Clinical update

Infusion therapy

Ensuring the safest care for patients undergoing infusion therapy through updated guidance

Ensuring the safest care for patients undergoing infusion therapy through updated guidance

Infusion therapies are increasingly delivered in community settings such as the patient’s home
Photo: Tim George

Essential facts

Many patients admitted to hospital or receiving care in other settings will be recipients of one or more infusion therapies. Total parenteral nutrition, chemotherapy, parenteral antimicrobial therapy, pain relief and other infusion therapies are increasingly delivered in community settings. While the move away from hospitals helps meet patients’ lifestyle and clinical needs, it can have implications for care and safety.

What’s new

The RCN has published updated standards for infusion therapy. They are intended to help healthcare professionals ensure each patient receives the most appropriate infusion therapy through the most apt device and site, in the most suitable environment and at the right time. Infusion therapies, cannulation and phlebotomy are increasingly delegated to healthcare support workers. Nurses must ensure they have delegated these tasks appropriately, the standards state.

Types of infusion therapy

The scope of infusion therapies includes, but is not limited to, intravenous, subcutaneous, intra-osseous and epidural infusions. Therapies may include fluids, medications, blood and blood components and parenteral nutrition.

Risk factors/complications

The move away from the traditional hospital setting brings extra risks that need to be considered by nurses delivering infusion therapies. Nurses must minimise the infection and safety risks. The guidance sets out how to recognise and respond to complications, such as phlebitis, haematoma and catheter-related bloodstream infections.

How to help your patient

Patient experience is a new section in the updated standards. When selecting vascular access devices and treatment regimens, it is important to consider patients’ lifestyle as well as their individual infusion therapy and other clinical care needs. Younger patients may have differing considerations to older patients, and some individuals may not have access to supportive carers. Infusion therapy may only be one element of a patient’s healthcare needs. All such factors therefore need to be taken into consideration when assessing each patient for infusion therapy.

Expert comment

Vicki Burns is a systemic anti-cancer therapy outreach manager at The Christie NHS Foundation Trust, Manchester

‘Used alongside specific national and local policies, the RCN infusion therapy standards support and inform cancer nurses involved in all aspects of practice.

‘Clear standards are imperative to guide cancer nurses on expectation, accountability and to ensure evidence-based care is at the heart of their practice.

‘Developments in infusion practice have led to significant improvements in quality, safety and patient experience. These have enabled greater flexibility for cancer services, a prime example being the drive towards delivering more cancer therapies closer to, and in, the patient’s home.

‘Finding the right place for a patient to receive therapy can bring many benefits, but can also bring additional risks, which need careful management by nursing staff.’

Further information

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