Infusion therapy is when medication or fluids are administered through a needle or catheter, usually via an intravenous line (IV). It is a method of delivering medication or nutrition that can’t be taken orally or that needs to be dispensed quickly and/or at a controlled pace. Some types of chemotherapy, for example, need to be dripped slowly into the bloodstream. Other drugs need to reach the bloodstream quickly in life-and-death situations such as anaphylactic shock, heart attack, poisoning or stroke.
Infusion therapy can be intravenous, epidural, intramuscular, or subcutaneous. It is used to deliver medication for a wide variety of conditions, including:
- autoimmune disorders
- cancer
- congestive heart failure
- Crohn’s disease
- dehydration
- diabetes
- hemophilia
- hormone deficiencies
- hypercoagulation disorders that can cause blood clots
- hypergammaglobulinemia
- immune deficiencies
- infections that are unresponsive to oral antibiotics
- lupus
- migraines
- multiple sclerosis
- osteoarthritis
- osteoporosis
- pain management
- psoriasis
- rheumatoid arthritis
- severe infections such as cellulitis, pneumonia, and sepsis
- psoriatic arthritis
- ulcerative colitis
How is Infusion Therapy Delivered?
Although infusion therapy can be delivered via several methods, it is usually delivered intravenously. An intravenous line (IV) is a soft, flexible tube placed inside a vein that allows medical staff to introduce fluids, medications and blood products directly into your bloodstream. A small, narrow catheter is inserted into the vein, most often in your hand or lower arm. This catheter is attached to plastic tubing, which in turn is attached to a bag of fluid.
In some cases, the catheter is capped rather than attached to tubing (a saline lock or heparin lock, sometimes called a hep-lock). If you need IV fluid or medication later, the cap is removed and the tubing is attached.
Once the catheter is in place, it is covered with a transparent bandage. This protects the site from becoming infected and allows nurses to monitor the site for signs of infection or for signs that the catheter has shifted out of place. In addition to potential vein damage, a catheter that has shifted out of place can prevent IV fluids and medications from entering the bloodstream as needed.
A variety of needle and catheter sizes may be used to start an IV. Bigger needles, or large bore needles, are used in emergency situations as they allow fluids and medications to enter the bloodstream more quickly. Some infusions, such as blood products, also need a larger bore needle so they can flow through the catheter without the risk of blood clotting in the tubing.
Sterility and infection prevention are now foremost in IV care. The area where the needle will puncture the skin is cleaned thoroughly, and only sterile needles and catheters are used to insert the IV, which is now a closed-loop system (there are no openings to outside air that could introduce infection.) Any time an IV bag needs to be changed or a medication injected into the IV line, nurses use sterile procedures to prevent bacteria from entering the system.
Who Delivers Infusion Therapy?
Infusion therapy is a highly specialized practice. If you have ever had an intravenous line (IV), you know some of what is involved: vein evaluation and access site identification, effective IV insertion, monitoring of fluids and medications, blood test orders and reviews, dressing changes and more. Special types of infusions, such as central lines or PICC lines, must be monitored especially closely to minimize infection risk.
While registered nurses can start and manage IVs, nurses who specialize in infusion therapy — Certified Registered Nurses of Infusion (CRNI®s) — are an integral part of healthcare teams. Their responsibilities include correctly dosing medications and keeping patients safe from catheter-related bloodstream infections and other complications.
CRNIs are exceptional nurses who pass a rigorous exam covering the core areas of infusion nursing. They are part of a global community of elite nurses across multiple disciplines — including home care, pediatrics, oncology, and many more — who have demonstrated their skill and qualifications through challenging certifications. CRNI certification eligibility requirements include a current, active, unrestricted registered nurse (RN) license in the United States and a minimum of 1,600 hours of experience in infusion therapy as an RN within the past two years.
Where is Infusion Therapy Delivered?
Initially practiced only on the most critically ill patients, infusion therapy has evolved into a highly specialized mode of treatment utilized with 90% or more of all hospitalized patients. However, infusion therapy is no longer confined to the hospital setting. It can be delivered in a wide variety of settings, including skilled nursing facilities, doctor’s offices and clinics, and inside the home.
There are many situations requiring intravenous therapy at home, including: long-term and/or high-dose antibiotics; chemotherapy; nausea medication for cancer treatment or pregnancy; patient-controlled pain management; hormone deficiencies; and total parenteral nutrition, among others.
National IV Nurse Day
Every January 25, healthcare professionals and the Infusion Nurses Society (INS) celebrate National IV Nurse Day. Proclaimed by then-Congressman (now Massachusetts Senator) Ed Markey in 1980, the U.S. House of Representatives designated this day to honor and recognize the accomplishments and impacts of the nation’s infusion nurse specialists each year. We take this opportunity each year to thank infusion nurses for their pivotal role in bringing hope, facilitating healing, and championing health.
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