Risk factors for difficult intravenous access
Abstract:
Objective: The aim of this study was to evaluate differences in nurses’ ratings of risk factors for difficult intravenous access (DIVA) between oncology infusion unit nurses who perform ≤ 10 insertions compared to > 10 insertions per week.
Methods: An email requesting that recipients complete a revised version of the “Survey on Nurses” perceived DIVA factors that contained a list of 53 risk factors was sent to 152 nurses, of whom 81 responded. Nurses rated each DIVA risk factor, using a 0 (not at all predictive) to 10 (extremely predictive) scale.
Results: Of the 81 nurses who completed the survey, 55.5% and 44.5% performed ≤ 10 insertions versus > 10 insertions per week, respectively. No differences were found between the groups on age, sex, education, or years of experience in nursing or in infusion nursing. Compared to nurses who performed ≤ 10 insertions per week, those who performed > 10 rated only 1 risk factor as more predictive of DIVA (ie, the patient has a history of cirrhosis). Risk factors with the highest DIVA prediction scores were multiple intravenous attempts on the day of treatment, history of multiple venipunctures during previous visits, current or past history of intravenous drug use, and occurrence of dehydration.
Conclusion: Findings can be used to identify high-risk patients and educate oncology nurses.
Reference:
Alfaro E, Ejercito R, Canote M, Cosgrove T, Hawker JJ, Quinn M, Miaskowski C. Number of Intravenous Insertions Per Week Does Not Influence Infusion Nurses’ Ratings of Risk Factors for Difficult Intravenous Access (DIVA). J Infus Nurs. 2025 May-Jun 01;48(3):206-213. doi: 10.1097/NAN.0000000000000590. Epub 2025 Apr 29. PMID: 40327880.