Related Experiment Video
Updated: May 15, 2025

A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings
Published on: November 9, 2016
Optimizing Strategies for Managing Difficult Intravenous Access
Ahmed Alaaeldin Saad1, Mecit Can Emre Simsekler1, Sundos Ahmed2
1Department of Management Science & Engineering, Khalifa University of Science & Technology, Abu Dhabi, United Arab Emirates.
Background:
Difficult intravenous (IV) access (DIVA) remains a significant challenge in healthcare, leading to treatment delays, patient discomfort, and adverse outcomes. Contributing factors include patient conditions (eg, obesity, dehydration, anatomical variations) and provider-related challenges (eg, inadequate training, improper technique). Addressing DIVA requires a structured, data-driven approach.
Purpose:
This study examines the root causes of IV access complications, their prevalence, and distribution across healthcare settings. It evaluates the impact of an escalation pathway and data-driven strategies to improve IV success rates, provider training, and process standardization.
Patients And Methods:
A retrospective analysis was conducted on 311 DIVA patients at Sheikh Shakhbout Medical City (SSMC), Abu Dhabi, UAE, over seven months (June-December 2023). Data were obtained from electronic medical records (EMR) and Intensive Care Outreach Nurse (ICON) consultation forms. A novel IV escalation pathway and documentation system facilitated data collection on patient demographics, IV access reasons, and primary diagnoses.
Results:
Among ICON-assisted patients, 74.6% had a known DIVA history, with cancer and renal disease being common conditions. ICONs achieved a first-attempt success rate of 68.8%, underscoring the need for improved floor nurse training. The most frequent IV access indications were medication administration, antibiotics, laboratory tests, and analgesia. Additionally, 57.3% of ICON consultations occurred outside standard hours, highlighting resource allocation challenges.
Conclusion:
Structured escalation pathways, advanced nurse training, and data-driven decision-making are critical in addressing DIVA. Recommendations include a dedicated IV access team, ultrasound-guided cannulation, and predictive analytics to identify high-risk patients, ultimately enhancing patient outcomes and healthcare efficiency.
More Related Videos
09:57A Protocol to Set Up Needle-Free Connector with Positive Displacement on Central Venous Catheter in Intensive Care Unit
Published on: July 13, 2019
05:04Author Spotlight: Evaluating Clinicians' Adoption of Ultrasound-Guided Vascular Cannulation Through Simulation Training
Published on: August 9, 2024
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,...
Routes of Drug Administration: Parenteral
The intravenous route (IV) of drug administration can be further categorized into two types. The bolus injection administers the entire dose rapidly, while an intravenous infusion slowly delivers smaller doses steadily.
The IV route is often...
One-Compartment Model: IV Infusion
The one-compartment model for IV infusion uses mathematical equations to describe the rate of change in drug quantity in the body. At steady-state or infusion equilibrium, the drug input...
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
One of the advantages of...
Drug Delivery: Parenteral Route
There are three primary parenteral routes: intravenous (IV), intramuscular (IM), and subcutaneous (SC). The IV route introduces the drug directly into the bloodstream, ensuring immediate action. The IM route...