Assessing competecy for intravenous sticks

Nurses General Nursing

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Does anyone out there have a good program that they would not mind sharing in assessing competency for intravenous sticks if the unit in which the nurse performs does not get many peripheral IVs? By not many I would estimate approximately 1 - 2 per month.

Would a return demonstration on a manikin arm suffice for assessing competency for IV insertion? Everyone must agree that performing this on a manikin and performing an IV on a real subject is two different things.

What do you think?

Shadow 1100:idea:

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Specializes in Critical Care, Education.

IV sticks are a 'complex' competency - that involve a lot of psychomotor skills in addition to cognitive (theory). There are multiple stages to psychomotor competency development, beginning with just being able to select & hold the equipment correctly. At the other end of the scale, people who can perform the skill correctly and smoothly without any hesitation are called "proficient". In order to achieve and maintain proficiency, you have to have frequent opportunities to perform the skill.

Doing just 1 - 2 sticks per month is not enough to develop or maintain proficiency. A better tactic would be to shift this work to one or two individuals - they would have enough volume to maintain proficiency. This is why many organizations are re-introducing the concept of IV teams.

Although mannikin arms are a good way to familiarize you with using the equipment, they aren't realistic enough to develop true competency. The best simulation training I have seen is Laredal's Virtual IV http://www.laerdal.com/search.aspx?q=virtual+IV It is a 'high fidelity' simulator that not only gives the student a very realistic visual, but also provides a very authentic tactile experience - palpating the vein, vein "pop", etc. Of course, it is mucho expensive. NOTE: I have no financial connection to Laerdal - LOL.

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How can you follow the previous reply!! Great post. But, I totally agree with HouTx . . 1-2 / month is not adequate and the fake arm is, well . . . fake! The only use for the fake arm is to practice the step by step process . . . nothing substitutes for the real thing. I volunteer my arm for our new nurses since I've got easy veins and needlesticks don't bother me (although I don't allow back of hand attempts . . . ouch! esp for the newbie). The ER is a great place to get lots and lots of opportunities for practice . . . maybe that can be arranged?

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Try same day surgery units. You will get a lot of opportunities to start ivs. Good luck:)

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Did you literally just write all that about starting IVs?? WOW, are you really that scared about something so simple? Psychomotor skills that focus on holding the equipment, and are staged?

You take an IV needle and insert into vien. IV established. DON"T FORGET THE TAPE!!! IT WILL FALL OUT!!!!!

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Specializes in Infusion Nursing, Home Health Infusion.

Sure it might be simple on big veins...but if what you say is TRUE. then HOW COME for the past 27 yrs I have started thousands upon thousands of IVs that other nurses COULD NOT get!!! AGAIN there is a lot more involved than just sticking in a catheter OR IV Therapy related lawsuits would not be as prevalent as they currently are.

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After learning on the fake arm and starting on real arms it is much different. I think you need the real arm to really get the feel of things. I volunteer for as many as I can which is usually a decent amount on peds because kids and IVs are not a great combination. I found in the beginning just hitting the vein to take blood helped me a lot. It took me a while to feel comfortable and the transilluminator is still my best friend with the tiny patients or ones that are really dehydrated. Bigger kids are easier but knowing the anatomy of where to go is helpful too. I am not a feel kind of person so that is something I have to work on.

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