Implementation of an ultrasound-guided approach for arterial line placements in neonates—quality improvement project

Objective Our goal was to improve placement success rates for peripheral arterial line (PAL) placements by introducing an ultrasound-guided (USg) approach. Our aim was to maintain success rates over 70% within 18 months. Study design Interventions included development of a training curriculum, and p...

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Bibliographic Details
Published inJournal of perinatology Vol. 44; no. 10; pp. 1527 - 1533
Main Authors Culjat, Marko, Dzaja, Domagoj, Colangelo, Heather, Gardiner, Jill, Lee, Kyong-Soon, Whyte, Hilary
Format Journal Article
LanguageEnglish
Published New York Nature Publishing Group US 25.12.2023
Nature Publishing Group
Subjects
692/700/1421
692/700/1720
Arterial lines
Catheterization, Peripheral - methods
Control charts
Design standards
Female
Humans
Infant, Newborn
Male
Medical instruments
Medicine
Medicine & Public Health
Neonates
Newborn babies
Pediatric Surgery
Pediatrics
Placement
Process control
Process controls
Quality control
Quality Improvement
Quality Improvement Article
Statistical process control
Success
Ultrasonic imaging
Ultrasonography, Interventional
Ultrasound
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Summary:Objective Our goal was to improve placement success rates for peripheral arterial line (PAL) placements by introducing an ultrasound-guided (USg) approach. Our aim was to maintain success rates over 70% within 18 months. Study design Interventions included development of a training curriculum, and procedure standardization. Among 302 patients, 115 underwent USg catheter placement; the traditional method was used in 187 patients. Outcome measures were first-attempt and overall success rates. Process measures were proportion of PALs placed under US guidance, trainer availability, and trainee sign-off. Line complications were balancing measures. Statistical process control charts were used to monitor metrics. Results Sustained improvement was seen with the USg approach. The USg approach had first and overall attempt success by the trainers (i.e., independent users) of 83.7% (77/92) and 96.5% (111/115), compared to 50.3% (82/163) and 73.8% (138/187) with the traditional approach. Conclusion Introducing the USg approach had a significant impact on PAL placement success in neonatal patients.
Bibliography:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ISSN:0743-8346
1476-5543
DOI:10.1038/s41372-023-01860-9