Abstract: Aims to streamline a clinical referral pathway (flow chart) for difficult venous access (DVA). Conducts a review of current literature to provide a theoretical basis to support the project. Uses the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) Model to develop the project, collecting a six-month sample of referral data to identify trends. Identifies four key themes during daa analysis: patient clinical condition; difficult access; staff education and training; and urgency for treatment