Abstract
Objective: Peripheral intravenous (IV) access is a routine yet challenging procedure in pediatric settings, as children are particularly prone to difficult venous access. Multiple puncture attempts can elevate a child’s pain and fear and increase family anxiety, potentially leading to mistrust in nursing staff. In central Taiwan, this study evaluated the effectiveness of the Difficult Intravenous Access (DIVA) scale in enhancing pediatric nurses' ability to assess and manage difficult IV access. We aimed to improve insertion success rates, reduce family complaints, and foster family trust.
Methods: From February 2023 to September 2024, the “DIVA Scale Execution Accuracy” was set as a quality indicator in a central Taiwan medical center’s pediatric ward. Using a “DIVA Scale Execution Record,” we tracked accuracy in DIVA scale usage. The Plan-Do-Check-Act (PDCA) cycle was applied with interventions including (1) educational training on DIVA scale application, (2) reminder scorecards in injection rooms, and (3) a poster illustrating the “DIVA Scale in Intravenous Injection Processes.” The “Peripheral IV Catheter Insertion Record” monitored success rates.
Results: During the study period, 48.8% of pediatric patients encountered difficult venous access. Initially, the IV catheter insertion success rate was 67.5%. After the PDCA cycle and DIVA scale interventions, this rate improved to 86.6% in 2024, with DIVA scale execution accuracy rising from 96.7% to 97.1%.
Conclusion: Implementing the DIVA scale in central Taiwan effectively improved pediatric nurses' competency in assessing and managing difficult venous access, contributing to higher IV insertion success rates, reduced family complaints, and enhanced trust. This approach also lowered hospital costs and advanced pediatric nursing quality.
Notes
References:
Ozyazicioglu, N. & Arikan, D. (2008). The effect of nurse training on the improvement of intravenous applications. Nurse Education Today, 28(2), 179-85. https://doi.org/10.1016/j.nedt.2007.03.002
VL Scott-Warren, RB Morley. (2015). Paediatric vascular access. BJA Education, 15(4), 199-206. https://doi.org/10.1093/bjaceaccp/mku050
Varuna Vyas, Ankur Sharma, Shilpa Goyal, Nikhil Kothari (2021). Infraredvein visualisation devices for ease of intravenous access in children: hope versus hype. All India Institute of Medical Sciences, Jodhpur, India, 53(1), 69-78. https://doi.org/10.5114/ait.2021.103515
Vinograd A.M., Zorc J.J., Dean A.J., Abbadessa M.K.F., & Chen A.E.(2018). First-attempt success, longevity, and complication rates of ultrasound-guided peripheral intravenous catheters in children.Pediatric Emergency Care, 34(6), 376-380. https://doi.org/10.1097/PEC.0000000000001063
Sigma Membership
Non-member
Type
Poster
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Other
Keywords:
Pediatric Nursing, Competence, Peripheral Intravenous Access, Children, Taiwan
Recommended Citation
Lin, Chieh Yu and Wu, Wan Ting, "Enhancing Pediatric Nurses' Competency in Assessing Difficult Intravenous Access in Central Taiwan" (2025). International Nursing Research Congress (INRC). 147.
https://www.sigmarepository.org/inrc/2025/posters_2025/147
Conference Name
36th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Seattle, Washington, USA
Conference Year
2025
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Enhancing Pediatric Nurses' Competency in Assessing Difficult Intravenous Access in Central Taiwan
Seattle, Washington, USA
Objective: Peripheral intravenous (IV) access is a routine yet challenging procedure in pediatric settings, as children are particularly prone to difficult venous access. Multiple puncture attempts can elevate a child’s pain and fear and increase family anxiety, potentially leading to mistrust in nursing staff. In central Taiwan, this study evaluated the effectiveness of the Difficult Intravenous Access (DIVA) scale in enhancing pediatric nurses' ability to assess and manage difficult IV access. We aimed to improve insertion success rates, reduce family complaints, and foster family trust.
Methods: From February 2023 to September 2024, the “DIVA Scale Execution Accuracy” was set as a quality indicator in a central Taiwan medical center’s pediatric ward. Using a “DIVA Scale Execution Record,” we tracked accuracy in DIVA scale usage. The Plan-Do-Check-Act (PDCA) cycle was applied with interventions including (1) educational training on DIVA scale application, (2) reminder scorecards in injection rooms, and (3) a poster illustrating the “DIVA Scale in Intravenous Injection Processes.” The “Peripheral IV Catheter Insertion Record” monitored success rates.
Results: During the study period, 48.8% of pediatric patients encountered difficult venous access. Initially, the IV catheter insertion success rate was 67.5%. After the PDCA cycle and DIVA scale interventions, this rate improved to 86.6% in 2024, with DIVA scale execution accuracy rising from 96.7% to 97.1%.
Conclusion: Implementing the DIVA scale in central Taiwan effectively improved pediatric nurses' competency in assessing and managing difficult venous access, contributing to higher IV insertion success rates, reduced family complaints, and enhanced trust. This approach also lowered hospital costs and advanced pediatric nursing quality.
Description
Peripheral intravenous (IV) access is routine in pediatric care but often challenging due to children's higher risk for difficult venous access. Accurate assessment by pediatric nurses is critical. Implementing the Difficult Venous Access (DIVA) scale in central Taiwan improved nursing competency in managing difficult access, resulting in higher IV success rates, fewer family complaints, and better overall care quality.