Abstract
Those with poorly visualized or palpated peripheral veins, accompanied with a history of poor access, are at increased risk for multiple venous punctures in the emergency department. A need exists for identifying this population prior to multiple failed attempts, and, providing ultrasound as a first line attempt at obtaining intravenous access. An existing screening tool was updated for ease of use and tested in the emergency department.|Purpose: The purpose of this quality improvement project is to decrease the number of intravenous attempts in the difficult intravenous access (DIVA) population. This will be accomplished by the use of an updated screening tool.|Sample/Setting: The setting was in the emergency department of Abrazo Central Campus in Phoenix, AZ. The sample included 100 men and women over the ages of 18 that required placement of intravenous access for medical treatment or diagnostics.|Methods: This was a quality improvement project where patients were surveyed and all results were reviewed by the primary researcher. Results: The updated screening tool identified 100% of the patients that required ultrasound for intravenous line placement. The updated screening tool also identified an additional ~50% that screened positive for needing ultrasound for intravenous placement but did not require it.|Conclusion: The use of screening tools for intravenous access in the emergency department setting is beneficial for those patients with difficult intravenous access. The updated screening tool does not miss those who would benefit from ultrasound, although, it does over identify about half of the time, those patients that don't require ultrasound for intravenous line placement.