Hospitals see a rise in the critically ill population. These patients present with multiple comorbidities resulting in frequent emergency department trips. Unfortunately, with each visit, these patients require a vascular access device. Over time their veins will no longer be easily accessible. Patients with veins that are no longer visible, palpable, or require special techniques to obtain access are considered to be difficult intravenous access (DIVA) patients. They will likely experience multiple attempts with each admission to the hospital, resulting in physical and emotional pain, not to mention being costly. The purpose of this paper is to compare the advantages and disadvantages of using a vascular access team versus a generalist model, mainly focusing on the efficiency and effectiveness of the line placement for DIVA patients. A rapid critical appraisal was performed on multiple studies to gather evidence to support this project. The data retrieved included success rate, complication rate, dwell time, time to insertion, patient satisfaction, and cost. In addition to reviewing statistical results, a qualitative study provided feedback from patient interviews. After extensive research on this topic, gathering conclusive data was the most challenging. There are many moving parts to a patient admitted to a hospital, and they will often pass through so many hands that collecting data and evaluating it can be challenging. However, the information is still valuable.

Date of publication

Fall 12-29-2022

Document Type

MSN Capstone Project



Persistent identifier



Masters in Nursing

Included in

Other Nursing Commons