Vascular access
a torch? This is especially true of ultrasound- guided vascular access.”
Best practice UGVA: techniques that protect vessels and elevate success
With experience supporting hundreds of clinicians across NHS Trusts nationwide on UGVA, Vygon’s clinical education team endorses thorough preparation and technique as critical to success. In fact, best practice UGVA starts before the probe touches the skin. Key steps include: l Patient preparation should address positioning, comfort, explanation, and anxiety reduction.
l Equipment readiness is paramount. Ensure the ultrasound device is fully charged and configured, select the correct probe, set depth and gain, and have sterile gel, probe covers, and fixation materials ready.
l Identify vessels and structures, and advance the needle with continuous ultrasound guidance.
l Maintain ANTT (Aseptic Non-Touch Technique) throughout. Protecting vessel health is inseparable from protecting patients from infection.
l Appropriate device selection. Consider midlines or PICC where dwell time, therapy type, and vessel characteristics warrant. The right device reduces repeated punctures, bruising, and early failure, protecting limited venous capital.
Crucial, in the experience of DIVA trainer, Sean O’Donnell, is the consideration of human factors and effective, patient-centred communication when it comes to UGVA. “Patients are reassured by confident, competent clinicians. Seeing their veins on a machine allows discussion of the challenge and a solution.” Ian agrees: “UGVA succeeds in calm, well-
prepared environments, and DIVA patients benefit when teams move beyond ‘just another cannula’. “Good practice involves explaining the plan, showing patients and carers the ultrasound
‘Increasing first attempt cannulation and phlebotomy saves time and resources, as less consumables are used and
less clinical time is required.’ David Wynne, clinical educator
image where appropriate, and narrating the steps you will take. Confidence, empathy, and clear communication help reduce anxiety and build trust.” For DIVA patients particularly, UGVA can be
transformational, offering: l Fewer punctures and less pain through real- time guidance.
l Timely intervention: Faster time to a guaranteed cannulation, meaning earlier therapy and fewer delays.
l Better experience: Reduces needle-related anxiety and the psychological burden of repeated failures.
“Patient outcomes will be improved by zero delays in treatment and timely intervention, which ultimately means less time in hospital, and that’s a system-wide win,” says David. “DIVA patients aren’t always listened to when
they explain their particular challenges to a clinician. Many patient pathways involve some form of IV therapy. Without reliable access, the DIVA patient receives suboptimal therapy, usually over a longer time period.”
Benefits to the NHS: success, speed and sustainability It has been demonstrated that embedding UGVA delivers measurable system benefits: l Higher first-pass success reduces consumables and frees staff time.
l Shorter procedure duration streamlines workflows and reduces bottlenecks.
l Fewer complications and re-attempts lower cost and bed-day utilisation.
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“Increasing first attempt cannulation and phlebotomy saves time and resources, as less consumables are used, and less clinical time is required,” says David. “This reduces length of stay and gets patients home quicker, so the efficiency gains to the NHS are significant.” Sean also notes that robust cannulation skills limit escalation to theatres and avoid sedation risks and resource-intensive workflow, which is particularly salient in paediatrics. Yet, despite its benefits, UGVA is not universal. Three recurring barriers emerge: 1. Training access Resident doctors, advanced practitioners, and outreach teams frequently report limited hands-on UGVA training. David notes: “Without routine exposure and mentorship, confidence lags. It should be a skill every trained clinician has, to support vessel health and preservation. That’s why we need to expand adoption as a priority.”
2. Equipment availability and funding Cost and procurement delays limit ultrasound availability at the point of care. For NHS Trusts considering how to improve vascular access outcomes, the investment represents not just a clinical imperative but also a financial opportunity. As Ian puts it: “Cost is always a barrier in the NHS, and you can’t practise without access to an ultrasound machine. Without practice, confidence stalls.”
3. Local variation and pathway inconsistency Some Trusts have mature vascular access
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