title: Focused simulation training: emergency department nurses' confidence and comfort level in performing ultrasound-guided vascular access.
abstract: OBJECTIVE
  The objective of this study is to assess Emergency Department (ED) nurses' confidence, comfort level, and competency in performing ultrasound-guided vascular access after a focused ultrasound simulation training session.
  
  
  METHODS
  A cross-sectional study at an academic medical center. A simulation-based ultrasound training module was used to train ED nurses in ultrasound-guided intravenous (IV) access. The training module consisted of didactics followed by hands-on practice on human models and Blue Phantom ultrasound training block model. All subjects completed a questionnaire after completing the training module.
  
  
  RESULTS
  A total of 40 nurses were enrolled. All subjects successfully demonstrated competency during the training session by identifying upper extremity sonographic vascular anatomy on a human model and performing real-time ultrasound-guided IV access on Blue Phantom ultrasound training block model. On a scale of 1-10, the average confidence level in performing the ultrasound-guided vascular access was 6.9 [95% confidence interval (95% CI) 6.3-7.46], with 98% (95% CI, 92-102%) reporting no difficulty in recognizing upper limb vascular anatomy on ultrasound. Ninety-two percent (95% CI, 84-100%) agreed that focused training in ultrasound-guided IV access was adequate to learn the procedure.
  
  
  CONCLUSIONS
  After a focused simulation training session, ED nurses had a high level of comfort using ultrasound for vascular access. Despite having a moderate degree of confidence, ED nurses were accurate in identifying vascular anatomy and performing ultrasound-guided vascular access.
authors.affiliation: Department of Emergency Medicine, University of Arizona Medical Center, Tucson, AZ - USA.
authors.forename: Srikar
authors.initials: S
authors.lastname: Adhikari
authors.affiliation: Department of Emergency Medicine, Southern Arizona VA Healthcare System, Tucson, AZ - USA.
authors.forename: Charles
authors.initials: C
authors.lastname: Schmier
authors.affiliation: Department of Emergency Medicine, University of Kansas Medical Center, Kansas City, KS - USA.
authors.forename: Jared
authors.initials: J
authors.lastname: Marx
mesh_terms: D000046:Academic Medical Centers; D001291:Attitude of Health Personnel; D002404:Catheterization / Q000009:adverse effects; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D004509:Education, Nursing, Continuing / Q000379:methods*; D004636:Emergency Service, Hospital; D006801:Humans; D007318:Inservice Training; D008953:Models, Anatomic; D008955:Models, Cardiovascular; D009048:Motor Skills; D009741:Nursing Staff, Hospital / Q000193:education*; D019047:Phantoms, Imaging; D011795:Surveys and Questionnaires; D013647:Task Performance and Analysis; D018084:Ultrasonography, Interventional / Q000009:adverse effects / Q000295:instrumentation; D034941:Upper Extremity / Q000098:blood supply*; D000078329:Workforce