Clinical update

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. 

New updated guidance for infusion therapy has been released
Picture: iStock

Essential facts

Many patients admitted to hospital or receiving care in other settings, including their own homes, are 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 hospital helps meet patients’ lifestyles and clinical needs, it can have implications for patient care and safety.

What’s new?

The RCN has published updated standards for infusion therapy guided by evidence to ensure the safest care. It is intended to help healthcare professionals ensure each patient receives the most appropriate infusion therapy through the most appropriate device and site, in the most appropriate environment and at the right time.

The standards state infusion therapies, cannulation and phlebotomy are increasingly delegated to healthcare support workers. Nurses must ensure they have delegated these tasks appropriately.

Types of infusion therapy

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

Risk factors and complications

The move away from traditional hospital settings brings extra risks which need to be considered by nurses delivering infusion therapies. Effective infection prevention and control measures are integral to all aspects of infusion therapy. 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 guidance. When selecting vascular access devices and treatment regimens, it is important to consider patients’ lifestyles as well as their individual infusion therapies and other clinical care needs.

Younger patients may have differing considerations to older patients, and some individuals may have no access to carers. Infusion therapy may only be one element of the patient’s healthcare needs. All factors need to be considered when assessing patients for infusion therapy and they should be able to make informed decisions in partnership with healthcare professionals.

Expert comment

Anna Crossley is RCN professional lead of for acute, emergency and critical care

Anna Crossley

‘Changing service delivery sees more infusion therapies delivered outside hospital settings and closer to people’s homes. Emergency nurses need to be aware that there are likely to be more people presenting at emergency departments who are receiving infusion therapies at home, as well as delivering emergency infusion therapies in accident and emergency departments. 

'Many of them may have been discharged from hospital earlier than they would have been in the past to continue treatment in the community. This new guidance draws on the latest evidence, highlights the importance of patient experience, listening to the patient and getting the right treatment to improve their quality of life. The new RCN guide should be used alongside local policies.’

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