Peripheral Intravenous Cannulation Using Three Different Techniques on Nursing Students

Study Overview
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Brief Summary
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Aim: The primary objective was to assess the effect of three different teaching techniques on the success of first-time peripheral intravenous cannulation (PVC) insertion as well as the vein prominence of nursing students. As a secondary objective, the authors conducted research on the students' PVC knowledge levels and skills performance, in the PVC procedure and the duration of the procedure, their satisfaction, and self-confidence in learning. Design: A randomized controlled trial with a pretest and posttest was conducted between February and July 2022, with near-infrared light visualization (n=49), isometric exercise (n=50), and each other's arms (n=48) with nursing students in Turkey.

Detailed Description
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Aim: The primary objective was to assess the effect of three different teaching techniques on the success of first-time peripheral intravenous cannulation (PVC) insertion as well as the vein prominence of nursing students. As a secondary objective, the authors conducted research on the students' PVC knowledge levels and skills performance, in the PVC procedure and the duration of the procedure, their satisfaction, and self-confidence in learning. Methods: A randomized controlled trial with a pretest and posttest was conducted between February and July 2022, with near-infrared light visualization (n=49), isometric exercise (n=50), and each other's arms (n=48) with nursing students in Turkey. Performing the application on the NIR light visualization group: The participants in this group were taught to use the device, previously. The NIR light device was held by the researchers at 20cm. The participant performing PVC carried out the procedure on the arm vein of another volunteer classmate with the help of vein imaging by NIR. All interventions were conducted under the observation of the researchers. Two researchers made assessments independent of each other based on the C-PVC. The researchers used a chronometer to measure and record how long the PVC took. Participants were asked about the degree of vein prominence under NIR light after the tourniquet was applied, using inspection and palpation. The chronometer was started after the tourniquet was applied and stopped when the catheter plaster was applied. The time that it took to choose the materials needed for the PVC was not added to this time. The researchers recorded whether the PVC procedure was successful or unsuccessful. The cannula's placement during PVC was evaluated by drawing blood and returning it to the vein with a syringe. The PVC procedure was considered a failure if the vein was not opened or no blood reached the syringe. The catheter was taken out, a cotton tampon was applied, and the arm was elevated for five minutes whether the PVC attempt was successful or not. The SCLS was completed immediately after the procedure. Performing the application on the isometric exercise group: In this group, the participants performing PVC carried out the procedure by observing vein dilation after isometric exercise. Before the procedure, the students on whom PVC was to be performed were given two stress balls, and they were told how to use them for 15 minutes. The stress balls used in the study were 6 cm in diameter and yellow. They were of medium hardness and made of high-quality silicone. The participants were told to squeeze and relax the stress ball in the palm of their hands after counting from one to three, to continue doing this until the procedure began, and to concentrate on squeezing the ball. Participants were asked about the degree of vein prominence after the isometric exercise and tourniquet was applied, using inspection and palpation. The remaining stages were carried out in the same way as with all of the groups. Control group: The students in this group performed the PVC procedure directly on each other's arm veins without NIR or isometric exercise. Participants were asked about the degree of vein prominence after the tourniquet was applied, using inspection and palpation. The remaining stages were carried out in the same way as with all of the groups.

Official Title
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The Effect of First Attempts at the Success of Peripheral Intravenous Cannulation Using Three Different Techniques on Nursing Students: A Randomized Controlled Trial

Conditions
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Image, Knowledge, Attitudes, Practice

Intervention / Treatment
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* Other: Near infrared light imaging
* Other: Isometric exercise with stress ball


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: participants who did not use alcohol participants who did not drug abuse participants who completed the immunization /vaccination schedule. participants who volunteered to participated in the study Exclusion Criteria: participants who were diagnosed with a chronic illness, participants who have a disorder causing bleeding, participants who have a psychiatric illness, participants who had not received vaccinations for HBV, HCV, or HIV vaccine participants who were pregnant participants who did not volunteer to participate in the study were not included in the study.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 45 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: This is a prospective, randomized controlled experimental study.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: NIR light visualization<br>The participant performing PVC carried out the procedure on the arm vein of another volunteer classmate with the help of vein imaging by NIR. All interventions were conducted under the observation of the researchers. The researchers used a chronometer to measure and record how long the PVC took. Participants were asked about the degree of vein prominence under NIR light after the tourniquet was applied, using inspection and palpation. The chronometer was started after the tourniquet was applied and stopped when the catheter plaster was applied. The time that it took to choose the materials needed for the PVC was not added to this time. The researchers recorded whether the PVC procedure was successful or unsuccessful. The cannula's placement during PVC was evaluated by drawing blood and returning it to the vein with a syringe. The PVC procedure was considered a failure if the vein was not opened or no blood reached the syringe. | Other: Near infrared light imaging<br>* The participant performing PVC carried out the procedure on the arm vein of another volunteer classmate with the help of vein imaging by NIR. All interventions were conducted under the observation of the researchers.<br>|
| Experimental: isometric hand exercise<br>In this group, the participants performing PVC carried out the procedure by observing vein dilation after isometric exercise. Before the procedure, the students on whom PVC was to be performed were given two stress balls, and they were told how to use them for 15 minutes. The stress balls used in the study were 6 cm in diameter and yellow in color. They were of medium hardness and made of high-quality silicone. The participants were told to squeeze and relax the stress ball in the palm of their hands after counting from one to three, to continue doing this until the procedure began, and to concentrate on squeezing the ball. Participants were asked about the degree of vein prominence after the isometric exercise and tourniquet was applied, using inspection and palpation. The remaining stages were carried out in the same way as with all of the groups. | Other: Isometric exercise with stress ball<br>* Before the procedure, the students on whom PVC was to be performed were given two stress balls, and they were told how to use them for 15 minutes. The participants were told to squeeze and relax the stress ball in the palm of their hands after counting from one to three, to continue doing this until the procedure began, and to concentrate on squeezing the ball.<br>|
| No Intervention: Control group: no intervention<br>The students in this group performed the PVC procedure directly on each other's arm veins without NIR or isometric exercise. Participants were asked about the degree of vein prominence after the tourniquet was applied, using inspection and palpation. The remaining stages were carried out in the same way as with all of the groups. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Prominence of the selected vein (image) | Prominence of the vein: 1st degree : veins not visible or palpable, 2nd degree : veins visible but not palpable, 3rd degree : veins barely visible and palpable, 4th degree : veins visible and palpable, 5th degree : veins clearly visible and easily palpable. | 6 months | 
| Knowledge, attitude, practice | A higher total test score was interpreted as a higher level of PVC knowledge. According to the test score, which was between 0 and 40 points, a higher total test score in the assessment demonstrated that the student's PVC skills level was high. | 6 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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peripheral intravenous cannulation, infrared light, isometric exercise