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Difficult intravenous access tool in patients receiving peripheral chemotherapy: A pilot-validation study
Lucia Pagnutti1, Alessandra Bin1, Raffaela Donato1
1Oncology Department, Teaching Hospital, Udine, Italy.
Summary
A new tool, the Difficulty of Intravenous line insertion in cancer patients (DIVA-CP) tool, was developed to assess venous access challenges in chemotherapy patients. It shows promise for improving patient care and identifying needs for central catheters.
Area of Science:
- Oncology Nursing
- Clinical Assessment Tools
- Patient Care
Background:
- Peripheral intravenous line insertion can be challenging in cancer patients undergoing chemotherapy.
- Accurate assessment of venous access difficulty is crucial for effective treatment delivery and patient comfort.
Purpose of the Study:
- To develop and validate a tool, the Difficulty of Intravenous line insertion in cancer patients (DIVA-CP) tool, for measuring intravenous line insertion difficulty.
- To aid oncology nurses in assessing patients receiving peripheral chemotherapy.
Main Methods:
- A pilot-validation study was conducted in two phases.
- Phase 1 involved literature review and expert oncology nurse input for item development and validity assessment.
- Phase 2 included 260 patients, with data analyzed for construct validity (exploratory factor analysis) and inter-rater reliability (Cohen's Kappa).
Main Results:
- A 10-item DIVA-CP tool was developed, identifying four key factors: vein accessibility, venous fragility, procedural difficulties, and repeated exposure.
- Factor analysis explained 61.578% of the variance.
- The tool demonstrated excellent inter-rater reliability (κ > 0.61 for 7 out of 10 items).
Conclusions:
- The DIVA-CP tool is a promising pilot instrument for assessing intravenous access difficulty in cancer patients.
- It can assist nurses in identifying patients who may require central catheters.
- Further studies are needed to refine the tool for optimal use in oncological settings.
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