Evidence map›Paper›PMID 40201765›Full record

ArticleRisk management and healthcare policy2025

Optimizing Strategies for Managing Difficult Intravenous Access.

Ahmed Alaaeldin Saad, Mecit Can Emre Simsekler, Sundos Ahmed, Rawaa Ouda, Omar Khaddam, Mohamed Sanousi, Mini Benny, Hani Abdalla Sunbati, Deanne Kashiwagi, Ahmad Al Rifai and 2 more

Abstract read
In one paragraph

Article in Risk management and healthcare policy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Ahmed Alaaeldin SaadDepartment of Management Science & Engineering, Khalifa University of Science & Technology, Abu Dhabi, United Arab Emirates.ORCID 0009-0001-4942-8580
Mecit Can Emre SimseklerDepartment of Management Science & Engineering, Khalifa University of Science & Technology, Abu Dhabi, United Arab Emirates.ORCID 0000-0002-1555-5012
Sundos AhmedDepartment of Medicine, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates.ORCID 0009-0002-5015-2961
Rawaa OudaDepartment of Medicine, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates.ORCID 0009-0000-1933-6768
Omar KhaddamDepartment of Medicine, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates.
Mohamed SanousiDepartment of IT, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates.
Mini BennyDepartment of Nursing, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates.
Hani Abdalla SunbatiDepartment of Nursing, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates.
Deanne KashiwagiDivision of Hospital Internal Medicine, Mayo Clinic, Rochester, MN, 55902, USA.
Ahmad Al RifaiDepartment of Medicine, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates.
Masood AhmadDepartment of Anesthesia, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates.
Siddiq AnwarDepartment of Medicine, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates.ORCID 0000-0002-0051-2423

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

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.

Indexed as

difficult intravenous accesshealthcare operationshealthcare qualityIV escalation pathwaypatient experiencepatient safetyrisk management

Identifiers

PMID40201765
PMCPMC11977548

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.