Throughout my nursing career, I have seen that many nurses use the word infiltrate so loosely. I have seen and heard of nurses who document and give reports stating that the patient has an infiltrate when they really weren’t sure that the incident occurred in the first place. I know some of you may say that “if a nurse doesn’t know what an infiltrate is, well then they shouldn’t be a nurse!” However, I think that with experience comes knowledge. The more experience the nurse has increases one’s knowledge base and understanding of what an IV infiltration is, the signs to watch out for, and the prevention methods.

What is a peripheral IV infiltration? This is when fluids such as IV medications, blood products, and the like begins leaking around the intravenous site into the tissues instead of going into the vein or bloodstream. This can happen because the intravenous catheter was either inaccurately positioned when placed or a dislodgement of sorts. The signs of an IV infiltration in which I previously mentioned, is the fluid, solution, or medications going into the encompassing tissue around the IV access point. While anyone can fall victim to an infiltration, the risks increase when the patients are the recipients of acidic or irritating fluids, medications, and/or solutions.

To determine if a patient has a peripheral IV infiltrate, the health care provider should ask themselves: Is the surrounding area swollen? Does the area look red in color? Does the patient complain of pain at the site? Is the temperature different when compared to another area? If an infiltrate is caught promptly, the nurse saves herself from a potential lawsuit and the patient decreases the risks of sustaining irreversible nerve, tissue, and even muscle damage to and surrounding the affected areas.

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Another way nurses can save themselves from a potential lawsuit is to diligently assess the area and educate the patient about the site. For instance, tell the patient to notify you if the IV causes discomfort, especially with infusing IV medications, fluids, and/or solutions, and if they notice any swelling or redness to the encircling area.

I should note that if a patient does complain of at least one of these signs or systems, then it would be best to be proactive and safe to remove that IV access and restart a new one elsewhere. However, if an infiltrate does exist even after all your positive interventions, one should follow their facility policy and protocol for IV therapy and infiltrations. Although, we now live in the world where some individuals are pursuers of monetary gains (even though you did your very best to take care of your patients).

Let’s face it: Nurses get into the profession because we love to help others and we love what we do. But, in the court of law many believe that infiltrations are preventable complications. Did the patient sustain injury? If so, was this caused because the nurse performed below standard of care? Completely and accurately documenting while being conscious to also record in centimeters the area size of swelling, sticking to the standard of care, diligently assessing the area, and following your facility policy and procedures for IV therapy and infiltrations may hinder a medical malpractice claim your way. Documenting the size of the swollen area could possibly determine the outcome of your case, if you were ever involved in a malpractice case. In essence, this could determine perchance if you were negligent or not in a court of law. For instance, if the size of swelling was small or non-existent then the court may find that you were doing your due diligence in catching or preventing such an incident. On the other hand, if the area was large, then the court may possibly find that you weren’t adhering to the standards of care and may find you guilty in a nursing negligence claim.

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Anitra Green
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