EASE:  EASE is a method that can be applied to IV lines attempts, PICC line attempts and other forms of intravenous or intra-arterial interventions that assures that if an initial attempt fails,  there is  a pause during which the patient  is involved in options regarding any possible future attempts.   Patients often report dis-satisfaction and significant injury with regards to repeated IV , PICC  line, or phlebotomy attempts.  As such, it is important to consider not only the patients medical needs, but also the desires of the patient in a respectful and thoughtful manner.

EXPLAIN: Explain why you think the first intervention failed in matter-of-fact terms. Do not blame the failure on the patient.  Explain ways, if there are any in which the patient can help increase the chances of the next intervention being successful.

AGREE: Agree on a plan of action as to what the patient wants to happen if this intervention is not possible. For example, does the patient wish for you to try again, do they wish for you to call another nurse or phlebotomist,    The patient should be asked if they wish to continue or offered an alternative if one exists. If the patient refuses further intervention, this should be immediately brought to the attention of the person who ordered the intervention. Remember, peripheral lines and PICC lines often have lower infection rates than central lines, so if at all possible a peripheral line,if applicable should be the patients preferred choice.

SPAN: Reach out to colleagues and others with more expertise or who might be able to offer suggestions. Include the patient if possible or appropriate in the process.  Often patients who have had difficulty with IV and PICC line starts know what has worked in the past.  Use the patient, your colleagues and others as a resource.

ENGAGE: If the patient is unwilling to move forward after a failed attempt or a series of failed attempts, it is time to ask for help or further direction from the person who ordered the intervention or a senior staff member.  If you are the senior staff member or person who ordered the intervention it is vitally important that you engage the person at this time. Perhaps the patient has lost confidence that the procedure can be safely performed or the pain and anxiety is just too great.  Perhaps the patient is not convinced that this is the only option. Maybe the intervention is not absolutely necessary at this time.  Regardless, it is important that the patient receives education and engagement at this point that is more intensive and informative.  The use of open and respectful communication is essential for active engagement.