Difficult Intravenous Access in Older Adults with Cancer: Can Vein-Locating Technology Be Key for Vessel Health?

While previous studies suggest that patient risk factors such as advanced age and cancer disease are accountable for difficult intravenous access (DIVA), very few studies have studied how the coexistence of both risk factors impacts care outcomes. We aimed to compare DIVA status and peripheral intravenous catheter (PIVC) related care outcomes in adults and older adults with cancer. A retrospective analysis was conducted using an existing dataset from a large Action-Research project conducted with the nursing team from a surgical oncology ward in Portugal. Study findings show that one in every three older adults is at moderate to high risk of DIVA. Compared to younger adults, this cohort is less likely to experience first-attempt success in PIVC insertion (69.7% versus 82%; χ2(1) = 4.17, p = 0.046), a higher number of consecutive puncture attempts (t(198) = -2.67, p = 0.008) and PIVC-related adverse events (23.6% versus 13.5%). These findings support the importance of formally conducting DIVA assessment in oncology settings, using structured approaches and instruments, as well as introducing vein-locating technologies such as ultrasound imaging and electrical stimulation technology that promote efficient, safe, and sustainable nursing practice.