News | September 1, 1999

I.V. Q & A: Site Checks

Editor's Note: Have questions about infusion therapy? I.V. Q and A is the place to look for answers. Check back weekly for a new question related to the placement, use, and maintenance of I.V.s.

I'm an RN in Maryland. I am a chairperson of our Clinical Practice Council. We are currently revisiting our IV policy. We currently require site checks every two hours which with our current staffing and acuity is next to impossible on most units. Please give us any information that INS has regarding existing IV sites.

Observation of IV cannulation sites certainly is dependent on many factors including patient population (pediatrics, geriatrics, critical care), infusates being administered, electronic-versus gravity-assisted infusions, competency levels of professional staff, etc.
Documentation of site checks is key: monitoring and assessment practices must be consistent across the board and are also dependent on the above-listed factors. Since many infusates require electronic infusion devices (EIDs), they will require frequent site assessment; the mere fact that a medication must be controlled either due to its immediate effect on the patient's physical condition or that the potential for injury is great (irritants, vesicants, pH and/or osmolarity issues, fluid overload, etc.) automatically demands frequent site assessments.

I am also not sure of your staffing dynamics. I cannot suggest an appropriate frequency for site checks. Obviously, your staff must see their patients at least twice per shift. It would seem prudent that site checks on infusion therapy patients would have to occur at least twice: at the beginning and close of each shift. Considering the legal implications of IV therapy, visiting every two hours to check conditions, perform treatments, administer medications, and observe the infusion therapy in progress is more than reasonable.

Reprinted with permission from the INS Newsline, Intravenous Nurses Society, Cambridge, MA; These questions come from I.V. clinicians and are answered by Debbie Benvenuto, CRNI, INS Nurse Educator/IV Therapy and coordinator of the INS National IV Nursing Network.

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