Registered Nurses' Association of Ontario

Nursing Best Practice Guidelines

Background Context
  • Infusion therapy has evolved from an extreme measure used only as a last resort with the most critically ill, to a highly scientific, specialized form of treatment used for greater than 90% of hospitalized clients (Corrigan,1995).
  • Infusion therapy is the parenteral administration of fluids, medications, nutritional support, and transfusion of blood and blood products, delivered through a vascular access device (VAD) inserted into a peripheral or central vein.
  • Vascular access devices (VADs) are an integral aspect of health care for neonates, children, and adults (Health Canada, 1997) and have moved beyond the acute care setting to chronic care, long term care, and the home in both urban and rural centres.
  • Client assessment by nurses at the onset of infusion therapy, coupled with access device insertion by nurses and physicians has demonstrated improved client satisfaction, fewer delays in therapy related to loss of vascular access, fewer device complications, preservation of peripheral veins, less nursing time spent attempting to gain vascular access, shorter hospital stays, fewer emergency room visits, and decreased costs associated with infusion therapy (Barton, Daneck, Johns & Coons, 1998; Kokotis, 2001).
  • Nurses with special training in infusion therapy and vascular access device care and practice, along with supportive organizational structures and processes, results in improved client outcomes and decreased complications (CDC, 2002; INS, 2000; Mermel et al., 2001).
  • Factors that contribute to supporting the structure necessary for effective infusion therapy include, and are not limited to: utilization of infusion nurse specialists; allocated financial resources; dedicated human resources; organizational policies; environmental readiness; nursing research and continuous quality improvement processes (Barton et al., 1998; CDC, 2002; Health Canada, 1997; INS, 2000).