ABSTRACT
INTRODUCTION: Objective measures such as hand motion analysis are needed to assess competency in technical skills, including ultrasound-guided procedures. Ultrasound-guided peripheral intravenous catheter placement has many potential benefits and is a viable skill for nurses to learn. The objective of this study was to demonstrate the feasibility and validity of hand motion analysis for assessment of nursing competence in ultrasound-guided peripheral intravenous placement. METHODS: We conducted a prospective cohort study at a tertiary children's hospital. Participants included a convenience sample of nurses with no ultrasound-guided peripheral intravenous experience and experts in ultrasound-guided peripheral intravenous placement. Nurses completed hand motion analysis before and after participating in a simulation-based ultrasound-guided peripheral intravenous placement training program. Experts also completed hand motion analysis to provide benchmark measurements. After training, nurses performed ultrasound-guided peripheral intravenous placement in clinical practice and self-reported details of attempts. RESULTS: A total of 21 nurses and 6 experts participated. Prior to the hands-on training session, experts performed significantly better in all hand motion analysis metrics and procedure time. After completion of the hands-on training session, the nurses showed significant improvement in all hand motion analysis metrics and procedure time. Few nurses achieved hand motion analysis metrics within the expert benchmark after completing the hands-on training session with the exception of angiocatheter motion smoothness. In total, 12 nurses self-reported 38 ultrasound-guided peripheral intravenous placement attempts in clinical practice with a success rate of 60.5%. DISCUSSION: We demonstrated the feasibility and construct validity of hand motion analysis as an objective assessment of nurse competence in ultrasound-guided peripheral intravenous placement. Nurses demonstrated rapid skill acquisition but did not achieve expert-level proficiency.
Subject(s)
Catheterization, Peripheral/nursing , Clinical Competence , Education, Nursing, Continuing/methods , Hand , Learning Curve , Motor Activity , Simulation Training/methods , Ultrasonography, Interventional/nursing , Catheterization, Peripheral/adverse effects , Catheterization, Peripheral/methods , Feasibility Studies , Humans , Nurse's Role , Prospective Studies , Task Performance and AnalysisABSTRACT
The effect of concurrent visual feedback (CVF) on continuous aiming movements was investigated in the preferred hand of participants of college age (ns = 12 men, 8 women). Participants made continuous rapid reversal movements with a lightweight lever in the sagittal plane. Participants attempted to reach a short target (20 degrees) and a long target (60 degrees) in separate constant practice conditions, but alternated between the two targets in a variable practice condition. Four blocks of practice trials were provided in each condition, with 40 movements made in each. CVF of the position-time trace was provided for the first 20 movements of each block, but was removed for the remaining 20 movements in each block. Movements were more accurate and consistent during constant practice compared to variable practice where the short target was overshot and the long target was undershot. CVF reduced errors in all conditions, compared to movements without CVF, particularly for the short target during variable practice. The results suggest that the interference generated by alternating targets can be modulated by providing visual feedback, but once the visual feedback was removed, errors increased markedly.
