Clinical placements with hospital-based vascular access services can help dual undergraduate nursing and midwifery students build confidence and skills in peripheral intravenous catheter (PIVC) insertion, a new study has found.

About 70% of hospital admissions require a PIVC and there is a shortage of skilled inserters. In Australia, nursing and midwifery undergraduate programs teach PIVC insertion, however, this is typically limited to simulated PIVC insertion, with students denied the opportunity to obtain competency via hands-on hospital-based training programs.

Researchers set out to understand the experiences of undergraduate nurse/midwife students who received hospital-based training to achieve PIVC competency and the impact of the training on their future PIVC practice. Nineteen final-year students who took part in the study completed a five-day clinical placement with a hospital vascular access surveillance and education service, with 16 achieving clinical competency. The study also included 11 interviews and a survey 12 months later to assess the impact of the training.

Key themes identified included clinical PIVC training for undergraduate nurse-midwives building knowledge, skills and confidence.

“I enjoyed learning how to do it [cannulation] properly … I think overall it was a good experience to learn how to do that, because it’s a really great skill to have as a midwife, and it’s like every woman needs one if they’re having a fluid intervention in their labour and delivery, and it’s just something you should do rather than getting a doctor to do it, especially because sometimes the doctor isn’t around. I really enjoyed learning it and I look forward to using the skill,” a participant said.

Participants appreciated the opportunity to gain confidence in PIVC insertion with VASE in a simulation environment prior to patient interaction and received one-on-one education, supervision and feedback when developing their PIVC insertion skills.

Mixed mode, informative and detailed teaching building on undergraduate university training was a common theme also identified.

“I think it was really good,… we only had a three-hour session with our university learning, just on dummies, and then we hadn’t been able to do it on actual people, so starting with the VASE team, we started from the very start, like the basics, all over again, and then went from basics to cannulating people, so it was really good starting from yeah the basics,” a participant said.

Despite the benefits, several students/participants reported that it was difficult to find opportunities to cannulate once they finished the clinical rotation with the VASE team, due to staff being too busy or a lack of available qualified PIVC trainers to supervise them.

Results from the 12-month follow-up survey revealed that of those who had obtained their PIVC competency and had cannulated since commencing work as a new graduate nurse or midwife (60%), 100% reported that the skills they had developed with VASE had progressed their skills and knowledge with PIVC insertion across a range of departments (ED, ward, birth suite, rural).

Of those who had their undergraduate competency recognised by their graduate employer and who had completed a refresher workshop at a health service, over one-third (36%) of respondents stated that they had no challenges in maintaining their PIVC competency since starting work as a new graduate nurse or midwife.

However, 27% reported that there were limited opportunities to cannulate in their graduate work environment, with patients often cannulated in the Emergency Department or birth suite prior to admission to their ward. Additional challenges noted were a lack of PIVC competent assessors to assess new graduates (18%), as well as managers unaware that new graduates could now acquire their PIVC competency during their undergraduate degree (9%).

Researchers concluded that Australia could benefit from ensuring undergraduate clinical placement opportunities occur with vascular access specialist nurses with one-on-one learning opportunities to develop and obtain their cannulation competency.

Read the full study here