Degree Name
Nursing Practice, DNP
Publication Date
11-17-2025
First Advisor
Lisa Drake
Second Advisor
Paige Wimberley
Abstract
Patients meeting difficult intravenous access (DIVA) criteria often experience multiple failed intravenous (IV) access attempts, delayed diagnostics, and treatment initiation, particularly in rural emergency departments with limited resources. This quality improvement (QI) project evaluated whether targeted ultrasound-guided peripheral venous access training would improve staff self-efficacy, confidence, and self-reported procedural execution at a rural critical access hospital. Guided by Lewin’s Change Theory and Benner’s Novice to Expert Theory, a quasi-experimental pre-/post-intervention design was implemented. Nurses and paramedics completed the validated Peripheral Intravenous Insertion Confidence Assessment before and after a didactic and psychomotor training program. Statistical analysis included an independent samples t-test and Mann-Whitney U test. Results demonstrated statistically significant improvement in post-intervention scores with mean scores increasing from 4.44 (SD = 0.49) to 4.84 (SD = 0.34), indicating enhanced confidence, self-efficacy, and perception of procedural execution. The project established sustainable practices changes through equipment acquisition, strong leadership support, and internal train-the-trainer initiatives. Findings support that structured, low-cost ultrasound-guided peripheral venous access education in rural emergency departments can elevate clinical competence and capabilities, decrease delays in care, and enhance patient outcomes. This QI project demonstrates how Doctor of Nursing Practice (DNP) led initiatives can translate evidence-based practice into sustainable improvement in rural healthcare delivery.
Rights Management
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License
Recommended Citation
Sand, Ryan M., "Enhancing Emergency Department Staff Competency in Ultrasound-Guided Venous Access at a Rural Critical Access Hospital: A Quality Improvement Project" (2025). Doctor of Nursing Practice Projects. 249.
https://arch.astate.edu/dnp-projects/249
