Aseptic non-touch technique training for ultrasound guided difficult peripheral vascular access: A prospective randomized study

Background: This study aims to evaluate the effectiveness of simulator-based repetitive training on the aseptic non-touch IV placement technique using an ultrasound-guided peripheral vascular access (USPVA) simulator among physicians working in the emergency department (ED), anesthesiology, and medical intensive care units (ICUs) at a tertiary training hospital. Methods: In this prospective randomized study, participants received theoretical training, then randomized into two groups and performed USPVA on the simulator. The simulated vessels were at 5, 10, and 15 mm depths with 2, 4, and 6 mm diameters, respectively. Finally, pre- and post-questionnaires and simulator data were analyzed. Results: A total of 36 physicians, (18 from ED, 9 from anesthesiology and 9 from ICU) participated in the study. Training on the simulator significantly improved the success rate of vascular access (62.5% (135/216)) compared to baseline values (31.9% (69/216); p < 0.001). There was a significant increase in the successful application of the aseptic non-touch technique after the training (96.2% (208/216)) compared to pre-training (42.5% (92/216); p < 0.001). The survey results showed that participants acquired new knowledge related to the aseptic non-touch technique through simulator-based training. Conclusion: This study demonstrates the successful implementation of aseptic non-touch technique for USPVA training for physicians using a mixed reality simulator.