IV nursing, also called infusion nursing, is the nursing of patients needing intravenous (IV) therapy. Infusion nurses may be responsible for administering intravenous feedings or medications, giving blood transfusions, cleaning the insertion site of a tube, monitoring the patient for infection, knowing intravenous drug interactions, being aware of the different indications for patients of varying ages and conditions, and beginning emergency procedures, amongst other tasks. Nurses in this field should have either an associate’s degree, a bachelor’s degree, or a master’s degree in nursing, along with a license as a registered nurse (RN). The nurse must then specialize in IV nursing and pass the Certified Registered Nurse Infusion (CRNI®) exam.
Intravenous therapy typically refers to the direct delivery of nutrients or medications through a blood vessel. Many patients can eat while on this therapy, but those who rely solely on intravenous nutrition are called total parenteral nutrition (TPN) patients. This feeding method is used on patients who have non-functioning or impaired digestive systems due to surgery, coma, disease, or trauma, or for patients who need to rest their bowels. Often, IV therapy is used to administer antineoplastic agents, or drugs that block the abnormal reproduction of cells that result in masses called neoplasms. Blood transfusions, a procedure in which blood is transferred out of one person and given to another patient who has a deficiency of healthy blood, are also conducted intravenously.
The responsibility that is most popularly associated with IV nursing is inserting the IV line, a hollow needle attached to a catheter that administers fluids directly into the pierced vein. The catheter, or tube, is attached to a bag of fluids containing the necessary nutrition and medication. The fluids can drip continuously with the aid of gravity or with a regulatory device called an infusion pump that measures out the amounts of fluid the patient gets in a 24 hour period. The fluids can also be administered intermittently, disconnecting the patient from the catheter after each feeding. Fluids can also be pushed directly into the vein with a syringe.
Most IVs are placed in the arm or hand. To start an IV, a tourniquet is tied above the insertion site and the patient will be asked to clench his or her fist in order to enlarge the vein, making it easier to see. After finding the best vein, the area is cleaned, the skin is pulled taut, and the nurse inserts the needle into the vein at a 30 to 45 degree angle. In addition to line insertions, IV nursing includes the tasks of balancing fluids and electrolytes, monitoring vital signs, adjusting the patient’s nutritional status, administering fluids to keep the vein from closing, cleaning the tube, preventing infection, and changing the gauze at the site of the needle insertion.
Infusion nurses must be able to determine the correct doses and flow rates of medications and identify the right drug. For this reason, training in IV nursing includes courses in pharmacology, or the study of drugs and drug interactions. Infusion nurses may work in hospitals, long-term healthcare centers, ambulatory infusion centers, or in home care settings. Some patients may be able to administer fluids independently from home, while others may need a professional. For those who cannot afford home IV nursing, ambulatory infusion centers are often a more cost-effective option.