First Advisor

Carol Wallman


Rueckert-Hartman College for Health Professions

Degree Name

Doctor of Nursing Practice


Loretto Heights School of Nursing

Document Type

Thesis - Open Access

Number of Pages

80 pages



The purpose of the quality improvement project was to develop and implement a standardized multimodal nurse training program following a fixed curriculum for the placement of USGPIV in patients with Difficult Venous Access (DVA) to increase nurse knowledge, self-efficacy, skill level, and increase the number of nurses proficient for independent placements.

Evaluation Methods

This project incorporated a quasi-experimental time series with a mixed methodology study design using purposeful and convenience sampling. Participant demographic and descriptive data were collected at the beginning of the training program. Additionally, quantitative data was collected by evaluating pre-test data, followed by post-test data collection at two separate time intervals (post-test 1 and post-test 2). Finally, qualitative data evaluating eight post-intervention open-ended questions were evaluated for themes to provide program insight.


Thirteen registered nurses participated in the training program, with eight becoming proficient for independent USGPIV placements at the end of the training period. A Wilcoxon signed ranks test evaluating participant pre-test knowledge / post-test 1 knowledge showed statistical significance between the pre- and post-test 1 groups (z score -6.564, asymptotic significance < 0.001) and the pre- and post-test 2 groups (z score -4.808, asymptotic significance < 0.001) administered 10 weeks later. No statistical significance was found when comparing the post-test 1 and post-test 2 groups (z score -1.604, asymptotic significance 0.109). Participants increased their knowledge by 28.9% from the pre-test and post-test 1, and after 10 weeks, their knowledge dropped a negligible 2.6%. Self-efficacy was evaluated utilizing a two-sided paired sample T-test and there was statistical significance in the scores of the pre-test (mean 3.12) and post-test 1 (mean 4.49), pre-test (mean 3.12) to post-test 2 (mean 4.68), and post-test 1 (mean 4.49), and post-test 2 (mean 4.68), with all p values calculated at < 0.001. Skill level was evaluated by utilizing the Peripheral Ultrasound-guided Vascular Access Rating Scale (P-UGVA) developed by Primdahl et al. (2016), and data noted that 100 percent of the participant's scores increased from their 1st stick when compared to their last stick, and 86% achieved a perfect score on their last attempt. The thematic analysis findings revealed that the USGPIV multimodal nurse training program objectives were met. Multiple barriers to completion were identified and included nurses being too busy, scheduling, patient workloads, and staffing. Nurses recommended blocked hours for training on unscheduled days.


Developing and implementing a standardized multimodal nurse training program following a fixed curriculum was noted to increase participant knowledge, self-efficacy, skill level, and the number of nurses proficient for independent cannulations at one hospital facility. Nurse participants reported multiple barriers to achieving proficiency and recommended program enhancements for future training programs.

Date of Award

Spring 2023

Location (Creation)

Colorado (state); Denver (county); Denver (inhabited place)

Rights Statement

All content in this Collection is owned by and subject to the exclusive control of Regis University and the authors of the materials. It is available only for research purposes and may not be used in violation of copyright laws or for unlawful purposes. The materials may not be downloaded in whole or in part without permission of the copyright holder or as otherwise authorized in the “fair use” standards of the U.S. copyright laws and regulations.

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