ULTRASOUND-GUIDED PUNCTURE IN THE INSERTION OF PERIPHERALLY INSERTED CENTRAL VENOUS CATHETERS (PICC) BY NURSES: AN INTEGRATIVE LITERATURE REVIEW

Abstract

Introduction: The use of ultrasonography in nursing practice has emerged as an innovative technology that significantly contributes to the performance of invasive procedures, especially in the insertion of Peripherally Inserted Central Catheters (PICC). This technique enables real-time visualization of vascular structures, increasing procedural accuracy, reducing complications, and promoting greater patient safety, particularly among individuals with difficult venous access, such as neonates, pediatric patients, and critically ill patients. Objective: To analyze the scientific evidence available in the literature regarding the use of ultrasonography by nurses during PICC insertion, highlighting its effectiveness, benefits, and challenges in clinical practice. Methodology: This is an integrative literature review with a qualitative and descriptive approach, conducted through the Virtual Health Library (VHL), including the LILACS, BDENF, MEDLINE, and SciELO databases. Controlled descriptors and free terms related to ultrasonography, peripheral venous catheterization, and nursing were combined using Boolean operators. Inclusion criteria comprised full-text articles published between 2020 and 2025 in Portuguese and English. After applying the eligibility criteria and conducting a critical analysis of the studies, 16 publications were selected for the final sample. Results and Discussion: The analyzed studies demonstrated that the use of ultrasonography during PICC insertion by nurses significantly increases first-attempt success rates, reduces the number of repeated punctures, and decreases complications such as hematomas, infiltrations, phlebitis, and premature catheter loss. Benefits related to patient safety, quality of care, and strengthening nurses’ professional autonomy were also identified. However, barriers to implementation were observed, including structural limitations, lack of equipment, and the need for continuous professional training. Conclusion: It is concluded that ultrasound-guided puncture is an effective and safe strategy for PICC insertion performed by nurses, contributing to better clinical outcomes and improved quality of care. Despite the challenges to its widespread implementation, the benefits highlighted in the literature reinforce the need for investments in training, infrastructure, and institutional protocols that support the incorporation of this technology into evidence-based nursing practice.