Predicting difficult peripheral venous access

"Predictive tools, especially the Modified A-DIVA scale, enhance the likelihood of first-attempt success and support clinical decision-making. Incorporating these tools into routine practice ensures effective venipuncture management, reduces procedural delays, and minimizes complications" Nannini et al (2025).

"Predictive tools, especially the Modified A-DIVA scale, enhance the likelihood of first-attempt success and support clinical decision-making. Incorporating these tools into routine practice ensures effective venipuncture management, reduces procedural delays, and minimizes complications" Nannini et al (2025).

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Predicting difficult peripheral venous access

Abstract:

Background: Venipuncture is a routine procedure in hospital clinical practice; however, procedural failure occurs frequently. This scoping review aims to identify and synthesize studies predicting difficult intravenous venous access (DIVA) in adult patients in hospital settings.

Methods: A scoping review was conducted across major biomedical databases, including PubMed, Embase, Cochrane, and CINAHL, from June to July 2024. Twelve records were included covering 11,841 adult inpatients. Methodological rigor was ensured using the Joanna Briggs Institute framework.

Results: The findings emphasized the impact of variables such as venous status, underlying conditions, and anthropometric factors on venipuncture success. Predictive scales like the A-DIVA, EA-DIVA, and Modified A-DIVA demonstrated accuracies of up to 97%.

Discussion: Predictive tools, especially the Modified A-DIVA scale, enhance the likelihood of first-attempt success and support clinical decision-making. Incorporating these tools into routine practice ensures effective venipuncture management, reduces procedural delays, and minimizes complications.

Reference:

Nannini F, Mancin S, Morales Palomares S, Pettinari G, Cosmai S, Lopane D, Cattani D, Mazzoleni B. Predicting difficult peripheral venous access in hospitalized adult patients: A scoping review. J Vasc Access. 2025 Oct 3:11297298251374415. doi: 10.1177/11297298251374415. Epub ahead of print. PMID: 41044897.