I am posting this for a colleague in the hematology/oncology clinic. Her question is: "We rarely do this because most of our patients have central lines, but if we need to infuse a 24 hour infusion of chemo that is classified as an irritant (such as ifosfamide) how often do you think we should assess the PIV site? We were unable to find any information on the ONS website for recommendations.
I suggested every 2 hours, but would like to hear from other nurses.
Thanks-Andy
As you mentioned this is not the most appropriate type of VAD for an irritant by continuous infusion. I would refer you to the newest position paper from INS on "Recommendations for Frequency of Assessment for Short Peripheral Catheter Sites." www.ins1.org.
If there were to be a serious problem that produced a lawsuit, a number of issues would be considered including venipuncture site in an area of joint flexion, the size of the catheter, the type of device used to stablize the catheter, and the use of an armboard if a site in an area of joint flexion was used. There are all addressed in the Infusion Nursing Standards of Practice. Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861