Dataset Information

Improving peripheral venous cannula insertion in children: a mixed methods study to develop the DIVA key.

ABSTRACT:

Objective

To develop and validate a difficult intravenous access risk assessment and escalation pathway, to increase first time intravenous insertion success in paediatrics.

Methods

Mixed methods underpinned by literature and co-production principles. Iterative development of the instrument was informed through semi-structured interviews and stakeholder workshops. The instrument includes a risk assessment, inserter skill self-assessment, and escalation pathways. Reproducibility, reliability, and acceptability were evaluated in a prospective cohort study at a quaternary paediatric hospital in Australia.

Results

Interview data (three parents, nine clinicians) uncovered two themes: i) Recognition of children with DIVA and subsequent escalation is ad hoc and problematic; and ii) Resources and training impact inserter confidence and ability. Three workshops were delivered at monthly intervals (February-April 2020) involving 21 stakeholders culminating in the co-production of the "DIVA Key". The DIVA Key was evaluated between May-December 2020 in 78 children; 156 clinicians. Seventy-eight paired assessments were undertaken with substantial agreement (concordance range = 81.5 to 83.0%) between the assessors. Interrater reliability of the DIVA risk assessment was moderate (kappa = 0.71, 95% CI 0.63-0.80). The DIVA Key predicted multiple insertion attempts for red (high risk) DIVA classification (relative risk ratio 5.7, 95% CI 1.2-27.1; reference low risk). Consumer and clinician satisfaction with DIVA Key was high (median (IQR) = 10 [8-10]; 8 [8-10 respectively).

Conclusion

The DIVA Key is a straightforward, reliable instrument with inbuilt escalation pathway to support the identification of children with difficult intravenous access.

SUBMITTER: Schults JA

PROVIDER: S-EPMC8851754 | biostudies-literature | 2022 Feb

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Improving peripheral venous cannula insertion in children: a mixed methods study to develop the DIVA key.

Schults Jessica A JA Kleidon Tricia M TM Gibson Victoria V Ware Robert S RS Monteagle Emily E Paterson Rebecca R Charles Karina K Keys Adam A McBride Craig A CA McTaggart Steven S Lawton Benjamin B Macfarlane Fiona F Sells Chloe C Rickard Claire M CM Ullman Amanda J AJ

BMC health services research 20220217 1

<h4>Objective</h4>To develop and validate a difficult intravenous access risk assessment and escalation pathway, to increase first time intravenous insertion success in paediatrics.<h4>Methods</h4>Mixed methods underpinned by literature and co-production principles. Iterative development of the instrument was informed through semi-structured interviews and stakeholder workshops. The instrument includes a risk assessment, inserter skill self-assessment, and escalation pathways. Reproducibility, r ...[more]

PMID: 35177041

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Dataset Information

Improving peripheral venous cannula insertion in children: a mixed methods study to develop the DIVA key.

Objective

Methods

Results

Conclusion

Publications

Improving peripheral venous cannula insertion in children: a mixed methods study to develop the DIVA key.

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