The placement of umbilical venous catheters (UVC) has routinely been placed "blind" by bedside providers using various approximations for catheter depth. Placement is then confirmed with x-ray, which is the current standard of care. Point-of-care ultrasound (POCUS) is increasingly being utilized in Neonatal Intensive Care Units (NICU) for both diagnostic and procedural applications. POCUS is a well-suited technology for the NICU as it is non-invasive, radiation-free, and can be performed and interpreted immediately by the bedside provider. Neonatal POCUS has been widely published as a both an adjunct and potentially superior alternative to radiography to confirm appropriate UVC placement. This quality improvement (QI) project seeks to implement POCUS for the routine placement and positioning of UVCs in the NICU at Comer Children's Hospital.

We aim to improve UVC placement. Specifically, we aim to improve success rate, reduce duration of procedure, reduce number of catheter manipulations, reduce number of x-rays and radiation, as well as reduce catheter migration and potential complications.

We will modify the current UVC procedure form/dot phrase in EPIC to include baseline data of interest and outcome measurements. We will develop a redcap for database for data acquisition. Concurrent with baseline data collection, we will train bedside providers to use POCUS for UVC placement and positioning. Once trained, providers will be able to use POCUS for all UVC procedures. Each procedure will require at least one confirmatory x-ray for comparison as standard-of-care. There will be chart reviewing to compare the groups.

REDCap, PACS IntelliSpace Enterprise, Excel

A yet to be established POCUS quality assurance review session to meet bi-weekly/monthly