Point-of-Care Ultrasound for Vascular Access in the Neonatal Intensive Care Unit

Grant Application

Mia Harton, MD, UPMC Magee-Womens Hospital and UPMC Children’s Hospital of Pittsburgh

Proposed Innovation

Vascular access procedures are routine in neonatal intensive care units (NICUs). Peripheral and central lines are commonly used to provide at-risk infants with extended nutritional support, fluids, and medicine during their hospitalization. These lines have increasingly been placed using interventional radiology and surgical procedures, which can lead to serious complications such as a central line-associated bloodstream infection (CLABSI).

This project is aimed at introducing point-of-care ultrasound (POCUS) to guide catheter placements in the NICUs at UPMC Magee-Womens Hospital and UPMC Children’s Hospital of Pittsburgh. The goal is to reduce the number of infants needing a central line placement by interventional radiology or surgical procedures, decreasing radiation exposure and infection risk, and reducing the need to transfer critically ill newborns between hospitals.

Improvements in Action

Through this project, simulation training will be developed within the two NICUs to teach POCUS skills to advanced practice providers and physicians at both hospitals. A core POCUS team will be established at both NICUs to ensure vascular access services are available around- the-clock.

Intended Results

Using POCUS in the NICU is expected to have widespread benefits for infants, families, and providers. Babies and their families will experience less stress with faster procedures in fewer attempts, more stable access to vessels using deeper ultrasound-guided placements, fewer cases of CLABSI, and decreased need for sedation and radiation. In addition, fewer patients will need to be transported to Children’s Hospital for care. Providers will be able to complete procedures more efficiently and successfully. Eventually, they also will be able to teach the course and assist other learners.