New Toolkit Shines Light on Dangers of IV Infiltration and Extravasation and Facilitates IV Safety

Continuous IV Monitoring Represents New Addition, Raising the Bar for Patient Safety

Britain’s National Health Service (NHS) is responsible for 570 million patient interactions annually. NHS Resolution, an arm of the NHS that provides litigation support throughout the system on improving patient care, is chartered with ensuring that the highest safety standards characterize those interactions.

To that end, NHS Resolution has emphasized preventing extravasations and infiltrations across the entire NHS system, placing it at the global forefront of improving IV safety in clinical environments. Andrew Barton, vascular access specialist nurse consultant and IV safety advocate is the author of the just-released NIVAS (National Infusion and Vascular Access Society) Infiltration and Extravasation Toolkit, which is designed to highlight the risks of both and facilitate healthcare organizations’ ability to improve patient safety and experience when it comes to IVs.

Its strategy is based on five tenets: Prevention (safe IV therapy administration and vascular access practice); Recognition (identifying the early stages of extravasation); Treatment (early intervention to reduce or stop tissue damage); Follow-up (ensure the patient is followed up with and supported); and Reporting (standardized incident reporting of both infiltration and extravasation events).

The concept of continuous IV site monitoring is highlighted in the Prevention section of the Toolkit, stating: “Infusion monitoring technology is available which uses visible and near-infrared light to measure tissue changes surrounding the PIVC, alerting clinicians to the early stages of extravasation.”

To further this strategy, NIVAS recommends that:               

  • All NHS hospitals should have an extravasation lead for non-chemotherapy and chemotherapy practice.
  • All NHS hospitals should improve awareness of non-chemotherapy and chemotherapy extravasation and have guidelines in place.
  • All NHS hospitals should standardize reporting of infiltration and extravasation incidents.
  • All NHS hospitals should support the creation of a vascular access service team.

Andrew recently oversaw a clinical evaluation of ivWatch’s technology at NHS Frimley Health Foundation Trust hospital in the U.K. He noted that his unit saw up to 5 extravasation injuries per week. However, the use of technology revealed that his extravasation rate was more than double the rate he presumed. The implementation of ivWatch reduced the rate of extravasation injury by 100% and also increased the accuracy of vascular injury diagnosis overall. For example, the misclassification of extravasations as phlebitis has long presented problems for patients and hospitals alike. The robust clinical results from the study will be published and presented in late Spring 2024.

We at ivWatch are excited by the potential the NIVAS toolkit has to help spread the word regarding extravasation and infiltration injury prevention and believe that NHS’s dedication to our shared patient safety mission is something that will be repeated across Europe and also here in the U.S. as awareness of the importance of preventing IV injury grows.

To learn more about the extravasation toolkit visit:: https://nivas.org.uk/contentimages/main/NIVAS-Infiltration-and-Extravasation-toolkit-version-1-Feb-2024.pdf.