Journal of Infusion Nursing Infusion Nursing The Journal of Infusion Nursing is a member benefit of the Infusion Nurses Society. INS is a professional association dedicated to enhancing infusion prac- tices that will improve patient outcomes. Through its many member benefits, INS offers access to the latest infusion research, technology, and education. For more information about the benefits of INS membership, visit www.ins1.org. Articles that appear in the Journal of Infusion Nursing are selected by a process of double-blind peer review. Articles are reviewed by three or more members of the Editorial Review Board or other selected experts. INS retains final approval on all articles published in this journal. INS is not responsible for any statements made or opinions expressed herein. INS does not endorse or recommend any product or service discussed or advertised in this publication. Data and information developed by the authors of specific articles are for informational and educational purposes, and are not intended for application without independent, sustaining investigation on the part of potential users. Contents 40. Flushing and Locking S77 41. Vascular Access Device (VAD) Assessment, Care, and Dressing Changes S81 42. Administration Set Change S84 I. General S84 II. Primary and Secondary Continuous Infusions S84 III. Primary Intermittent Infusions S84 IV. Parenteral Nutrition S85 V. Propofol Infusions S85 VI. Blood and Blood Components S85 VII. Hemodynamic and Arterial Pressure Monitoring S85 43. Phlebotomy S85 I. General S86 II. Blood Sampling via Direct Venipuncture S86 III. Blood Sampling via a Vascular Access Device S87 44. Vascular Access Device (VAD) Removal S91 I. Short Peripheral and Midline Catheters S91 II. Nontunneled Central Vascular Access Devices (CVADs) S91 III. Surgically Placed CVADs: Tunneled Cuffed/Implanted Ports S92 IV. Arterial Catheters S93 SECTION SEVEN: VASCULAR ACCESS DEVICE (VAD)-RELATED COMPLICATIONS 45. Phlebitis S95 46. Infiltration and Extravasation S98 47. Nerve Injuries S102 48. Central Vascular Access Device (CVAD) Occlusion S104 49. Infection S106 50. Air Embolism S108 51. Catheter Damage (Embolism, Repair, Exchange) S109 I. General S109 II. Catheter Embolism S110 III. Catheter Repair S110 IV. Catheter Exchange S110 52. Central Vascular Access Device (CVAD)-Associated Venous Thrombosis S112 53. Central Vascular Access Device (CVAD) Malposition S114 SECTION EIGHT: OTHER INFUSION DEVICES 54. Intraspinal Access Devices S118 55. Intraosseous (IO) Access Devices S120 56. Continuous Subcutaneous Infusion and Access Devices S122 SECTION NINE: INFUSION THERAPIES 57. Parenteral Medication and Solution Administration S125 58. Antineoplastic Therapy S127 59. Biologic Therapy S129 60. Patient-Controlled Analgesia S131 61. Parenteral Nutrition S133 62. Transfusion Therapy S135 63. Moderate Sedation/Analgesia Using Intravenous Infusion S137 64. Therapeutic Phlebotomy S138 Appendix A. Infusion Team Definition S140 Appendix B. Illustrations S141 Glossary S146 Index S156 Note: The “S” in page numbers denotes supplement issue and does not refer to a specifi c standard. JIN-D-15-00057.indd 5 JIN-D-15-00057.indd 5 05/01/16 11:30 PM 05/01/16 11:30 PM