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In certain cases (e.g.: patient who are difficult to perfuse, thin veins, etc.), an increase in venipunctures performed by study nurses in healthcare services can lead to a loss of venous capital, repeated pain during punctures, discontinuous treatment follow-up and numerous requests for assistance from colleagues, including nurse anesthetists, but often too late.
The main objective of project is to reduce the number of punctures to access the venous system after evaluation of adult patients upon entering the hospitalization department using the A-DIVA tool. the A-DIVA score predicts the difficulty in infusing an adult patient
This research evaluates the importance of assessing the venous capital access of hospitalized patients prior to the placement of an intravenous infusion, in order to save time in initiating therapeutic treatment and to prevent or reduce the number of venipunctures and the associated inconveniences (pain, discontinuous treatment monitoring). This approach aims to preserve the patient's venous capital.
In the proposed study, investigators will evaluate the patients' venous capital using the Adult-Difficult IntraVenous Access (A-DIVA) tool upon hospital admission and during hospitalization before any peripheral intravenous (IV) catheter placement.
During the inclusion visit, after obtaining informed consent, patients will be randomized into one of two groups:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| with Adult-Difficult IntraVenous Access (A-DIVA) and with A-DIVA modified score evaluation | Experimental | intravenous access of these patients will be evaluated by the ADIVA and with modified ADIVA (ADIVA m) scores before puncture by the nurse |
|
| without Adult-Difficult IntraVenous Access (A-DIVA) score evaluation | No Intervention | control group, patients will not undergo an evaluation of their intravenous access using the Adult-Difficult IntraVenous Access (A-DIVA) tool prior to peripheral IV catheter placement. They will receive standard care as routinely provided in the hospital. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| evaluation of intravenous access of patients with Adult-Difficult IntraVenous Access (A-DIVA) score prior to puncturing subject | Other | The patient's intravenous access will be evaluated using the A-DIVA score by the study nurse at the time of admission, prior to venipuncture performed by the care nurse |
| Measure | Description | Time Frame |
|---|---|---|
| Number of Venipunctures Performed to Establish the First Peripheral Intravenous Line in the Hospital services | Number of Venipunctures Performed to Establish the First Peripheral Intravenous Line in the Hospital services | Periprocedural Venipuncture performed by study nurse from Day 0 (date of admission to hospital service) to Day 10 or until hospital discharge subject |
| Measure | Description | Time Frame |
|---|---|---|
| pain score (numeric rating scale) during venipuncture | assess the patient's pain on a scale of 0 to 10 at the time of the puncture. A lower score indicates less painful, a higher score means that patient is more painful. | During venipuncture from Day 0 to Day 10 or throughout the entire hospitalization period |
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Inclusion Criteria:
Exclusion Criteria:
Patients in Intensive Care Units
Patients with Psychiatric Disorders or Under Psychiatric Care
Minor Patients Under 18 Years of Age
Pregnant or Breastfeeding Women
Vulnerable and Protected Individuals as Defined by the Public Health Code (Articles L.1121-5 to L.1121-8 and L.1122-1-2)
Patients Participating in Another Interventional Study
Dying patients
Patients Receiving Infusions of:
Patients refusing to participate in the study
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Eric MORTUREUX, PI | Contact | 01 49 36 70 41 | eric.mortureux@ght-gpne.fr |
| Name | Affiliation | Role |
|---|---|---|
| Eric MORTUREUX, IADE | CH BALLANGER | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| CHI Robert Ballanger | Aulnay-sous-Bois | 93602 | France |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 18347490 | Background | Yen K, Riegert A, Gorelick MH. Derivation of the DIVA score: a clinical prediction rule for the identification of children with difficult intravenous access. Pediatr Emerg Care. 2008 Mar;24(3):143-7. doi: 10.1097/PEC.0b013e3181666f32. | |
| 35548373 | Background | Heydinger G, Shafy SZ, O'Connor C, Nafiu O, Tobias JD, Beltran RJ. Characterization of the Difficult Peripheral IV in the Perioperative Setting: A Prospective, Observational Study of Intravenous Access for Pediatric Patients Undergoing Anesthesia. Pediatric Health Med Ther. 2022 May 4;13:155-163. doi: 10.2147/PHMT.S358250. eCollection 2022. |
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controlled, randomized study
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|
| evaluation of intravenous access of patients with modified Adult-Difficult IntraVenous access(A-DIVA modified) score prior to puncturing subject | Other | The patient's intravenous access will be evaluated using the A-DIVA-m score by the study nurse at the time of admission, prior to venipuncture performed by the care nurse |
|
| duration of successful catheter placement |
duration of successful catheter placement |
| During catheter placement from Day 0 to Day 10 or throughout the entire hospitalization period |
| 30691137 | Background | van Loon FHJ, van Hooff LWE, de Boer HD, Koopman SSHA, Buise MP, Korsten HHM, Dierick-van Daele ATM, Bouwman ARA. The Modified A-DIVA Scale as a Predictive Tool for Prospective Identification of Adult Patients at Risk of a Difficult Intravenous Access: A Multicenter Validation Study. J Clin Med. 2019 Jan 26;8(2):144. doi: 10.3390/jcm8020144. |