SHM Converge Scientific Abstract ePoster Gallery-Improving Pediatric Peripheral Iv Access Through a Learning Team and Diva Scoring System at a Children's Hospital

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This quality improvement project at a children’s hospital aimed to improve pediatric peripheral IV (PIV) access by standardizing Difficult IV Access (DIVA) scoring, escalation protocols, comfort measures, and ultrasound use. The team noted that children often have small or hard-to-see veins and movement during attempts, making landmark-based IV placement less than 50% successful and leading to more pain, anxiety, and treatment delays.<br /><br />Baseline data from April–May 2024 showed a significant PIV burden across pediatric units: 777 patients, 1,010 IVs, and 1,266 attempts. Children age 2 years or younger needed more attempts than older children (2.1 vs. 1.4 mean sticks per patient), 6% required four attempts, and 5% needed cross-unit support. In response, a multidisciplinary learning team created and launched a pediatric IV guideline and trained nurses and residents in ultrasound use.<br /><br />During the 2025 pilot, early implementation was affected by incomplete integration of DIVA scoring into the clinical information system, new workflows, and staffing transitions. Even so, adherence to the algorithm improved, with overall 92% adherence and increased ultrasound use. DIVA documentation and escalation compliance also improved.<br /><br />The authors concluded that the intervention was feasible and showed promise, but stronger results are expected after full CIS integration, sustained education, and expanded ultrasound capacity. Next steps include another data collection cycle and possible expansion of the pediatric vascular access team.

Asset Subtitle

Weijen W. Chang

Meta Tag

Author List Colleen Kent, Deborah A. Naglieri-Prescod, Joanne DeStasio, Kristen Whitehead, Kristy Parker, Lauren Sweetser, Mary Ann Westcott, Patricia A. Fontaine, Sarah Castro, Shannon Rowland, Stephanie M. Adam, Susan Sweeney, Weijen W. Chang, Zelia Almeida

Category Research

Concept Pediatric Vascular Access

Concept Difficult Vascular Access

Concept Standardized Clinical Guideline

Concept Quality Improvement

Concept Number of Attempts

Distinguished Non-Finalist

Presenter Organization Nemours Children's Hospital Florida

Presenting Author Weijen W. Chang

Track Quality Improvement

Keywords

pediatric peripheral IV access

Difficult IV Access scoring

DIVA escalation protocol

ultrasound-guided IV placement

quality improvement

children's hospital

vascular access

nursing education

clinical information system integration

pediatric patient comfort

Pediatric Vascular Access

Difficult Vascular Access

Standardized Clinical Guideline

Quality Improvement

Number of Attempts