This randomized controlled trial investigates the effects of two non-pharmacological techniques-squishy toy squeezing and vein palpation-on the success rate of peripheral intravenous catheter (PIVC) insertion in pediatric hematology and oncology patients. Data collection takes place in the procedure room of a pediatric outpatient clinic. The study includes children who have a Difficult Intravenous Access (DIVA) score of 4 or higher, indicating difficult venous access. Participants are randomly assigned to one of three groups: the squishy toy group, the palpation group, or the control group, which receives standard care.

In the squishy toy group, children use soft, elastic toys to activate hand muscles and improve blood flow, aiming to enhance vein visibility. In the palpation group, the target vein is gently tapped to increase local blood circulation and make the vein more prominent. The control group undergoes catheter insertion without any additional stimulation techniques. All data are recorded using structured forms that collect demographic, clinical, and procedural information. The study aims to determine whether these simple and cost-effective interventions improve the success rate of PIVC insertion in children with difficult venous access.

Inclusion Criteria:

• Children identified by the healthcare team as needing peripheral intravenous catheter placement who also have a Difficult Intravenous Access (DIVA) score of 4 or above.

Exclusion Criteria:

• Children unable to squeeze a toy due to physical limitations were excluded from the study.