Nurse-performed radial arterial access: A scoping review of reported practice, training and evidence gaps
TL;DR
The evidence remains limited and heterogeneous and no definitive conclusions can be drawn regarding safety, effectiveness or optimal implementation models, so future studies should use nurse-specific outcome reporting and evaluate training, competency assessment, credentialing, maintenance of competence and organizational impact.
Abstract
Introduction: Nurse-performed radial arterial access has been described as a potential area of advanced nursing practice in high-acuity settings, although the available evidence remains limited and fragmented. Objective: To map the extent, range and nature of the literature on nurse-performed radial arterial access, including reported clinical settings, nursing roles, training models, outcomes and evidence gaps. Materials and Methods: A scoping review was conducted in accordance with Joanna Briggs Institute methodology and PRISMA-ScR guidance. PubMed, Scopus and Web of Science were searched. Original studies involving adult populations and direct nurse involvement in radial arterial puncture, cannulation or device placement were included. Data were synthesized narratively. Results: Of 325 records identified, 6 studies met the inclusion criteria. Studies were conducted in Australia, Spain, China, Italy and the United Kingdom, mainly in intensive care units, neuro-intensive care units and cardiac catheterization laboratories. Nurse-performed radial arterial access was generally described within structured training or supervision frameworks. Reported outcomes included procedural success, first-attempt success, complications, catheter durability and learning curve. However, studies were heterogeneous and one study reported outcomes aggregated for nurses and intensivists. Conclusion: Nurse-performed radial arterial access has been described in a small number of selected settings, mainly within structured training, supervision and progressive skill acquisition models. However, the evidence remains limited and heterogeneous and no definitive conclusions can be drawn regarding safety, effectiveness or optimal implementation models. Future studies should use nurse-specific outcome reporting and evaluate training, competency assessment, credentialing, maintenance of competence and organizational impact.