Simulation-Based Learning: The Impact of Technology-Enhanced Education on Peripheral Vascular Access Skills
Main Article Content
Abstract
Aims and objectives: To assess the impact of a technology-enhanced teaching program on students’ knowledge, confidence, and attitudes toward peripheral intravenous catheter (PIVC) insertion and ability to select optimal insertion sites.
Background: Near-infrared technology enhances venous assessment and can reduce the number of insertion attempts. Yet, adoption of near-infrared technology is limited.
Design: A randomized, controlled, interventional study design (Phase 1) and an observational design (Phase 2) were used.
Methods: Data on knowledge, confidence, and attitudes toward the technology were collected, along with assessments of students' ability to select optimal PIVC sites on patients with diverse skin tones.
Results: The program increased students’ knowledge and confidence. Near-infrared technology improved students’ ability to visualize vasculature in patients with dark skin and enabled objective assessment and adherence to evidence-based practices.
Conclusions: Technology-enhanced education improves nursing students' PIVC skills and promotes equitable care by enhancing insertion outcomes for patients with diverse skin tones.
Keywords:
peripheral intravenous catheter insertion, vascular access, vein visualization technology, nursing student, education
Article Details
How to Cite
BATHISH, Melissa A. et al.
Simulation-Based Learning: The Impact of Technology-Enhanced Education on Peripheral Vascular Access Skills.
Medical Research Archives, [S.l.], v. 13, n. 8, oct. 2025.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/6987>. Date accessed: 06 dec. 2025.
doi: https://doi.org/10.18103/mra.v13i8.6987.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
1. Alexandrou E, Ray-Barruel G, Carr PJ, et al. Use of short peripheral intravenous catheters: characteristics, management, and outcomes worldwide. J Hosp Med. 2018;13(5): doi: 10.12788/jhm.3039
2. Marsh N, Webster J, Ullman AJ, et al. Peripheral intravenous catheter non-infectious complications in adults: a systematic review and meta-analysis. J Adv Nurs. 2020;76(12):3346-3362. doi: 10.1111/jan.14565
3. Carr PJ, Rippey JCR, Budgeon CA, Cooke ML, Higgins N, Rickard CM. Insertion of peripheral intravenous cannulae in the emergency department: factors associated with first-time insertion success. J Vasc Access. 2016;17(2):182-190. doi: 10.5301/jva.5000487
4. Keleekai NL, Schuster CA, Murray CL, et al. Improving nurses' peripheral intravenous catheter insertion knowledge, confidence, and skills using a simulation-based blended learning program: a randomized trial. Simul Healthc. 2016;11(6):376-384. doi: 10.1097/SIH.0000000000000186
5. Loon FHJV, Puijn LAPM, Houterman S, Bouwman ARA. Development of the A-DIVA Scale: a clinical predictive scale to identify difficult intravenous access in adult patients based on clinical observations. Medicine (Baltimore). 2016;95(16):e3428. doi: 10.1097/MD.0000000000003428
6. Helm RE, Klausner JD, Klemperer JD, Flint LM, Huang E. Accepted but unacceptable: peripheral IV catheter failure. J Infus Nurs. 2015;38(3):189-203. doi: 10.1097/NAN.0000000000000100
7. Brown RA, Crookes PA, Iverson D. An audit of skills taught in registered nursing preparation programmes in Australia. BMC Nurs. 2015;14:68. doi: 10.1186/s12912-015-0113-7
8. Massey D, Craswell A, Ray-Barruel G, et al. Undergraduate nursing students' perceptions of the current content and pedagogical approaches used in PIVC education. A qualitative, descriptive study. Nurse Educ Today. 2020;94:104577. doi: 10.1016/j.nedt.2020.104577
9. Vizcarra C, Cassutt C, Corbitt N, Richardson D, Runde D, Stafford K. Recommendations for improving safety practices with short peripheral catheters. J Infus Nurs. 2014;37(2):121-124. doi: 10.1097/NAN.0000000000000028
10. Etafa W, Wakuma B, Tsegaye R, Takele T. Nursing students' knowledge on the management of peripheral venous catheters at Wollega University. PLoS One. 2020;15(9):e0238881. doi: 10.1371/journal.pone.0238881
11. Simonetti V, Comparcini D, Miniscalco D, Tirabassi R, Di Giovanni P, Cicolini G. Assessing nursing students' knowledge of evidence-based guidelines on the management of peripheral venous catheters: a multicentre cross-sectional study. Nurse Educ Today. 2019;73:77-82. doi: 10.1016/j.nedt.2018.11.023
12. Vandenhouten CL, Owens AK, Hunter MR, Raynak A. Peripheral intravenous education in North American nursing schools: a call to action. J Nurs Educ. 2020;59(9):493-500. doi: 10.3928/01484834-20200817-03
13. Hunter MR, Vandenhouten C, Raynak A, Owens AK, Thompson J. Addressing the silence: a need for peripheral intravenous education in North America. JAVA. 2018;23(3):157–165. doi: 10.1016/j.java.2018.06.001
14. Indarwati F, Munday J, Keogh S. Nurse knowledge and confidence on peripheral intravenous catheter insertion and maintenance in pediatric patients: a multicentre cross-sectional study. J Pediatr Nurs. 2022;62:10-16. doi: 10.1016/j.pedn.2021.11.007
15. Ahlin C, Klang-Söderkvist B, Johansson E, Björkholm M, Löfmark A. Assessing nursing students' knowledge and skills in performing venepuncture and inserting peripheral venous catheters. Nurse Educ Pract. 2017;23:8-14. doi: 10.1016/j.nepr.2017.01.003
16. Osti C, Khadka M, Wosti D, Gurung G, Zhao Q. Knowledge and practice towards care and maintenance of peripheral intravenous cannula among nurses in Chitwan Medical College Teaching Hospital, Nepal. Nurs Open. 2019;6(3):1006-1012. doi: 10.1002/nop2.288
17. Pitts S, Ostroff M. The use of visualization technology for the insertion of peripheral intravenous catheters. JAVA. 2019;24(3):10–14. doi: 10.2309/j.java.2019.003.007
18. Aulagnier J, Hoc C, Mathieu E, Dreyfus JF, Fischler M, Le Guen M. Efficacy of AccuVein to facilitate peripheral intravenous placement in adults presenting to an emergency department: a randomized clinical trial. Acad Emerg Med. 2014;21(8):858-863. doi: 10.1111/acem.12437
19. Eren H, Caliskan N. Effect of a vein imaging device and of fist clenching on determination of an appropriate vein and on catheter placement time in patients receiving chemotherapy: a randomized controlled trial. Cancer Nurs. 2022;45(2):105-112. doi: 10.1097/NCC.0000000000000931
20. Guillon P, Makhloufi M, Baillie S, Roucoulet C, Dolimier E, Masquelier A-M. Prospective evaluation of venous access difficulty and a near-infrared vein visualizer at four French haemophilia treatment centres. Haemophilia. 2015;21(1):21-26. doi: 10.1111/hae.12513
21. Kanipe W, Shobe K, Li Y, Kime M, Smith-Miller CA. Evaluating the efficacy and use of vein visualization equipment among clinical nurses in an intermediate care environment. J Infus Nurs. 2018;41(4):253-258. doi: 10.1097/NAN.0000000000000286
22. Parker SIA, Benzies KM, Hayden KA, Lang ES. Effectiveness of interventions for adult peripheral intravenous catheterization: a systematic review and meta-analysis of randomized controlled trials. Int Emerg Nurs. 2017;31:15-21. doi: 10.1016/j.ienj.2016.05.004
23. Sriparkdee C, Sawangwong S, Curry P, Tatiyanupunwong S. A randomized controlled trial comparing the AccuVein AV400 device to standard insertion technique for peripheral intravenous cannulation by experienced nurse anesthetists in obese patients undergoing elective surgery. Thammasat Medical Journal. 2016;16(4):546–552.
24. van der Woude OCP, Cuper NJ, Getrouw C, Kalkman CJ, de Graaff JC. The effectiveness of a near-infrared vascular imaging device to support intravenous cannulation in children with dark skin color: a cluster randomized clinical trial. Anesth Analg. 2013;116(6):1266-1271. doi: 10.1213/ANE.0b013e31828e5bde
25. Nickel B, Gorski L, Kleidon T, et al. Infusion therapy standards of practice, 9th edition. J Infus Nurs. 2024;47(1S Suppl 1):S1-S285. doi: 10.1097/NAN.0000000000000532
26. Adhikari S, Schmier C, Marx J. Focused simulation training: emergency department nurses' confidence and comfort level in performing ultrasound-guided vascular access. J Vasc Access. 2015;16(6):515-520. doi: 10.5301/jva.5000436
27. Awad MS, Abdullah MK, Ibrahim RH, Abdulla RK. Nursing students’ attitudes toward simulation technology in nursing education. Int J Eng Technol. 2019;14(14):31–45. doi: 10.3991/ijet.v14i14.10571
28. Fukuroku K, Narita Y, Taneda Y, Kobayashi S, Gayle AA. Does infrared visualization improve selection of venipuncture sites for indwelling needle at the forearm in second-year nursing students? Nurse Educ Pract. 2016;18:1-9. doi: 10.1016/j.nepr.2016.02.005
29. Marchionni C, Connolly M, Gauthier M, Lavoie-Tremblay M. Innovative approaches to teaching vascular access to nursing students in the COVID-19 era. Br J Nurs. 2021;30(14):S34-S41. doi: 10.12968/bjon.2021.30.14.S34
30. Mulyadi M, Tonapa SI, Rompas SSJ, Wang R-H, Lee B-O. Effects of simulation technology-based learning on nursing students' learning outcomes: a systematic review and meta-analysis of experimental studies. Nurse Educ Today. 2021;107:105127. doi: 10.1016/j.nedt.2021.105127
31. Demir D, Inal S. Does the use of a vein visualization device for peripheral venous catheter placement increase success rate in pediatric patients? Pediatr Emerg Care. 2019;35(7):474-479. doi: 10.1097/PEC.0000000000001007
32. El –Aziz RAE-RA, Osman YM. Effectiveness of AccuVein AV400 device versus ultrasound-guided cannulation of the great saphenous vein at the ankle in infants: a randomized controlled trial. Int J Anesthesiol Res. 2020;594–599. doi: 10.19070/2332-2780-20000118
33. Zhang Z, Wang X, Zhang L, et al. Infrared vein imaging for insertion of peripheral intravenous catheter for patients requiring isolation for Severe Acute Respiratory Syndrome Coronavirus 2 Infection: a nonrandomized clinical trial. J Emerg Nurs. 2022;48(2):159-166. doi: 10.1016/j.jen.2021.10.001
34. Glover KR, Stahl BR, Murray C, et al. A simulation-based blended curriculum for short peripheral intravenous catheter insertion: an industry-practice collaboration. J Contin Educ Nurs. 2017;48(9):397-406. doi: 10.3928/00220124-20170816-05
35. Goff DA, Larsen P, Brinkley J, et al. Resource utilization and cost of inserting peripheral intravenous catheters in hospitalized children. Hosp Pediatr. 2013;3(3):185-191. doi: 10.1542/hpeds.2012-0089
36. Hallam C, Weston V, Denton A, et al. Development of the UK Vessel Health and Preservation (VHP) framework: a multi-organisational collaborative. J Infect Prev. 2016;17(2):65-72. doi: 10.1177/1757177415624752
37. Pinelli F, Pittiruti M. The integrated short peripheral cannula: a new peripheral venous access device? J Vasc Access. 2023;24(3):353-357. doi: 10.1177/11297298211034023
38. Reddy VK, Lavoie MC, Verbeek JH, Pahwa M. Devices for preventing percutaneous exposure injuries caused by needles in healthcare personnel. Cochrane Database Syst Rev. 2017;11(11):CD009740. doi: 10.1002/14651858.CD009740.pub3
39. Zhang M, Lee M, Knott S. Is clinical performance adversely affected by wearing gloves during paediatric peripheral intravenous cannulation? Emerg Med Australas. 2014;26(5):455-460. doi: 10.1111/1742-6723.1227
Appendix 1
Demographic Questionnaire
Participants Demographic Data (Tick ( √ ) that apply to you)
1. What age group are you in?
☐1 ≤ 19 years
☐2 20 – 29 years
☐3 30 – 39 years
☐4 40 – 49 years
☐5 50 – 59 years
☐6 ≥ 60 years
2. What gender was assigned to you at birth? ☐1 Male ☐2 Female
3. Other than the education today, have you had any previous peripheral intravenous catheter (PIVC) insertion or venipuncture training? ☐1 Yes ☐2 No
4. If yes to question 3, where was the training conducted?
☐1 University ☐2 Hospital ☐3 Other, please specify: ___________
5. Do you have previous PIVC insertion or venipuncture experience?
☐1 Yes ☐2 No
6. If yes to question 5, please indicate duration of experience: ☐ Years ☐ Months
7. If yes to question 5, please indicate where the experience was gained:
☐1 University ☐2 Hospital ☐3 Other, please specify: ___________
Appendix 2
Knowledge of PIVC Insertion Questionnaire
Please answer the question by choosing/ticking (√) the option available
1. What factors would support placement of a PIVC? (Please select one)
☐ a. To deliver Mannitol 20%
☐ b. Anticipated duration of IV medication of 14 days
☐ c. To deliver 0.45% Sodium chloride + 5% Glucose
☐ d. To obtain blood sample*
2. As a general guideline, what type of peripheral IV catheter should be selected when considering routine peripheral venous access?
☐ a. The smallest gauge catheter the vein will accommodate to deliver prescribed therapy
☐ b. The longest length catheter the vein will accommodate to deliver prescribed therapy
☐ c. The smallest gauge and longest length catheter the vein will accommodate to deliver prescribed therapy
☐ d. The smallest gauge and shortest length catheter the vein will accommodate to deliver prescribed therapy
3. Please indicate which veins below are most appropriate for routine PIVC placement in adult patients: (Please select all that apply)
☐1 Veins of the wrist
☐2 Mid-forearm basilic vein
☐3 Vein of the ankle
☐4 Mid-forearm cephalic vein
☐5 Veins in areas of joint flexure
☐6 Antecubital fossa cephalic vein
☐7 Veins without bifurcations
☐8 Veins of the lower extremities
☐9 Vein section that does not have valves
4. Place the following PIVC catheter insertion steps in correct order from start to finish by putting number (1-9) in the box.
☐ 1 Occlude blood vessel [8]
☐ 2 Wash hands [1]
☐ 3 Remove stylet [7]
☐ 4 Thread catheter [5]
☐5 Release tourniquet [6]
☐6 Stabilize vein [3]
☐7 Connect to an IV administration set or saline lock [9]
☐8 Insert needle and catheter [4]
☐10 Don gloves [2]
5. Nurse A will insert a PIVC to adult patient who was admitted to the hospital one hour ago. Prior to the PIVC insertion, nurse A gives health education to the adult patient. What educational topics should be included in the health education? (please select one)
☐ a. Purpose, expected outcomes potential & complications/risks and benefits
☐ b. Type of the infusion therapy & the insertion procedure
☐ c. Infusion-device related care to prevent complications *
☐ d. All of the above
6. From the following examples, select the most appropriate documentation for a PIVC insertion procedure?
☐ a. Date, time, & name of the inserter
☐ b IV catheter & infusion characteristics
☐ c. Site insertion characteristics & patient responses
☐ d. All of the above
7. The greatest risk for contamination of the vascular access device after catheter placement is associated with failure to (Please select one)
☐ a. Perform routine site care
☐ b. Rotate the PIVC
☐ c. Disinfect the needleless connector
☐ d. Stabilize the catheter
Appendix 3
Confidence with PIVC Insertion Questionnaire
Please choose a response that best represents your confidence in PIVC insertion
1=strongly disagree
2=disagree
3=neither disagree nor agree
4=agree
5=strongly agree
No Statement Response
1 2 3 4 5
I am confident I can…
1 Perform a pre-insertion PIVC site assessment
2 Insert a PIVC within 1 or 2 attempts
3 Select the most appropriate PIVC device for the prescribed treatment plan
4 Assist my peers with difficult PIVC insertion
5 Select an ideal vein for PIVC insertion
6 Prepare the insertion site according to hospital protocol
7 Insert the PIVC correctly
8 Advance the PIVC correctly
9 Remove the needle/stylet with minimal blood exposure
10 Dress and secure the PIVC and tubing according to hospital protocol
11 Document PIVC insertion according to hospital protocol
12 Give patient education related to PIVC insertion and care
13 Document the results of site assessment according to the hospital protocol
14 Recognise signs and symptoms of PIVC complications
Appendix 4
1. Please indicate your level of agreement with the following statements: Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree
I found the near infrared education session helpful
I received useful information today on how to use near infrared technology
I would recommend the near infrared education session to my colleagues/peers
I found the near infrared device easy to use
I would feel more confident placing a PIVC using the near infrared device
I would like to use the near infrared device on all my patients
I think the near infrared device would enhance my ability to select an optimal site for PIVC insertion
I think the near infrared device would enhance my ability to insert a PIVC
Attitudes towards Vein Visualization Technology Questionnaire
2. Have you used an AccuVein near infrared device before? ☐1 Yes ☐2 No
3. If yes to question 2, how long have you been using the device?
☐1 0-3 months ☐2 4-6 months ☐3 7-12 months ☐4 Over 12 months
4. If yes to question 2, please indicate whether you gained additional insights from the education session today about using the AccuVein near infrared device efficiently:
☐1 Strongly agree ☐2 Somewhat agree ☐3 Neither agree nor disagree ☐4 Somewhat disagree ☐4 Strongly disagree
5. Please share any other comments about your experience of the education session today and using the near infrared device:
2. Marsh N, Webster J, Ullman AJ, et al. Peripheral intravenous catheter non-infectious complications in adults: a systematic review and meta-analysis. J Adv Nurs. 2020;76(12):3346-3362. doi: 10.1111/jan.14565
3. Carr PJ, Rippey JCR, Budgeon CA, Cooke ML, Higgins N, Rickard CM. Insertion of peripheral intravenous cannulae in the emergency department: factors associated with first-time insertion success. J Vasc Access. 2016;17(2):182-190. doi: 10.5301/jva.5000487
4. Keleekai NL, Schuster CA, Murray CL, et al. Improving nurses' peripheral intravenous catheter insertion knowledge, confidence, and skills using a simulation-based blended learning program: a randomized trial. Simul Healthc. 2016;11(6):376-384. doi: 10.1097/SIH.0000000000000186
5. Loon FHJV, Puijn LAPM, Houterman S, Bouwman ARA. Development of the A-DIVA Scale: a clinical predictive scale to identify difficult intravenous access in adult patients based on clinical observations. Medicine (Baltimore). 2016;95(16):e3428. doi: 10.1097/MD.0000000000003428
6. Helm RE, Klausner JD, Klemperer JD, Flint LM, Huang E. Accepted but unacceptable: peripheral IV catheter failure. J Infus Nurs. 2015;38(3):189-203. doi: 10.1097/NAN.0000000000000100
7. Brown RA, Crookes PA, Iverson D. An audit of skills taught in registered nursing preparation programmes in Australia. BMC Nurs. 2015;14:68. doi: 10.1186/s12912-015-0113-7
8. Massey D, Craswell A, Ray-Barruel G, et al. Undergraduate nursing students' perceptions of the current content and pedagogical approaches used in PIVC education. A qualitative, descriptive study. Nurse Educ Today. 2020;94:104577. doi: 10.1016/j.nedt.2020.104577
9. Vizcarra C, Cassutt C, Corbitt N, Richardson D, Runde D, Stafford K. Recommendations for improving safety practices with short peripheral catheters. J Infus Nurs. 2014;37(2):121-124. doi: 10.1097/NAN.0000000000000028
10. Etafa W, Wakuma B, Tsegaye R, Takele T. Nursing students' knowledge on the management of peripheral venous catheters at Wollega University. PLoS One. 2020;15(9):e0238881. doi: 10.1371/journal.pone.0238881
11. Simonetti V, Comparcini D, Miniscalco D, Tirabassi R, Di Giovanni P, Cicolini G. Assessing nursing students' knowledge of evidence-based guidelines on the management of peripheral venous catheters: a multicentre cross-sectional study. Nurse Educ Today. 2019;73:77-82. doi: 10.1016/j.nedt.2018.11.023
12. Vandenhouten CL, Owens AK, Hunter MR, Raynak A. Peripheral intravenous education in North American nursing schools: a call to action. J Nurs Educ. 2020;59(9):493-500. doi: 10.3928/01484834-20200817-03
13. Hunter MR, Vandenhouten C, Raynak A, Owens AK, Thompson J. Addressing the silence: a need for peripheral intravenous education in North America. JAVA. 2018;23(3):157–165. doi: 10.1016/j.java.2018.06.001
14. Indarwati F, Munday J, Keogh S. Nurse knowledge and confidence on peripheral intravenous catheter insertion and maintenance in pediatric patients: a multicentre cross-sectional study. J Pediatr Nurs. 2022;62:10-16. doi: 10.1016/j.pedn.2021.11.007
15. Ahlin C, Klang-Söderkvist B, Johansson E, Björkholm M, Löfmark A. Assessing nursing students' knowledge and skills in performing venepuncture and inserting peripheral venous catheters. Nurse Educ Pract. 2017;23:8-14. doi: 10.1016/j.nepr.2017.01.003
16. Osti C, Khadka M, Wosti D, Gurung G, Zhao Q. Knowledge and practice towards care and maintenance of peripheral intravenous cannula among nurses in Chitwan Medical College Teaching Hospital, Nepal. Nurs Open. 2019;6(3):1006-1012. doi: 10.1002/nop2.288
17. Pitts S, Ostroff M. The use of visualization technology for the insertion of peripheral intravenous catheters. JAVA. 2019;24(3):10–14. doi: 10.2309/j.java.2019.003.007
18. Aulagnier J, Hoc C, Mathieu E, Dreyfus JF, Fischler M, Le Guen M. Efficacy of AccuVein to facilitate peripheral intravenous placement in adults presenting to an emergency department: a randomized clinical trial. Acad Emerg Med. 2014;21(8):858-863. doi: 10.1111/acem.12437
19. Eren H, Caliskan N. Effect of a vein imaging device and of fist clenching on determination of an appropriate vein and on catheter placement time in patients receiving chemotherapy: a randomized controlled trial. Cancer Nurs. 2022;45(2):105-112. doi: 10.1097/NCC.0000000000000931
20. Guillon P, Makhloufi M, Baillie S, Roucoulet C, Dolimier E, Masquelier A-M. Prospective evaluation of venous access difficulty and a near-infrared vein visualizer at four French haemophilia treatment centres. Haemophilia. 2015;21(1):21-26. doi: 10.1111/hae.12513
21. Kanipe W, Shobe K, Li Y, Kime M, Smith-Miller CA. Evaluating the efficacy and use of vein visualization equipment among clinical nurses in an intermediate care environment. J Infus Nurs. 2018;41(4):253-258. doi: 10.1097/NAN.0000000000000286
22. Parker SIA, Benzies KM, Hayden KA, Lang ES. Effectiveness of interventions for adult peripheral intravenous catheterization: a systematic review and meta-analysis of randomized controlled trials. Int Emerg Nurs. 2017;31:15-21. doi: 10.1016/j.ienj.2016.05.004
23. Sriparkdee C, Sawangwong S, Curry P, Tatiyanupunwong S. A randomized controlled trial comparing the AccuVein AV400 device to standard insertion technique for peripheral intravenous cannulation by experienced nurse anesthetists in obese patients undergoing elective surgery. Thammasat Medical Journal. 2016;16(4):546–552.
24. van der Woude OCP, Cuper NJ, Getrouw C, Kalkman CJ, de Graaff JC. The effectiveness of a near-infrared vascular imaging device to support intravenous cannulation in children with dark skin color: a cluster randomized clinical trial. Anesth Analg. 2013;116(6):1266-1271. doi: 10.1213/ANE.0b013e31828e5bde
25. Nickel B, Gorski L, Kleidon T, et al. Infusion therapy standards of practice, 9th edition. J Infus Nurs. 2024;47(1S Suppl 1):S1-S285. doi: 10.1097/NAN.0000000000000532
26. Adhikari S, Schmier C, Marx J. Focused simulation training: emergency department nurses' confidence and comfort level in performing ultrasound-guided vascular access. J Vasc Access. 2015;16(6):515-520. doi: 10.5301/jva.5000436
27. Awad MS, Abdullah MK, Ibrahim RH, Abdulla RK. Nursing students’ attitudes toward simulation technology in nursing education. Int J Eng Technol. 2019;14(14):31–45. doi: 10.3991/ijet.v14i14.10571
28. Fukuroku K, Narita Y, Taneda Y, Kobayashi S, Gayle AA. Does infrared visualization improve selection of venipuncture sites for indwelling needle at the forearm in second-year nursing students? Nurse Educ Pract. 2016;18:1-9. doi: 10.1016/j.nepr.2016.02.005
29. Marchionni C, Connolly M, Gauthier M, Lavoie-Tremblay M. Innovative approaches to teaching vascular access to nursing students in the COVID-19 era. Br J Nurs. 2021;30(14):S34-S41. doi: 10.12968/bjon.2021.30.14.S34
30. Mulyadi M, Tonapa SI, Rompas SSJ, Wang R-H, Lee B-O. Effects of simulation technology-based learning on nursing students' learning outcomes: a systematic review and meta-analysis of experimental studies. Nurse Educ Today. 2021;107:105127. doi: 10.1016/j.nedt.2021.105127
31. Demir D, Inal S. Does the use of a vein visualization device for peripheral venous catheter placement increase success rate in pediatric patients? Pediatr Emerg Care. 2019;35(7):474-479. doi: 10.1097/PEC.0000000000001007
32. El –Aziz RAE-RA, Osman YM. Effectiveness of AccuVein AV400 device versus ultrasound-guided cannulation of the great saphenous vein at the ankle in infants: a randomized controlled trial. Int J Anesthesiol Res. 2020;594–599. doi: 10.19070/2332-2780-20000118
33. Zhang Z, Wang X, Zhang L, et al. Infrared vein imaging for insertion of peripheral intravenous catheter for patients requiring isolation for Severe Acute Respiratory Syndrome Coronavirus 2 Infection: a nonrandomized clinical trial. J Emerg Nurs. 2022;48(2):159-166. doi: 10.1016/j.jen.2021.10.001
34. Glover KR, Stahl BR, Murray C, et al. A simulation-based blended curriculum for short peripheral intravenous catheter insertion: an industry-practice collaboration. J Contin Educ Nurs. 2017;48(9):397-406. doi: 10.3928/00220124-20170816-05
35. Goff DA, Larsen P, Brinkley J, et al. Resource utilization and cost of inserting peripheral intravenous catheters in hospitalized children. Hosp Pediatr. 2013;3(3):185-191. doi: 10.1542/hpeds.2012-0089
36. Hallam C, Weston V, Denton A, et al. Development of the UK Vessel Health and Preservation (VHP) framework: a multi-organisational collaborative. J Infect Prev. 2016;17(2):65-72. doi: 10.1177/1757177415624752
37. Pinelli F, Pittiruti M. The integrated short peripheral cannula: a new peripheral venous access device? J Vasc Access. 2023;24(3):353-357. doi: 10.1177/11297298211034023
38. Reddy VK, Lavoie MC, Verbeek JH, Pahwa M. Devices for preventing percutaneous exposure injuries caused by needles in healthcare personnel. Cochrane Database Syst Rev. 2017;11(11):CD009740. doi: 10.1002/14651858.CD009740.pub3
39. Zhang M, Lee M, Knott S. Is clinical performance adversely affected by wearing gloves during paediatric peripheral intravenous cannulation? Emerg Med Australas. 2014;26(5):455-460. doi: 10.1111/1742-6723.1227
Appendix 1
Demographic Questionnaire
Participants Demographic Data (Tick ( √ ) that apply to you)
1. What age group are you in?
☐1 ≤ 19 years
☐2 20 – 29 years
☐3 30 – 39 years
☐4 40 – 49 years
☐5 50 – 59 years
☐6 ≥ 60 years
2. What gender was assigned to you at birth? ☐1 Male ☐2 Female
3. Other than the education today, have you had any previous peripheral intravenous catheter (PIVC) insertion or venipuncture training? ☐1 Yes ☐2 No
4. If yes to question 3, where was the training conducted?
☐1 University ☐2 Hospital ☐3 Other, please specify: ___________
5. Do you have previous PIVC insertion or venipuncture experience?
☐1 Yes ☐2 No
6. If yes to question 5, please indicate duration of experience: ☐ Years ☐ Months
7. If yes to question 5, please indicate where the experience was gained:
☐1 University ☐2 Hospital ☐3 Other, please specify: ___________
Appendix 2
Knowledge of PIVC Insertion Questionnaire
Please answer the question by choosing/ticking (√) the option available
1. What factors would support placement of a PIVC? (Please select one)
☐ a. To deliver Mannitol 20%
☐ b. Anticipated duration of IV medication of 14 days
☐ c. To deliver 0.45% Sodium chloride + 5% Glucose
☐ d. To obtain blood sample*
2. As a general guideline, what type of peripheral IV catheter should be selected when considering routine peripheral venous access?
☐ a. The smallest gauge catheter the vein will accommodate to deliver prescribed therapy
☐ b. The longest length catheter the vein will accommodate to deliver prescribed therapy
☐ c. The smallest gauge and longest length catheter the vein will accommodate to deliver prescribed therapy
☐ d. The smallest gauge and shortest length catheter the vein will accommodate to deliver prescribed therapy
3. Please indicate which veins below are most appropriate for routine PIVC placement in adult patients: (Please select all that apply)
☐1 Veins of the wrist
☐2 Mid-forearm basilic vein
☐3 Vein of the ankle
☐4 Mid-forearm cephalic vein
☐5 Veins in areas of joint flexure
☐6 Antecubital fossa cephalic vein
☐7 Veins without bifurcations
☐8 Veins of the lower extremities
☐9 Vein section that does not have valves
4. Place the following PIVC catheter insertion steps in correct order from start to finish by putting number (1-9) in the box.
☐ 1 Occlude blood vessel [8]
☐ 2 Wash hands [1]
☐ 3 Remove stylet [7]
☐ 4 Thread catheter [5]
☐5 Release tourniquet [6]
☐6 Stabilize vein [3]
☐7 Connect to an IV administration set or saline lock [9]
☐8 Insert needle and catheter [4]
☐10 Don gloves [2]
5. Nurse A will insert a PIVC to adult patient who was admitted to the hospital one hour ago. Prior to the PIVC insertion, nurse A gives health education to the adult patient. What educational topics should be included in the health education? (please select one)
☐ a. Purpose, expected outcomes potential & complications/risks and benefits
☐ b. Type of the infusion therapy & the insertion procedure
☐ c. Infusion-device related care to prevent complications *
☐ d. All of the above
6. From the following examples, select the most appropriate documentation for a PIVC insertion procedure?
☐ a. Date, time, & name of the inserter
☐ b IV catheter & infusion characteristics
☐ c. Site insertion characteristics & patient responses
☐ d. All of the above
7. The greatest risk for contamination of the vascular access device after catheter placement is associated with failure to (Please select one)
☐ a. Perform routine site care
☐ b. Rotate the PIVC
☐ c. Disinfect the needleless connector
☐ d. Stabilize the catheter
Appendix 3
Confidence with PIVC Insertion Questionnaire
Please choose a response that best represents your confidence in PIVC insertion
1=strongly disagree
2=disagree
3=neither disagree nor agree
4=agree
5=strongly agree
No Statement Response
1 2 3 4 5
I am confident I can…
1 Perform a pre-insertion PIVC site assessment
2 Insert a PIVC within 1 or 2 attempts
3 Select the most appropriate PIVC device for the prescribed treatment plan
4 Assist my peers with difficult PIVC insertion
5 Select an ideal vein for PIVC insertion
6 Prepare the insertion site according to hospital protocol
7 Insert the PIVC correctly
8 Advance the PIVC correctly
9 Remove the needle/stylet with minimal blood exposure
10 Dress and secure the PIVC and tubing according to hospital protocol
11 Document PIVC insertion according to hospital protocol
12 Give patient education related to PIVC insertion and care
13 Document the results of site assessment according to the hospital protocol
14 Recognise signs and symptoms of PIVC complications
Appendix 4
1. Please indicate your level of agreement with the following statements: Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree
I found the near infrared education session helpful
I received useful information today on how to use near infrared technology
I would recommend the near infrared education session to my colleagues/peers
I found the near infrared device easy to use
I would feel more confident placing a PIVC using the near infrared device
I would like to use the near infrared device on all my patients
I think the near infrared device would enhance my ability to select an optimal site for PIVC insertion
I think the near infrared device would enhance my ability to insert a PIVC
Attitudes towards Vein Visualization Technology Questionnaire
2. Have you used an AccuVein near infrared device before? ☐1 Yes ☐2 No
3. If yes to question 2, how long have you been using the device?
☐1 0-3 months ☐2 4-6 months ☐3 7-12 months ☐4 Over 12 months
4. If yes to question 2, please indicate whether you gained additional insights from the education session today about using the AccuVein near infrared device efficiently:
☐1 Strongly agree ☐2 Somewhat agree ☐3 Neither agree nor disagree ☐4 Somewhat disagree ☐4 Strongly disagree
5. Please share any other comments about your experience of the education session today and using the near infrared device: