There are many misconceptions surrounding IV infiltration, including the causes and detection methods.
KNOW THE FACTS
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A common misconception still persists that occlusion alarms on infusion pumps will signal infiltration.
Source: ECRI Evaluations & Guidance: Infiltration during Infusion Therapy: Why It Occurs and How to Prevent It. Published 2016 Apr 3.
Many people believe the main cause of an infiltration event is the fault of the nurse and “bad stick”
After tens of thousands of monitoring hours, we have found there are many causes of an infiltration. Education around this issue is key to help improve patient safety outcomes and how a monitored PIV is a necessary addition to IV therapy.
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Do not rely on EID alarms to detect intravenous IV infiltration or extravasation, as these alarms are not intended to detect disruption of the fluid flow pathway.
An IV may be infiltrated even if a clinician can easily flush the IV and/or get a blood return.
Another misconception focuses on IV assessment and if a clinician can get a blood return or is easily flushed the IV is not infiltrated.
Through our identification of the various causes of infiltration, it can be demonstrated that an IV can be infiltrated even if the clinician was capable of doing a flush or getting a blood return.
- Puncture of posterior vein wall could allow for an IV flush as well as a blood return
- Inflammation or vein porosity could allow for an IV flush as well as a blood return
- Catheter/Arm movement or leakage from insertion site could allow for an IV flush as well as a blood return.
Monitoring of inline intravenous pressure is not useful for predicting or detecting infiltration of peripheral catheter sites in infants.
Infusion pumps will alarm for occlusions only when downstream pressure reaches a specified value; elevated pressures resulting from infiltration are typically far lower than levels triggering occlusion alarms.
Source: ECRI Exclusive Hazard Report: High Priority- H0265: Infusion Pump Occlusion Alarms Cannot Detect Infiltrations. Published: 2015 Jul 8.
Relying on an infusion pump’s downstream occlusion alarm to identify an infiltration condition is not good practice.
Source: IV Infiltration Be Alarmed When Your Infusion Pump Isn’t. PA PSRS Patient Saf. Advis. 2007 Sep 4(3):97-9.
Infiltrations can occur any time even when nurses complete hourly IV checks.
Nurses are faced with many tasks that often put them in the difficult position of having to decide what they will not get done during their shift.
-Heavy workloads, declining patients, pull nurses in many different directions and assessments get missed. This phenomenon referred to as unfinished care or missed care documented in the literature. Unfinished care or missed care has consistently been associated with negative nurse, patient, and organizational outcomes. One of the primary reasons for this is inadequate resources. For example, units with more than 25 beds reported higher unfinished care.
Source: International Journal of Nursing Studies: “Unfinished nursing care, missed care, and implicitly rationed care: State of the science review”
Leading Infusion Pump Companies Recognize the Need
ivWatch is working with global leaders to improve patient safety with our infiltration detection technology.