Hi, I am looking to create a policy and competency for Ultrasound guided PIV placement. Does anyone have a copy of either of these that they are using at their facility? Currently our nurses who are trained in PICC placement use the ultrasound to place difficult periferal IV's but some of the nurses in the ICU's are interested in being trained in placement using an ultrasound machine. Thanks so much.

Our ED nurses and ICU nurses can take a short class in use of U/S for PIV placement. I've looked and cannot find a written policy, though.

Some issues to consider:

Where are they allowed to go?

Apparently some people have been told not to go proximal to the elbow while others have been taught that that is fine (I'm in the latter camp... and often, it's the only thing you've got left).

What devices are they allowed to place?

Our docs generally use arterial catheters for difficult PIVs because the guidewire makes it much easier. The nurses are not permitted to use these devices - though that is 'tribal knowledge,' not codified policy.

Is a special order required?

Some people have asserted this to be the case but it's simply at the discretion of the

RN

placing the line.

Our competency is a 3-hr class by a designated physician followed by 3 successful starts observed and signed by an MD.

We have no requirement for annual competencies... it just sorts itself out... there are those who do them and those who don't. The "do's" regularly get called on to place lines for other nurses.

Ultrasound is ~the~ way to go for solid lines in 'hard sticks.'

And they're fun to do.

PM me your email and I will send you our policy.