Peripheral Intravenous Access: Applying Infusion Therapy Standards of Practice to Improve Patient Safety

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  • Barb Nickel
    Barb Nickel is the critical care clinical nurse specialist for CHI Health St. Francis, a rural community hospital in Grand Island, Nebraska. She has served as chair/lead nurse planner for the Infusion Nurses Society’s National Council on Education and is a member of the Infusion Nurses Society Standards Practice Committee

Abstract

<jats:p>The most common invasive procedure performed in the hospital setting worldwide is the insertion of a peripheral intravenous catheter. Although use of peripheral intravenous access is common, its presence is far from benign, with a reported 35% to 50% failure rate, even in facilities with a dedicated infusion team. Significant complications related to the presence of a peripheral intravenous site include localized infection, bacteremia, phlebitis, and infiltration or extravasation. Consistent application of evidence-based standards of practice in all aspects of peripheral intravenous catheter care is essential to provide infusion therapy that delivers safe and quality care. Management of peripheral intravenous access in the complex setting of critical care is examined in this article. A case study approach is used to illustrate application of infusion therapy standards of practice in peripheral intravenous catheter insertion, indications for catheter placement, and assessment parameters to enhance early recognition of peripheral intravenous access–related complications.</jats:p>

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