients. Eight Emergency Department (ED) nurse champions were trained in various ultrasound-guided peripheral IV insertions. Central line data were compared for 8 weeks pre- and post-intervention. The study site experienced a 39% reduction in the total number of inpatient central lines inserted during project implementation despite a 12% increase in the average daily hospital census. The project implementation resulted in a 46% reduction in the total number of patient days per central line. The study concluded that implementing an ultrasound-guided peripheral vascular access program in the ED was able to reduce inpatient central line use.