Forum topic

Have you looked at this website's resources tab?  There's a whole section just devoted to infiltration and extravasation.  Good luck!

Sarah

 Over the past 20 years, I have reviewed in excess of 500 legal cases involving infiltration and extravasation, which means I am assessing hospital policy and procedures. In the past 5 or so years, I have seen a trend toward more indepth p & p for this complication but remember in the past 5 years those clinical events were happening between 6 to 8 years ago. Very few hospitals include anything about treatment with antidotes. Most do not correctly address the use of cold vs heat. And most do not include non-cytotoxic drugs and only write the p & p for oncology drugs. There are numerous IV drugs that are vesicants and NOT used to treat cancer. Fortunately the trend is to have better, more comprehensive p & p for this serious complication, the most frequent infusion related complication that leads to lawsuits of nurses. The standard of care is established by documents such as the INS Standards of Practice and the ONS Chemotherapy Guidelines, both call for written policies and procedures. In hospitals with an infusion and/or VA team, they are the experts and should be involved in managing this complication. If there is no team, the staff nurse is held to the same requirements as outlined in the standards of care. There are 3 ways I, as an expert witness, will assess a legal case. First, what was done to prevent the complication from occuring and this means following the standards of care. Second, how quickly was it recognized (documenting pain or edema and not removing the catheter is a serious red flag). Third, how appropriate was the management or know when to use cold vs heat and the appropriate antidote. I have just completed the updated revision of our online course on Infiltraion and Extravasation, a course that will provide the most updated evidence and assist with writing your policies and procedures. It offers 5 contact hours and 5 CRNI recertification units. Registration gives you access for 1 year. Check out additional information here Infiltration and Extravasation from Vascular Access Devices - Lynn Hadaway Associates, Inc. 

Lynn