Late Breaking Abstracts type 3 and brachial type 2 and 3, which required multiple punctures and the intervention of an expert/specialist vascular access nurse (Table 1). The reasons recorded: insertion of the needle outside the perforable membrane, its partial or total inversion, the small size of the device, the presence of scar tissue. Failed attempts were eliminated by NIDS Algorithm using SPIA in subsequent procedures, 215 and appropriate care tools, such as best positioning for exposure of the port, expert nurse and, ultrasound tecnique. Conclusions: The implementation of NIDS Algorithm using SPIA represents a proactive tool for a more adequate and safe nursing approach to the patient, according to principle of best clinical practice.