Recommendations for frequency of assessment of the short peripheral catheter site.

As many organizations choose to follow the Infusion Nurses Society (INS) recommendations for peripheral intravenous (IV) site rotation based on clinical indications rather than a specific time frame, INS recognizes the critical importance of site assessment to identify any signs of complications. The risks of peripheral IV catheters are well known, including phlebitis, infiltration/extravasation, and infection. Nerve damage is also a risk both during insertion and as a result of major infiltrations/extravasations. Minimizing the complications associated with these risks demands regular assessment for signs and symptoms and prompt removal when evident. Peripheral IV sites should be assessed for redness, tenderness, swelling, drainage, and/ or the presence of paresthesias, numbness, or tingling. In addition to site-related changes, the possibility of catheter-associated bloodstream infection must also be considered in any patient with a peripheral IV catheter who has an elevated temperature, even in the absence of site redness, tenderness, swelling, or drainage. There are limited evidence-based guidelines addressing how often to assess the peripheral IV site. Much of the general nursing literature addresses the need for “frequent” assessment of the IV site, and the 2011 Infusion Nursing Standards of Practice recommends “routine” assessment for signs and symptoms of phlebitis and infiltration. In the winter of 2012, INS convened a national task force of infusion therapy experts representing the varying areas of infusion practice based on population (neonatal, pediatric, geriatric, oncology) and settings (acute care, outpatient, home care, long-term care) to examine current practices and to develop specific recommendations for the frequency of peripheral IV assessment.