Ultrasound-Guided IV Access Value & ROI Calculator

Estimate the potential clinical, nursing-capacity, and financial impact of implementing ultrasound-guided peripheral IV (UGPIV) access for patients with difficult intravenous access (DIVA).

Conservative evidence-informed defaults Facility inputs are editable Direct savings separated from RN capacity value

1. Patient volume

Use an estimate from annual encounters, or replace it with your known annual DIVA volume.

Example facility volume used in Gala et al.
Published model default: 75%.
Published model default: 22%; local data preferred.
Operational assumption; reduce for partial adoption.

2. Clinical effect

Defaults use the lower-benefit edge of the 95% confidence interval from the 2025 Zaki meta-analysis.

Conservative default: 0.33. Published pooled estimate: 0.83 fewer attempts.
Conservative default: 4.06 min. Published pooled estimate: 9.75 min.

3. Financial and escalation assumptions

All values are editable. Facility-specific finance and vascular-access data should replace defaults when available.

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Labor excluded here to avoid double counting.
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National benchmark; local loaded labor cost is preferred.
Weakest default: derived from expert-opinion escalation assumptions in Gala et al.
Conservative implementation estimate derived from Amick et al.
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$190 midline − $1.53 UGPIV catheter in the 2026 INS report.
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Enter local incremental cost for longer catheter, cover, gel, etc.

4. Program investment

Enter actual implementation costs to calculate ROI and payback.

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Leave at $0 if suitable equipment already exists.
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Methodology & evidence

These notes are intentionally visible so users can audit where the assumptions come from.

Patient volume and DIVA assumptions
Estimated DIVA patients = Annual encounters × PIV rate × DIVA rate × Program reach

Gala S, Alsbrooks K, Bahl A, Wimmer M. The economic burden of difficult intravenous access in the emergency department from a United States' provider perspective. Journal of Research in Nursing. 2024;29(1):6-18. Full text

Attempts and nursing-time effect
Avoided attempts = Addressable DIVA patients × Attempts avoided per patient
RN hours returned = Addressable DIVA patients × Minutes saved ÷ 60

Zaki HA, Elmelliti H, Ponappan B, et al. Outcomes of POCUS-Guided Peripheral Intravenous Access in Difficult Venous Access Patients: A Systematic Review and Meta-Analysis. Journal of Clinical Ultrasound. 2025;53(8):1846-1859. doi:10.1002/jcu.24059. Full text

Midline avoidance
Avoided midlines = Addressable DIVA patients × Baseline midline escalation rate × Midline reduction

Amick AE, Feinsmith SE, Sell J, et al. Ultrasound-Guided Peripheral Intravenous Catheter Insertion Training Reduces Use of Midline Catheters in Hospitalized Patients With Difficult Intravenous Access. Journal of Patient Safety. 2022;18(3):e697-e703. PubMed

Hall W. Analyzing Midline and Ultrasound-Guided Peripheral Intravenous (UGPIV) Catheter Utilization Trends (2021–2024). Infusion Nurses Society. Published March 17, 2026. INS article

RN labor benchmark

U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics, May 2025: registered nurses mean hourly wage $48.76. BLS wage table

U.S. Bureau of Labor Statistics, Employer Costs for Employee Compensation, March 2026: private-industry wages and salaries represented 69.9% of total employer compensation. BLS compensation table

Planning estimate only. Results are not guaranteed financial savings and do not constitute medical, accounting, or reimbursement advice. Facility-specific data should replace literature-derived defaults whenever available. This version deliberately excludes monetized CLABSI, central-line complications, patient-satisfaction effects, physician time, ED throughput, and length-of-stay effects.