Ipsilateral Peripheral Intravenous Access Procedures (The iPIVAP Study)
Ipsilateral Peripheral Intravenous Access Procedures (The iPIVAP Study)
This pilot study will examine facilitators and barriers that impact staff uptake for
 implementation of practice change involving ipsilateral IV insertion in patients with
 axillary lymphadenectomy/dissection in a single radiology center.
This prospective single arm study will be conducted within DUH Department of Radiology CT
 Imaging. The study team will enroll 50 patients with a history of axillary SLNP presenting
 for routine radiographic scan to undergo ipsilateral IV insertion. Patients will complete
 baseline bilateral arm volumetric measurements and self-reported symptom assessments.
 Patients will be followed every 3 months for 1-year duration for development of lymphedema.
 Patient acceptance or reluctance to ipsilateral IV access will be categorized at time of
 screening. Staff uptake on practice change will be assessed through medical record
 documentation for number, location, and factors affecting IV attempts and their perceptions
 of practice change and acceptance at the end of one year.

 All participants will complete baseline measures: bilateral volumetric measurements and
 self-reported symptoms. Per DUH policy, participants will undergo SOC contralateral arm
 intravenous access attempt. After one failed attempt, ipsilateral intravenous access instead
 of pedal or neck access will be offered per research protocol. Nursing documentation will
 reflect the failed venipuncture and categorize a reason for the failed attempt. At the
 discretion of the treating radiologist, a participant who has a history of multiple failed IV
 placement attempts in the contralateral arm may proceed to IV placement in the ipsilateral
 arm on the first attempt.

 Patients with successful ipsilateral intravenous access will be provided a patient education
 sheet describing signs and symptoms that should be reported to the study team. All
 participants will be contacted by the study team at twelve week intervals for 12 months after
 their radiology encounter for completion of symptom assessments. If a subject reports new
 signs or symptoms of lymphedema during follow-up, a clinic appointment for volumetric
 measurements and thorough evaluation will occur within 2 weeks; findings will be discussed
 with their physician. Participants will undergo bilateral volumetric measurements, symptom
 assessments, and perceptions of the ipsilateral IV access protocol at the end of one year.
Inclusion Criteria:

 1. History of bilateral or unilateral axillary SLNP (sentinel biopsy, lymphadenectomy or
 dissection) and a previous or current failed contralateral IV attempt or at the
 discretion of the treating radiologist, a participant who has a history of multiple
 failed IV placement attempts in the contralateral arm may proceed to IV placement in
 the ipsilateral arm on the first attempt

 2. Scheduled to undergo routine imaging scan with contrast

 3. 18 years of age and older

 4. Read, reviewed and signed study-specific consent

 Exclusion Criteria:

 1. Active swelling, rash, or injury in bilateral upper extremities

 2. Subjects with diabetes, sickle cell disease, and/or peripheral vascular insufficiency
 as vascular inflammatory processes pose a lymphedema risk