Rapid Development of Ultrasound-Guided IV Insertion Skills in CRNA Professionals at a Tertiary Care Academic Hospital

Peripheral intravenous catheters are the most commonly used invasive devices in hospitals. Previously reserved as a last resort technique, ultrasound-guided IV (USGIV) access is associated with enhanced insertion success rates and is becoming the standard of care. However, many Certified Registered Nurse Anesthetists (CRNAs) lack formal USGIV access training. This quality improvement project aimed to train CRNAs from a large anesthesia department in USGIV access using a train-the-trainer model and evaluate the training’s effect on their knowledge, confidence, and skills. Conducted in UPMC Presbyterian’s Post Anesthesia Care Unit (PACU), the project involved adapting an existing USGIV course for five 45-minute training sessions with a volunteer sample of 60 CRNAs. Pre- and post-course surveys and quizzes measured knowledge and confidence. Skills were assessed using a competency checklist. The average knowledge score increased from 5.0 to 7.3 out of 10 (46% improvement, p<0.01), and confidence scores improved from 36 to 74 out of 100 (100% improvement, p=0.002). All 60 CRNAs (100%) met the skills competency requirement. Preferences for vascular phantom intravascular blocks were split, with 53% favoring commercial models and 47% favoring homemade tofu models. The adapted USGIV course significantly enhanced CRNA knowledge, confidence, and skills. These findings support the integration of a simulation-based course to bridge the knowledge and experience gap that CRNAs face in USGIV access. The cost-effective tofu phantom models were nearly as favored as commercial models, suggesting a viable alternative for training.