External Validation of the Difficult Intravenous Access (DIVA3) Score as a Clinical Predictive Rule for Identifying Difficult Intravenous Access in Children.

Background: Intravenous catheter insertion in pediatrics is associated with pain and discomfort. DIVA3 is a pediatric clinical score rule developed to estimate failure in intravenous placement for infants and children. Aim: This study aimed to validate the external validation of DIVA 3 as a clinical...

Full description

Bibliographic Details
Published in:Journal of Evidence-based Care Vol. 12; no. 3; pp. 33 - 41
Main Authors: Taghinejad, Fatemeh, Hashemi, Fatemeh, Mokhtari, Fatemeh, Nikfarid, Lida
Format: research tables/charts Journal Article
Published: Mashhad University of Medical Science Oct2022
Online Access:View this record in EBSCOhost
fields @attributes:
  recordID: 1
pdfLink:
plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=160319668&site=ehost-live
header:
  @attributes:
    shortDbName: ccm
    uiTerm: 160319668
    longDbName: CINAHL Complete
    uiTag: AN
  controlInfo:
    bkinfo:
    dissinfo:
    jinfo:
      jid:
        20082487
        HDZE
      jtl: Journal of Evidence-based Care
      issn: 20082487
      maglogo: N
    pubinfo:
      dt: Oct2022
      vid: 12
      iid: 3
      pid: 51616
      pub: Mashhad University of Medical Science
    artinfo:
      ui:
        160319668
        160319668
        160319668
        10.22038/EBCJ.2022.65216.2705
        160319668
      ppf: 33
      ppct: 8
      formats:
        fmt:
          @attributes:
            type: P
      tig:
        atl: External Validation of the Difficult Intravenous Access (DIVA3) Score as a Clinical Predictive Rule for Identifying Difficult Intravenous Access in Children.
      aug:
        au:
          Taghinejad, Fatemeh
          Hashemi, Fatemeh
          Mokhtari, Fatemeh
          Nikfarid, Lida
        affil: MSc in Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
      sug:
        subj:
          Catheterization, Peripheral Evaluation
          Scales Evaluation
          Instrument Validation
          Human
          Child
          Prospective Studies
          Cross Sectional Studies
          Hospitals, Pediatric
          Child, Hospitalized
          Iran
          Sensitivity and Specificity
          Confidence Intervals
          Interrater Reliability
          kappa Statistic
          Nurses
          Validation Studies
          Child: 6-12 years
      ab: Background: Intravenous catheter insertion in pediatrics is associated with pain and discomfort. DIVA3 is a pediatric clinical score rule developed to estimate failure in intravenous placement for infants and children. Aim: This study aimed to validate the external validation of DIVA 3 as a clinical predictive rule for identifying difficult intravenous access in children. Method: This prospective cross-sectional study was performed on 310 children aged less than 12 years who underwent intravenous catheter placement in the pediatric wards of two specialized pediatrics hospitals in Tehran. The DIVA 3 score was estimated and recorded by a nurse. The measured outcome was failure or success of Peripheral Intravenous (PIV) PIV cannula placement on the first attempt. The number of attempts was recorded for all cases. The failure rates were determined for all children with DIVA score of 4 and graters. The sensitivity, specificity, and positive and negative predictive values were determined considering a confidence interval (CI) of 95%. Results: Sensitivity, specificity, Positive Predictor Value, and Negative Predictive value of DIVA3 (cutoff point ≥4) were 95.9%, 84.3%, 93.8, and 84.3%, respectively (95% CI: 0.932-0.932). For 85 cases, two nurses scored the amount of success in catheterization at the same time using DIVA3 to calculate inter-rater agreement. Kappa values were between 0.52 and 0.89. Implications for Practice: The results support the importance of using DIVA3 despite the variable diagnostic value which had in numerous studies. The results emphasize the relationship between other factors and the need to consider them in the success rate prediction algorithm.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
    refInfo:
    holdings:
      @attributes:
        islocal: N