Anesthesia Providers’ Perceptions of Ultrasound-Guided Arterial Line Placement: A Doctor of Nursing Practice Project

Abstract

Despite multiple studies supporting the advantages of ultrasound guidance, no formal processes are consistently followed, leaving anesthesia providers to use clinical judgment and personal preferences when selecting methods for arterial line placement. The goal of this project was to identify the perceptions of anesthesia providers regarding ultrasound guided arterial line placement in their current practice and after utilization of an educational resource. Pre- and post-implementation data were collected over a two-week period using Qualtrics software and analyzed using Excel. Anesthetists reported several barriers towards implementation including inadequate education and training on ultrasound-guided arterial catheterization, lack of available ultrasound equipment, and prolonged procedure set-up and duration. The anesthetists’ confidence and likelihood of using ultrasound for arterial line placement increased, suggesting that these anesthetists are willing to attempt ultrasound for arterial line placement in future cases. Further education on ultrasound techniques for arterial line placement may increase provider confidence and prevalence for utilization of ultrasound. Several limitations were identified, including a small sample size (n=9), resulting in only 6 participants completing the pre-implementation survey and 5 participants completing the post-implementation survey. The smaller sample size limited statistical significance, and the ability to generalize the results to the overall population of CRNAs. If this quality improvement project was to be replicated, an ultrasound workshop conducted by the project lead would greatly benefit overall CRNA comfortability and confidence with using ultrasound, and therefore, participation.