Related Experiment Video For Chemotherapy
Updated: Apr 7, 2026

Computed Tomography (CT) Guided Implantation of a Totally Implantable Venous Access Port (TIVAP) through Subclavian Vein
Published on: January 13, 2026
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.
Purpose:
to develop a tool for measuring the difficulty of intravenous line insertion in cancer patients (DIVA-CP) receiving peripheral chemotherapy.
Methods:
a pilot-validation study divided into two phases was performed in a north-eastern Italian outpatient chemotherapy centre. In the first phase, a review of the literature and brainstorming sessions/direct discussions among expert oncology nurses were used to develop items on the DIVA-CP tool, and a panel of expert oncology nurses assessed the tool face and content validity. In the second phase, 260 adult patients undergoing single chemotherapy cycles were consecutively enrolled. Data was analysed for construct validity (explorative factor analysis) and inter-rater reliability (Cohen's Kappa).
Results:
a 10-item tool was developed with four factors that were identified through factor analysis, explaining a total variance of 61.578%: accessibility to first choice veins (23.057%), venous fragility (15.197%), probable difficulties during the procedure (12.642%), and repeated exposure (10.691%). The tool demonstrated excellent inter-rater reliability (κ > 0.61 for 7 out of 10 items).
Conclusions:
the DIVA-CP tool is still a pilot instrument that needs to be improved through future studies. The tool has great potential and may perform an important role in oncological settings, allowing for easier venous assessment of patients receiving peripheral chemotherapy who are at risk of difficult intravenous access insertion. In addition, this instrument may help nurses to identify patients that may benefit from a central catheter promptly.
Related Concept Videos
Parentral Nutrition: Centeral and Peripheral Parental Nutrition
PN can be administered through two primary routes:
1. Central Parenteral Nutrition (CPN):
CPN involves delivering a high concentration of nutrients through a large vein. This is typically achieved using a Peripherally Inserted Central Catheter (PICC) or,...
Hemodialysis I: Introduction
Hemodialysis II: Procedure and Complications
Cardiac Catheterization IV: Nursing Management
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
One of the advantages of...
Venous Thrombosis III: Interprofessional Care

