Resident Abstracts

UHC/AACN Nurse Residency Program

2016 NRP Annual Meeting - Call for Abstracts
Organization: University Medical Center of El Paso
Nurse residency coordinator name(s) and email (s): Julie Gest JGest@umcelpaso.org

Anticipated number of nurse residents approved for travel by your organization: Two
Project/presentation title: External Jugular Access Action Plan
Organization name: No Vein, No Gain
Nurse resident(s)/project participant(s):
Maria Meza
(Name)

Dayna Valdez _____________

(Name)

mmeza213@gmail.com_____________
(E-mail)

daynavaldez10@hotmail.com
(E-mail)

Learning objectives (list 2-3): for purpose of evaluating for podium presentation
1. Identify potential candidates for External Jugular (EJ) IV access and the necessity for one.
2. Describe the procedure for insertion, maintenance, and removal of EJ IV access.
1 Discuss the role of inter-professional teamwork and its importance in reducing the delay in IV
treatment and unnecessary central line placements in the Emergency Department.

Abstract narrative (300 words or less):

A delay in emergent intravenous (IV) treatment due to difficult peripheral vein access causes a significant
professional practice gap in numerous Emergency Rooms in the United States. To begin closing this gap,
the No Vein, No Gain team have created an External Jugular Access Action Plan. The goal is to decrease
the length of time it takes for initial IV treatment by 25% in 2016 and 50% in 2017; by having trained
RNs place External Jugular (EJ) peripheral IV access to patients after multiple failed IV attempts in the
Emergency Department (ED).

The action plan consists of five major components: developing a unit approved policy for EJ insertion,
instituting a Performance Improvement (PI) Tool, creating an EJ Competency Assessment for RNs,
collaborating with inter-professionals, and offering quarterly in-service sessions. The Competency
Assessment is a checklist created to train, educate, and evaluate RNs on evidence-based techniques for
inserting, maintaining, and removing EJ access. The PI Tool is used to track the exact amount of time
when the patient with difficult peripheral access first arrived to the room to the successful IV access time.
This tool will be audited weekly for insertion type, number of failed peripheral IV attempts, and
indication for EJ access.

Nurse Residents anticipate the project to become fully integrated in the Emergency Department after all
RNs have been thoroughly trained and educated on EJ access by the Nurse Educator and Medical Faculty
at the end of March 2016. Additional strategies, such as one-on-one training with educator on mannequins
in the simulation laboratory, are being formed in case of goal deficiency by the end of 2016. By merging
the EJ Access Action Plan with the units already established Ultrasound-Guided IV Access Action Plan,
residents hope to improve patient outcomes by closing the delay in starting IV medication treatment.

References

Booth, J., Ellis, K., Viles, A. (n.d.). External Jugular IV Cannulation -- RN Verification Program. The
University of Alabama at Birminham. Retrieved from: http://cjpems.com/EJ.pdf
Costantino, T.G., Kirtz, J.F., Satz, W.A. (2010). Ultrasound-Guided Peripheral Venous Access vs. the
External Jugular Vein as the Initial Approach to the Patient with Difficult Vascular Access. The
Journal of Emergency Medicine. (39)4. Pgs. 462-467. Retrieved from:
http://dx.doi.org/10.1016/j.jemermed.2009.02.004
Infusion Nurses Society (2011). Infusion Nursing Standards of Practice. [Supplement]. Journal of
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Mohamed, M.I. (2015). Case Report: Management of unusual site for contrast media extravasation in
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Sansivero, G.E. (2010). Features and Selection of Vascular Access Devices. Seminars in Oncology
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The Association for Vascular Access (2011). Cannulation of the Internal and External Jugular Veins by
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http://avainfo.org/website.