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dc.contributor.authorSchults, Jessica
dc.contributor.authorRickard, Claire
dc.contributor.authorKleidon, Tricia
dc.contributor.authorPaterson, Rebecca
dc.contributor.authorMacfarlane, Fiona
dc.contributor.authorUllman, Amanda
dc.date.accessioned2019-08-26T23:29:10Z
dc.date.available2019-08-26T23:29:10Z
dc.date.issued2019
dc.identifier.issn1527-6546
dc.identifier.doi10.1111/jnu.12505
dc.identifier.urihttp://hdl.handle.net/10072/386532
dc.description.abstractBackground: Peripheral venous cannulation is considered a routine procedure, yet 50% of first attempt insertions fail, necessitating repeat insertion attempts. Identification of children with difficult intravenous access (DIVA) can help promote prompt escalation to an appropriately skilled clinician. Objective: To describe current international practice regarding the identification and management of children with DIVA, and to systematically review clinical tools and clinical pathways for children with DIVA. Methods: A cross‐sectional, international survey; followed by a systematic review and critical appraisal of clinical pathways using the Appraisal of Guidelines for Research Evaluation (AGREE) II checklist. Results: A total of 148 clinicians from eight countries completed the survey. The majority were nurses (n = 92; 62%), practicing as vascular access specialists (n = 27; 18%). Twenty‐three respondents (16%) reported using a DIVA tool, of which the DIVA Score was most common (n = 5; 22%). Five clinical pathways were identified from the survey and review. Based on the AGREE II domains, pathways generally scored well for scope and purpose, and for clarity of presentation areas. Information on the rigor of development and editorial independence was infrequently detailed. Based on AGREE II findings, one pathway was recommended for clinical practice, and four were recommended for use with modification. Conclusions: Resources for the identification and escalation of children with DIVA are not standardized or consistently used. Further work is needed to streamline processes for DIVA identification and escalation to the appropriate clinician, with technology‐assisted insertion capability. This will enhance patient experiences and reduce harm from multiple insertion attempts. Clinical Relevance: Multiple failed insertion attempts come at great cost to the child, family, and healthcare service. Early identification and management of the child with DIVA can ensure prompt escalation and management, improving the patient and family experience.
dc.description.peerreviewedYes
dc.languageEnglish
dc.language.isoeng
dc.publisherWiley
dc.relation.ispartofjournalJournal of Nursing Scholarship
dc.subject.fieldofresearchNursing
dc.subject.fieldofresearchcode1110
dc.subject.keywordsPediatrics
dc.subject.keywordsdifficult intravenous access
dc.subject.keywordsperipheral catherization
dc.subject.keywordssurvey of practice
dc.titleDifficult Peripheral Venous Access in Children: An International Survey and Critical Appraisal of Assessment Tools and Escalation Pathways
dc.typeJournal article
dc.type.descriptionC1 - Articles
dcterms.bibliographicCitationSchults, J; Rickard, C; Kleidon, T; Paterson, R; Macfarlane, F; Ullman, A, Difficult Peripheral Venous Access in Children: An International Survey and Critical Appraisal of Assessment Tools and Escalation Pathways., Journal of Nursing Scholarship, 2019
dcterms.dateAccepted2019-06-05
dc.date.updated2019-08-05T23:57:49Z
dc.description.versionAccepted Manuscript (AM)
gro.description.notepublicThis publication has been entered into Griffith Research Online as an Advanced Online Version.
gro.rights.copyright© 2019 Sigma Theta Tau International. This is the peer reviewed version of the following article: Difficult Peripheral Venous Access in Children: An International Survey and Critical Appraisal of Assessment Tools and Escalation Pathways, Journal of Nursing Scholarship, which has been published in final form at 10.1111/jnu.12505. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving (http://olabout.wiley.com/WileyCDA/Section/id-828039.html)
gro.hasfulltextFull Text
gro.griffith.authorRickard, Claire
gro.griffith.authorSchults, Jessica
gro.griffith.authorKleidon, Patricia
gro.griffith.authorUllman, Amanda J.


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