Rating Scale for the Assessment of Competence in Ultrasound-guided Peripheral Vascular Access – a Delphi Consensus Study

Primdahl, Stine C.; Todsen, Tobias; Clemmesen, Louise; Knudsen, Lars; Weile, Jesper

doi:10.5301/jva.5000581

Cited by 10 publications

(14 citation statements)

References 22 publications

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“…Two competence assessment tools were identified: one as a checklist of competence and one as a rating scale for competencies [ 54 , 55 ]. Validity evidence was only explored for the rating scale [ 56 ].…”

Section: Resultsmentioning

confidence: 99%

Education in the placement of ultrasound-guided peripheral venous catheters: a systematic review

Jørgensen

Laursen

Konge

et al. 2021

Scand J Trauma Resusc Emerg Med

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Background Placing a peripheral vein catheter can be challenging due to several factors, but using ultrasound as guidance increases the success rate. The purpose of this review is to investigate the knowledge already existing within the field of education in ultrasound-guided peripheral vein catheter placement and explore the efficacy and clinical impact of different types of education. Methods In accordance with PRISMA-guidelines, a systematic search was performed using three databases (PubMed, EMBASE, CINAHL). Two reviewers screened titles and abstracts, subsequently full-text of the relevant articles. The risk of bias was assessed using the Cochrane Collaboration risk of bias assessment tool and the New Ottawa scale. Results Of 3409 identified publications, 64 were included. The studies were different in target learners, study design, assessment tools, and outcome measures, which made direct comparison difficult. The studies addressed a possible effect of mastery learning and found e-learning and didactic classroom teaching to be equally effective. Conclusion Current studies suggest a potential benefit of ultrasound guided USG-PVC training on success rate, procedure time, cannulation attempts, and reducing the need for subsequent CVC or PICC in adult patients. An assessment tool with proven validity of evidence to ensure competence exists and education strategies like mastery learning, e-learning, and the usage of color Doppler show promising results, but an evidence-based USG-PVC-placement training program using these strategies combined is still warranted.

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Section: Resultsmentioning

confidence: 99%

Education in the placement of ultrasound-guided peripheral venous catheters: a systematic review

Jørgensen

Laursen

Konge

et al. 2021

Scand J Trauma Resusc Emerg Med

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“…Details about the Delphi study for developing the P-UGVA rating scale is available in a previous report. [ 12 ] The final rating scale consists of eight key elements: preparation of utensils, ergonomics, preparation of the ultrasound device, identification of blood vessels, anatomy, hygiene, coordination of the needle, and completion of the procedure (Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…Alignment of content was ensured through development of the scale using a Delphi-process on input from experts. [ 12 ] Response process was ensured through pilot studies and training of the assessors. Internal structure showed excellent reliability at a level considered sufficiently high for certification (Cronbach's alpha>0.8).…”

Section: Discussionmentioning

confidence: 99%

“…In a Delphi consensus study, we recently developed a global rating scale for competence assessment of Peripheral Ultrasound-Guided Vascular Access (P-UGVA). [ 12 ] It is important when implementing such measures to ensure validity towards the construct—otherwise the concept of training towards a set level of standard falls flat as the standard becomes irrelevant.…”

Section: Introductionmentioning

confidence: 99%

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Validation of the Peripheral Ultrasound-guided Vascular Access Rating Scale

et al. 2018

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Evidence-based standards in proficiency are needed for ultrasound-guided peripheral intravenous access. In this study, we explored the validity of the Peripheral Ultrasound-Guided Vascular Access (P-UGVA) Rating Scale.We recruited 3 groups of physicians (5 novices, 5 intermediates, and 5 experts) of increasing proficiency in peripheral ultrasound-guided intravenous access. All participants performed 3 peripheral ultrasound-guided intravenous accesses on three different patients. Performance was video-recorded by 3 cameras and the ultrasound image. Synchronized and anonymized split-screen film clips were rated using the P-UGVA rating scale by 2 assessors, which also assessed overall performance on a 1–5 Likert-scale. Evidence of validity was explored using the contemporary validity framework by Messick (content, response process, internal structure, relations to other variables, and consequences).Content and response process was ensured in the development of the rating scale and validity study. Internal consistency of the P-UGVA rating scale was excellent and sufficient high for certification purposes (Cronbach's alpha = 0.91). Proficiency groups were successfully discriminated by the UPGIVA rating scale (P = .029, one-way ANOVA), and the P-UGVA rating scale scores also correlated strongly with the overall performance evaluations (rho = 0.87, P < .001, Pearson correlation). We calculated a pass/fail score of 29, which lead to a theoretical false positive rate of 26.5% and false negative rate of 8.5%.We present validity evidence for the P-UGVA rating scale and an evidence-based standard in proficiency for ultrasound-guided peripheral intravenous access.

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“…Whilst these data are dated, this investigation indicated lack of training and validation of competency as a direct cause of complications. In current literature, this concept of training and validation is illustrated in both newer ultrasound practices and with infection reduction methods (Primdahl et al 2016;Rusche et al 2001). Insufficient understanding of evidence-based assessment, selection, insertion and management of peripheral and central venous access devices leaves the patient at risk for more serious complications and the added trauma associated with frequent replacement of catheters (Rickard et al 2013).…”

Section: The Need For Adequate Educationmentioning

confidence: 99%

Training and Education

Alexandrou

Mifflin

Carr

2019

Vessel Health and Preservation: The Right Approach for Vascular Access

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Optimal vascular access insertion and management requires clinicians to have appropriate education and skill on the best procedural techniques or be supervised during the process of acquiring the necessary education. The second quadrant of the Vessel Health and Preservation (VHP) model requires a qualified inserter, a clinician who has undertaken a comprehensive clinical and vascular assessment and is applying the latest evidence and guidelines to select the most appropriate device for patient treatment, leading to the successful insertion of a peripheral or central VAD. Appropriate device selection and number of necessary lumens are a determination made according to lowest risk for patient insertion and potential for infection, in conjunction with the needs of the therapy. Selection of the best vascular access for the patient also requires an understanding of the most appropriate intravascular device to be used, influenced by infusate characteristics to be administered and the length of anticipated dwell, which in turn, influences the most appropriate vessel and anatomical position for device placement.

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Rating Scale for the Assessment of Competence in Ultrasound-guided Peripheral Vascular Access – a Delphi Consensus Study

Abstract: We developed an RS for assessment of UGVA competence based on opinions of ultrasound experts through a modified Delphi consensus study.

Cited by 10 publications

References 22 publications

Education in the placement of ultrasound-guided peripheral venous catheters: a systematic review

Education in the placement of ultrasound-guided peripheral venous catheters: a systematic review

Validation of the Peripheral Ultrasound-guided Vascular Access Rating Scale

Training and Education

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