I am honored to nominate Tanner Keeling, RN, for the DAISY Award in recognition of his remarkable initiative, compassion, and leadership in improving care for some of our most vulnerable patients through the creation of the ICU Ultrasound Peripheral IV (PIV) Program.

Tanner identified a persistent and often frustrating challenge within our ICU: patients with difficult venous access were frequently subjected to multiple painful IV attempts, delays in receiving medications or fluids, and, in many cases, the insertion of central lines, which carry increased risk of infection and other complications. These situations caused stress for both patients and staff, disrupted workflows, and at times negatively impacted patient outcomes. Rather than accepting this as a routine challenge in critical care, Tanner recognized it as a solvable problem—and he took action.

Drawing on his clinical knowledge, passion for innovation, and deep commitment to patient-centered care, Tanner created and led the development of a formal ultrasound-guided PIV program tailored specifically for our ICU setting. He not only researched and piloted best practices but also developed and delivered a comprehensive training program for nursing staff, including hands-on instruction, skill validation, and ongoing mentorship. To enhance hands-on learning, Tanner collaborated with the SIM lab manager to design and create realistic practice arms with embedded veins, allowing nurses to build confidence and skill in a controlled environment before applying these techniques in real patient care.

Since its inception in 2023, Tanner has successfully incorporated ICU nurses from every adult critical care unit—CVICU, BICU, NSICU, SICU, MICU, and CSO—into the program. His inclusive and collaborative approach has led to hospital-wide adoption of ultrasound-guided IV placement, ensuring that all critically ill patients benefit from timely, effective peripheral access regardless of their location.

The results of Tanner’s work have been truly transformative. Patients who once endured repeated needle sticks now receive IV access quickly, with minimal discomfort and fewer complications. The program has significantly reduced delays in patient care caused by difficulties obtaining peripheral access, allowing for faster initiation of life-saving medications, fluids, and diagnostics. Many patients who previously required central lines are now managed effectively with peripheral IVs, reducing infection risk and improving overall outcomes.

The program has also empowered nurses, increasing their confidence, autonomy, and clinical skills. Staff members consistently express how much more supported and competent they feel when caring for patients with difficult access. What once was a major source of frustration has become a strength of our ICU teams, thanks to Tanner’s initiative.

Tanner’s leadership throughout this initiative has been exceptional. He has not only improved care processes but has also elevated the culture of our ICU. His commitment to education and professional growth has inspired others to pursue additional training and to share their own knowledge more freely. He leads by example—always approachable, always encouraging, and always focused on what’s best for the patient. His efforts have made a lasting difference—not just in clinical outcomes, but in team morale and cohesion.

Tanner Keeling exemplifies what it means to be a DAISY Nurse. His compassion for patients, his courage in challenging the status quo, and his unwavering integrity in pursuing excellence in care make him a role model for all of us. The ICU Ultrasound PIV Program has changed lives—and it exists because of Tanner’s vision, dedication, and heart.