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Parenteral Nutrition (PN) delivers essential nutrients directly into the bloodstream, bypassing the digestive system. It is commonly used for individuals with severe digestive disorders or conditions that prevent normal nutrient absorption.
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Intravenous (IV) infusion is often utilized when continuous and controlled drug delivery is necessary, such as during surgery or in the treatment of chronic diseases. This method offers numerous advantages, including immediate drug action, precise control over dosage, and bypassing the first-pass metabolism.
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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.

Risk Management and Healthcare Policy
|April 9, 2025
PubMed
Summary
This summary is machine-generated.

Difficult intravenous (IV) access poses challenges, but a structured pathway and advanced training improve success rates. Data-driven strategies are key to enhancing patient care and efficiency in managing IV access complications.

Keywords:
IV escalation pathwaydifficult intravenous accesshealthcare operationshealthcare qualitypatient experiencepatient safetyrisk management

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Area of Science:

  • Healthcare management
  • Clinical nursing
  • Patient safety

Background:

  • Difficult intravenous (IV) access (DIVA) is a significant healthcare challenge, causing delays and adverse outcomes.
  • Factors contributing to DIVA include patient conditions and provider-related issues.
  • A structured, data-driven approach is essential for addressing DIVA.

Purpose of the Study:

  • To examine the root causes, prevalence, and distribution of IV access complications.
  • To evaluate the impact of an escalation pathway and data-driven strategies.
  • To improve IV success rates, provider training, and process standardization.

Main Methods:

  • Retrospective analysis of 311 DIVA patients at Sheikh Shakhbout Medical City (SSMC) from June to December 2023.
  • Data collected from electronic medical records (EMR) and Intensive Care Outreach Nurse (ICON) consultation forms.
  • Utilized a novel IV escalation pathway and documentation system for data collection.

Main Results:

  • 74.6% of ICON-assisted patients had a history of DIVA, with cancer and renal disease being common.
  • ICONs achieved a 68.8% first-attempt success rate, indicating a need for improved floor nurse training.
  • 57.3% of ICON consultations occurred outside standard hours, highlighting resource challenges.

Conclusions:

  • Structured escalation pathways and advanced nurse training are critical for managing DIVA.
  • Recommendations include a dedicated IV access team, ultrasound-guided cannulation, and predictive analytics.
  • Implementing these strategies can enhance patient outcomes and healthcare efficiency.