Objective To summarize the evidence of identification and management of difficult intravenous access （DIVA） in adult patients, so as to provide evidence for clinical nursing practice. Methods The evidence-based methods were used by two researchers to retrieve relevant literature from databases and professional websites from database inception to August, 2023. JBI′s literature quality evaluation criteria and evidence grading system were applied to evaluate the quality of literature and the level of evidence. Results A total of 13 articles were included, consisting of 3 guidelines, 2 expert consensus reports, 2 clinical decision, 3 evidence summaries, and 3 systematic reviews. Twenty-four pieces of evidence were summarized, and factored into 5 themes (risk factor identification,DIVA assessment, catheterization personnel, catheterization strategy, education and training). Conclusion Nurses should pay attention to the identification and management of DIVA methods, and select evidence for application, so as to improve the success rate of DIVA injection.