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 ( ISSN: 2814-2098 )                                                                                                                                                           Cholisah Suralaga * 

https://ijojournals.com/                                                                              Volume 08 || Issue 01 || January, 2025 || 

The Effect Of Using The Diva Score Screening On The Success Of IV Insertion In The Pediatric Ward Unit Of M Hospital, Jakarta 

 

The Effect Of Using The Diva Score Screening On The Success Of IV Insertion In The 
Pediatric Ward Unit Of M Hospital, Jakarta 

 
 

 

 

 

 

 
 

 
 

 
 

 

The Effect Of Using The Diva Score Screening On The Success Of IV Insertion In The 

Pediatric Ward Unit Of M Hospital, Jakarta 

Abstract 

IV insertion is an invasive procedure that can cause complications such as pain, anxiety, and 
trauma. In the Pediatric Ward Unit of M Hospital, Jakarta, IV insertion failures still occur in children, 
often due to factors like small vein diameters, non-linear vein shapes, and thinner, more fragile vein 
walls. The DIVA score was developed and is used as a guideline to determine the success rate of 
intravenous insertion. This study aims to analyze the effect of using the DIVA score screening on the 
success rate of IV insertions in the Pediatric Ward Unit of M Hospital, Jakarta. A quasi-experimental 
design with a control group was employed. The study population consisted of 36 pediatric patients 
aged 0-13 years in the Pediatric Ward of M Hospital, Jakarta. Data collection was carried out 
through observation by filling in the DIVA Score observation sheet. The study results that IV 
insertion without using the DIVA score screening, 8 respondents (44.4%) succeeded with one 
attempt, 7 respondents (38.9%) succeeded after two attempts, and 3 respondents (16.7%) 
succeeded after more than two attempts. In contrast, for IV insertion using the DIVA score 
screening, all 18 respondents (100%) succeeded with just one attempt. There is a significant 
difference in the success rate of IV insertion when using the DIVA score screening, with a p-value of 
0.000 ≤ 0.05. It is recommended that the DIVA score be implemented comprehensively, especially 
in units that frequently deal with patients at risk of difficult venous access. 

Keywords: IV Insertion, DIVA Score, Difficult Veins, Insertion 

 
 
 

Cholisah Suralaga1, Masniati Br Sidabalok 2, Andi Mayasari Usman3

 

1,3 Nursing Department, Faculty of Health Science, Nasional University,Jakarta, Indonesia 

2 Bachelor of Nursing, Faculty of Health Science, Nasional University, Jakarta, Indonesia

 

Corresponding Author:
Cholisah Suralaga
Nursing Department, Faculty of Health Science
Nasional University, Jakarta, Indonesia
Jl. Sawo Manila, No.61 RT.14/RW.7, Pejaten Barat, Pasar Minggu, Kota Jakarta Selatan,
 Daerah Khusus Ibukota Jakarta 12520 Indonesia,

DOI 10.5281/zenodo.14744680 IJO JOURNALS

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https://zenodo.org/records/14744680


IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING 
 ( ISSN: 2814-2098 )                                                                                                                                                           Cholisah Suralaga * 

https://ijojournals.com/                                                                              Volume 08 || Issue 01 || January, 2025 || 

The Effect Of Using The Diva Score Screening On The Success Of IV Insertion In The Pediatric Ward Unit Of M Hospital, Jakarta 

 

INTRODUCTION 

IV insertion is a collaborative nursing procedure performed by nurses to administer fluids or 

medication directly into the venous blood vessels in large quantities and for extended periods using 

an infusion set. IV insertion in children when admitted to the hospital can cause prolonged trauma 

(Zannah, et al., 2015).  IV insertion can also lead to infections and pain due to repeated needle 

punctures. This results in anxiety and trauma, causing children to resist the IV insertion procedure 

(Hartini, 2015). IV insertion is essential in children for nutritional or medication needs through 

parenteral routes and to maintain fluid and electrolyte balance. Parenteral nutrition is a form of 

nutrition provided directly through the bloodstream without passing through the digestive tract 

(Kemenkes, 2019). The difficulty of IV insertion in neonates is caused by their small vein size, and 

the limited expertise of professional nurses in inserting IVs in babies often leads to repeated 

punctures  (Hastuti et al., 2021). Complications from IV insertion procedures and the administration 

of fluids through an IV include a stinging or painful sensation  (Pramesti, 2018).  

IV access can be established through peripheral or central veins, depending on the patient's 

needs. However, failure often occurs when attempting IV access, due to anatomical issues, clinical 

conditions, and the skill of the medical personnel performing the procedure. This procedure is 

performed on over 70% of hospitalized patients and is necessary during pediatric hospital care 

(Perdana, et al., 2020b). Ensuring patient safety during clinical practice requires quick and effective 

venous access, especially in emergencies and for all anesthesia procedures. Inhalational anesthesia 

is often administered to pediatric patients undergoing anesthesia procedures worldwide to 

facilitate access to IV insertion. However, in certain situations, this is not feasible, particularly in 

procedures conducted outside the operating room. One of the purposes of IV insertion is to 

administer medications, fluid therapy, transfusions, and contrast agents for imaging procedures. 

In a study conducted in a pediatric hospital by Larsen et al. (2023), of 592 patients who 

underwent IV insertion, more than 50% succeeded after two or more attempts, with an average of 

2.1 attempts. A similar study by Reigart et al. found that only 48% of patients succeeded in 

obtaining IV access on the first attempt. This highlights the difficulty of obtaining peripheral access 

during the early stages of IV insertion. Patients may experience challenges and trauma due to 

repeated injections, which can also result in more severe pain and potentially lead to complications 

such as hematoma and an increased risk of infection (Reigart, et al., 2022).  

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IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING 
 ( ISSN: 2814-2098 )                                                                                                                                                           Cholisah Suralaga * 

https://ijojournals.com/                                                                              Volume 08 || Issue 01 || January, 2025 || 

The Effect Of Using The Diva Score Screening On The Success Of IV Insertion In The Pediatric Ward Unit Of M Hospital, Jakarta 

 

The DIVA score is based on four proportional variables, including age, vein visibility after 

tourniquet application, vein palpability after tourniquet application, and a history of prematurity 

(gestational age at birth <38 weeks) (Yen, et al., 2018). Each predictor variable is assigned a point 

value, with a total score ranging from 0 to 10. The Difficult Intravenous Access (DIVA) scale has 

been developed and used as a guideline in several studies to determine the success rate of IV 

insertion. 

Preliminary studies conducted in the Pediatric Ward Unit of M Hospital, Jakarta, revealed 

that the number of patients each month is quite high. According to quality indicator data for IV 

insertion incidents of more than 2 attempts in 2024, over the past three months, 41 patients 

required IV insertion between April and June 2024, with 17 patients in April 2024, 17 patients in 

May 2024, and 7 patients in June 2024. Almost all of these patients underwent IV insertion. The 

difficulty of insertion in children is often due to their smaller vein diameter compared to adults, as 

well as non-linear vein shapes and thinner vein walls, which complicate the procedure. Therefore, 

the researcher is interested in conducting a study titled "The Effect of DIVA Score Screening on the 

Success Rate of IV Insertion in the Pediatric Ward Unit of M Hospital, Jakarta." 

 

MATERIALS AND METHODS 

The research design used in this study is a quasi-experimental design with a control group. 

The study population consisted of pediatric patients aged 1-13 years in the ward unit, with an 

average of 41 children per month. The sampling technique applied in this study was purposive 

sampling, with the inclusion criteria as follows: 1) Pediatric patients requiring IV insertion. 2) Aged 

1-13 years. 3) Obtained informed consent from parents or guardians. The exclusion criteria were: 1) 

Children with certain medical conditions (e.g., severe edema or vascular abnormalities). 2) Children 

with a history of extensive IV insertion (more than four insertion attempts). 3) Children undergoing 

medical treatments, such as vasoconstrictor medication use. 

The sample consisted of 36 children, divided into two groups: 18 children for the control 

group and 18 children for the intervention group. The dependent variable in this study was the 

success rate of IV insertion, while the independent variable was the DIVA Score Screening. The 

instruments used in this study were: 1) A respondent characteristic sheet covering age and gender. 

2) A DIVA score observation sheet, which included the observation of IV insertion based on five 

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IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING 
 ( ISSN: 2814-2098 )                                                                                                                                                           Cholisah Suralaga * 

https://ijojournals.com/                                                                              Volume 08 || Issue 01 || January, 2025 || 

The Effect Of Using The Diva Score Screening On The Success Of IV Insertion In The Pediatric Ward Unit Of M Hospital, Jakarta 

 

indicators: history of prematurity, age, vein visibility, vein palpability, and skin color. 3) The IV 

insertion SOP sheet used at M Hospital, Jakarta. Data analysis was conducted using the Mann-

Whitney test. 

 

RESULT 

Table 1. Frequency Distribution of IV Insertion Success Without DIVA Score Screening in the 
Pediatric Ward Unit of M Hospital, Jakarta (n = 18) 

Insertion 
Attempt 

Number of 
Respondents 

Percentage (%) 

1 attempt 8 44.4% 

2 attempts 7 38.9% 

> 2 attempts 3 16.7% 

Total 18 100% 

Based on Table 1, regarding the success of IV insertion without using DIVA score screening, 

out of 18 respondents, 8 (44.4%) succeeded with 1 attempt, 7 (38.9%) succeeded after 2 attempts, 

and 3 (16.7%) succeeded after more than 2 attempts. 

Table 2. Frequency Distribution of IV Insertion Success Using DIVA Score Screening in the 
Pediatric Ward Unit of M Hospital, Jakarta (n = 18) 

Insertion 
Attempt 

Number of 
Respondents 

Percentage (%) 

1 attempt 18 100% 

Total 18 100% 

Based on Table 2, regarding the success of IV insertion using DIVA score screening, all 18 

respondents (100%) succeeded with 1 attempt. 

Table 3. Effect of Using DIVA Score Screening on the Success Rate of IV Insertion in the Pediatric 
Ward Unit of M Hospital, Jakarta (n = 18) 

Variabel 1 insertion 2 insertion > insertion p-value 

Control 8 7 3 
0.000 

Intervention 18 0 0 

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IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING 
 ( ISSN: 2814-2098 )                                                                                                                                                           Cholisah Suralaga * 

https://ijojournals.com/                                                                              Volume 08 || Issue 01 || January, 2025 || 

The Effect Of Using The Diva Score Screening On The Success Of IV Insertion In The Pediatric Ward Unit Of M Hospital, Jakarta 

 

 
 The statistical Mann-Whitney test results showed a p-value of 0.000 (p-value ≤ 0.05), 

indicating that Ha is accepted, meaning there is a significant difference in the success rate of IV 

insertion when using DIVA score screening in the Pediatric Ward Unit of M Hospital, Jakarta. 

 

DISCUSSION 

Frequency Distribution of IV Insertion Success Without DIVA Screening 

In this study, 8 respondents (44.4%) succeeded with one attempt, which suggests that most 

nurses or healthcare providers involved have sufficient skills to perform the insertion without the 

assistance of the DIVA screening tool. However, the results also show that some respondents 

required more than one attempt (38.9% with two attempts and 16.7% with more than two 

attempts), possibly reflecting the challenges in locating a suitable vein. 

Previous research supports these findings, where the success of IV insertion is often 

influenced by the clinical experience and techniques used by medical personnel. A study by Fields 

et al. (2014) revealed that using aids such as ultrasound or DIVA screening can increase the success 

rate on the first attempt, especially in patients with difficult venous access (Fields, 2014)). However, 

in situations where such tools are unavailable, clinical experience and the skill of the healthcare 

provider become the primary determining factors. 

Another study by Gorski et al. (2016) also emphasized the importance of clinical experience 

in improving IV insertion success rates. They found that more experienced nurses tend to have 

higher first-attempt success rates compared to less experienced nurses, even without tools like 

DIVA screening. 

IV insertion requires good knowledge and skills to identify the right vein, particularly in 

patients with conditions like obesity, dehydration, or small and unclear veins. Ideally, the first 

attempt should succeed to reduce pain, tissue trauma, and infection risk. However, factors such as 

subcutaneous tissue thickness, skin color, and the condition of the patient's veins can affect the 

success of the procedure. 

The results of this study show that despite not using DIVA screening, the success rate for the 

first insertion was relatively high at 44.4%. However, significant challenges remain, with 38.9% 

requiring two attempts and 16.7% more than two. This indicates a need for improved technical 

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IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING 
 ( ISSN: 2814-2098 )                                                                                                                                                           Cholisah Suralaga * 

https://ijojournals.com/                                                                              Volume 08 || Issue 01 || January, 2025 || 

The Effect Of Using The Diva Score Screening On The Success Of IV Insertion In The Pediatric Ward Unit Of M Hospital, Jakarta 

 

skills and possibly the consideration of using aids in certain situations to reduce the frequency of 

repeated insertions. 

 

Frequency Distribution of IV Insertion Success Using DIVA Screening 

The study results, showing 100% success on the first attempt with the use of DIVA 

screening, demonstrate the effectiveness of this method in clinical practice. These results reflect 

not only advances in medical technology but also highlight the importance of evidence-based 

approaches in patient care requiring venous access. 

Research by Schoenfeld et al. (2018) supports these findings, showing that the use of DIVA 

screening can improve IV insertion success rates in patients with difficult venous access. In this 

study, patients identified through DIVA and then given appropriate interventions (such as 

ultrasound use) showed significant improvement in first-attempt success rates compared to the 

control group. 

Additionally, Fields et al. (2014) reaffirmed that technologies like DIVA enable early 

identification of patients with potential venous access difficulties, allowing for the use of more 

advanced techniques like ultrasound guidance or selecting alternative, more accessible veins. This 

study found that IV insertion success rates on the first attempt increased significantly when 

screening technology was used compared to procedures without screening. 

DIVA screening is a method used to identify patients at high risk of experiencing difficult 

venous access before IV procedures are performed. This tool helps healthcare providers determine 

more effective strategies, such as using ultrasound or choosing veins that are easier to access. By 

conducting early identification, the likelihood of multiple insertion attempts can be minimized, not 

only improving patient comfort but also reducing the risk of complications such as phlebitis or 

infection. The results showing 100% success on the first attempt with the use of DIVA screening 

confirm the importance of this technology in clinical practice, particularly in patients at high risk for 

difficult venous access. DIVA screening not only helps in choosing the right technique but also 

minimizes risks associated with multiple insertions, such as tissue trauma, infection, and increased 

patient pain. 

 

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IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING 
 ( ISSN: 2814-2098 )                                                                                                                                                           Cholisah Suralaga * 

https://ijojournals.com/                                                                              Volume 08 || Issue 01 || January, 2025 || 

The Effect Of Using The Diva Score Screening On The Success Of IV Insertion In The Pediatric Ward Unit Of M Hospital, Jakarta 

 

Effect of Using DIVA Score Screening on IV Insertion Success Rates 

The Mann-Whitney statistical test results showing a p-value of 0.000 confirm that using the 

DIVA score has a significant positive effect on clinical outcomes. In the context of this study, these 

results demonstrate that the use of DIVA screening can positively impact IV insertion success rates, 

reduce the number of required insertion attempts, and decrease complications that may arise from 

repeated insertions. 

Research by Fields et al. (2014) supports these findings, showing that the use of DIVA 

screening significantly increases IV insertion success on the first attempt compared to a control 

group without screening. In that study, patients identified through the DIVA score as high-risk were 

given special interventions, such as ultrasound use, which significantly increased insertion success. 

Additionally, a study by Sebbane et al. (2013) also demonstrated that the DIVA score is an 

effective predictor for identifying patients with difficult venous access. This study confirmed that 

using the DIVA score allows medical personnel to prepare better, ultimately increasing first-attempt 

IV insertion success and reducing complications such as hematoma or phlebitis. 

DIVA (Difficult Intravenous Access) screening is a tool used to assess and identify patients 

likely to experience difficulty during IV insertion (Schmidt, et al., 2022). This tool combines various 

risk factors, including the patient's physical condition, such as obesity, dehydration, and vein 

characteristics, to provide a risk score that healthcare providers can use to predict challenges in 

venous access (Eren, 2022). By using this screening, healthcare providers can take preventive steps, 

such as using specific techniques or tools (e.g., ultrasound), which can significantly improve first-

attempt success rates (Perdana, et al., 2022a). 

According to the researchers, using the DIVA score screening has a significant impact on IV 

insertion success rates. This study confirms that the DIVA score is an effective tool in predicting 

potential challenges during IV insertion and can help nurses choose the most appropriate strategy 

for each patient. Furthermore, this success is not only important for improving healthcare efficiency 

and effectiveness but also for reducing patient trauma, avoiding repeated insertions, and 

minimizing the risk of complications. 

 

 

 

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IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING 
 ( ISSN: 2814-2098 )                                                                                                                                                           Cholisah Suralaga * 

https://ijojournals.com/                                                                              Volume 08 || Issue 01 || January, 2025 || 

The Effect Of Using The Diva Score Screening On The Success Of IV Insertion In The Pediatric Ward Unit Of M Hospital, Jakarta 

 

CONCLUSION 

A total of 8 respondents (44.4%) succeeded with one IV insertion, 7 respondents (38.9%) succeeded 

with two insertions, and 3 respondents (16.7%) succeeded with more than two insertions.All 18 

respondents (100%) succeeded with one IV insertion. This was because the healthcare staff 

understood and were able to coordinate effectively; if a DIVA score greater than 4 was detected, 

the IV insertion was performed by the scheduled insertion team.There is a significant difference in 

the success rate of IV insertion between those using the DIVA score screening and those not using it 

in the Pediatric Ward of M Hospital, Jakarta, with a p-value of 0.000 (≤ 0.05). 

ACKNOWLEDGEMENT 

The authors would like to thank the institutions and respondents for their cooperation 

during data collection and express their deepest gratitude to all parties who have supported them 

during this research and to those who have taken the time to fill out the survey and provide 

valuable input. 

 

AUTHOR’S CONTRIBUTION 

Cholisah Suralaga as a principal investigator, conceptualised and designed the study, 

prepared the draft of the manuscript, conducted the study; Masniati Br Sidabalok as reviewed the 

manuscript, conceptualized and designed the research, provided advice on data analysis and data 

interpretation; Andi Mayasari Usman did the data analysis and interpretation; drafted the 

manuscript conducted research studies and assisted in drafting the manuscript.  

 

DECLARATION OF CONFLICTING INTERESTS 

The authors declared no potential conflicts of interest with respect to the research, 

authorship and/or publication of this article. 

 

FUNDING 

The authors received no financial support for the research, authorship and/or publication of 

this article. 

 

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IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING 
 ( ISSN: 2814-2098 )                                                                                                                                                           Cholisah Suralaga * 

https://ijojournals.com/                                                                              Volume 08 || Issue 01 || January, 2025 || 

The Effect Of Using The Diva Score Screening On The Success Of IV Insertion In The Pediatric Ward Unit Of M Hospital, Jakarta 

 

REFERENCES 

Eren, H. (2022). Difficult Intravenous Access and Its Management. In Ultimate  Guide to Outpatient 

Care. IntechOpen. https://doi.org/10.5772/intechopen.96613 

Fields, J. M. , P. N. E. , A. A. K. , & K. B. S. (2014). A The Difficult Intravenous Access (DIVA) Score: A 

Clinical Prediction Rule for Identifying Children with Difficult Intravenous Access. Pediatric 

Emergency Care, 30(1), 40–42. https://doi.org/10.1097/PEC.0000000000000052 

Gorski, L. A., Hadaway, L., Hagle, M., Broadhurst, D., Clare, S., Kleidon, T., & Vesel, L. (2016). 

Infusion Therapy Standards of Practice. Journal of Infusion Nursing, 39(1). 

Hartini, S. (2015). Penurunan skala nyeri pemasangan infus dengan EMLA pada anak prasekolah di 

ruang instalasi gawat darurat. Jurnal Keperawatan Dan Kesehatan Masyarakat Cendekia 

Utama, 4(2) 

Hastuti, W., Pujiwati, S., & Apriliyanti, R. (2021). Pemberian Air Susu Ibu (Asi) Dan Dextrose 5% 

Untuk Mengurangi Nyeri Pemasangan Infus Pada Neonatus (Breast Milk And Dextrose 5% 

To Reduce The Pain Of Infusion In Neonates). Jurnal Ilmu Keperawatan Maternitas, 4(1) 

Kemenkes. (2019). Peraturan Menteri Kesehatan Republik Indonesia Nomor HK.01.07  Tahun 2019 

tentang Pedoman Nasional Pelayanan Kedokteran Tata Laksana Malnutrisi Pada Dewasa. In 

Kementerian Kesehatan Republik Indonesia. 

Larsen, E., Gavin, N. C., Runnegar, N., Mihala, G., Keogh, S., McMillan, D., & Rickard, C. M. (2023). 

Association between parenteral nutrition–containing intravenous lipid emulsion and 

bloodstream infections in patients with single-lumen central venous access: A secondary 

analysis of a randomized trial. Journal of Parenteral and Enteral Nutrition, 47(6). 

Perdana, A., Manggala, S. K., & Karina, A. (2020a). Perbandingan Keberhasilan Insersi Kanul 

Intravena Antara Penggunaan dan Tanpa Penggunaan Pemindai Vena pada Pasien 

Pediatrik. Majalah Anestesia & Critical Care, 38(3), 176– 184. 

https://doi.org/10.55497/majanestcricar.v38i3.200 

DOI 10.5281/zenodo.14744680 IJO JOURNALS

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https://doi.org/10.5772/intechopen.96613
https://doi.org/10.1097/PEC.0000000000000052
https://doi.org/10.55497/majanestcricar.v38i3.200


IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING 
 ( ISSN: 2814-2098 )                                                                                                                                                           Cholisah Suralaga * 

https://ijojournals.com/                                                                              Volume 08 || Issue 01 || January, 2025 || 

The Effect Of Using The Diva Score Screening On The Success Of IV Insertion In The Pediatric Ward Unit Of M Hospital, Jakarta 

 

Perdana, A., Manggala, S. K., & Karina, A. (2020b). Perbandingan Keberhasilan Insersi Kanul 

Intravena Antara Penggunaan dan Tanpa Penggunaan Pemindai Vena pada Pasien 

Pediatrik. Majalah Anestesia & Critical Care. 

Pramesti, T. A. (2018). Pemberian Non-Nutritive Sucking (Pacifier) Terhadap Respon Nyeri 

Neonatus Yang Dilakukan Pemasangan Infus. Journal of Borneo Holistic Health, 1(1). 

https://doi.org/10.35334/borticalth.v1i1.381 

Reigart, J. R., Chamberlain, K., Eldridge, D., O’Brien, E., Freeland, K. D., Larsen, P., & Hartzog, T. H. 

(2022). Peripheral intravenous access in pediatric inpatients. Clinical Pediatrics, 51(5). 

Schindler, T. (2022). Advances in medical imaging techniques. Journal of Diagnostic Medicine, 

27(2). 

Schmidt, G. A., Blaivas, M., Conrad, S. A., Corradi, F., Koenig, S., Lamperti, M., & Slama, M. (2019). 

Ultrasound-guided vascular access in critical illness. Intensive Care Medicine. 

Schoenfeld, E. M., Shapiro, N. I., Mader, T. J., & Weiner, S. G. (2018). Development and Validation 

of a Difficult Intravenous Access Score: A Clinical Prediction Rule for Identifying Patients at 

Risk of Difficult Intravenous Access. Journal of Emergency Medicine, 54(5). 

Sebbane, M., Claret, P. G., Lefebvre, S., Mercier, G., Rubenovitch, J., Eledjam, & Coussaye, J. E. 

(2013). Predicting Peripheral Intravenous Catheterization Difficulty in the Emergency 

Department: The DIVA Score. Annals of Emergency Medicine, 61(5) 

Yen, K. , . , Riegert, A., & Gorelick, M. H. (2018). A Pediatric Difficult Intravenous Access (DIVA) 

Score to Improve the Success of Intravenous Access in Children. Pediatric Emergency Care, 

34(7). 

Zannah, M., Agustina, R., & Marlinda, E. (2015). Peran Orang Tua Terhadap Tingkat Kecemasan 

Anak Pada Saat Pemasangan Infus Diinstalasi Gawat Darurat (Igd) Rsud Banjarbaru. Dunia 

Keperawatan: Jurnal Keperawatan Dan Kesehatan, 3(2). 

 

 

 

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