A safe and effective winged peripheral intravenous cannula for use in clinical practice.

Vascular access continues to be a key factor for the reliable and safe delivery of intravenous (IV) therapy to patients in any healthcare setting. Clinical guidelines advocate for the right vascular access device selection, in order to reduce avoidable complications, eg multiple stabs, phlebitis, thrombophlebitis, insertion site infection, and blood stream infection, while improving efficiency and reducing costs. Peripheral intravenous catheters or cannulas (PIVCs) remain widely used for gaining vascular access in all clinical settings, with both adults and children, because they provide a relatively cheap and simple way to provide blood sampling and the prompt administration of IV medications.

Achieving successful subcutaneous access in palliative patients.

Subcutaneous administration of medications is a well-recognised route for delivering prescribed therapies, in particular analgesia for patients requiring palliative care. Technological advancements in infusion devices and dressings can result in well-tolerated and effective methods for continuous infusions for this group of individuals. This article discusses how technological developments are resulting in subcutaneous access devices that are easy to insert and can meet the needs of a growing patient population, as well as complying with the latest guidelines on sharps safety.

Current thinking on catheter securement and infection prevention.

Janice Gabriel, Clinical Network Manager, NHS England (Wessex), Southampton, janice.gabriel@nhs.net , explains the importance of catheter securement in preventing complications of infusion therapy.

Understanding the challenges to vascular access in an ageing population.

At the beginning of the 21st century, one in five of UK residents can expect to see their 100th birthday and one in four people are aged 60 years or older. The UK has an ageing population. With older age comes an increasing variety of comorbidities that have an impact not only on an individual's quality of life but also on healthcare resources.

Subcutaneous infusion in palliative care: a focus on the neria soft 90 infusion set.

Subcutaneous administration of medications and/or fluids can play a crucial part in supporting patients at home and thereby avoiding the need for hospitalisation. It is an area of patient care that has received little attention compared with other types of parenteral therapies. However, it is an effective and safe route for continuous administration for individuals requiring palliative care.

Subcutaneous fluid administration and the hydration of older people.

Hypodermoclysis, or the subcutaneous administration of fluids, is a method of rehydration that is not routinely used in the UK. Yet it is a simple and effective method of fluid administration for individuals with mild-to-moderate dehydration, especially for the frail and elderly (Sasson and Shvartzman, 2001). Subcutaneous infusion is an alternative route of parenteral administration.

The role of subcutaneous infusion in integrated, patient-centred palliative care.

The NHS Outcomes Framework (Department of Health (DH), 2010) set out the UK Government's plans to reform the NHS to focus more on patient outcomes.

Intravenous versus subcutaneous access for palliative care patients.

The subcutaneous route for medication administration can prove highly effective both in terms of reliability and clinical outcomes. It is also well tolerated by patients for whom the enteral route is not an option. This extended feature comment reviews the advantages and disadvantages of both the intravenous and subcutaneous routes of medication administration for patients requiring palliation.

Preventing and managing complications of CVADs.

Patient assessment and the appropriate management of long-term central venous access devices are essential to diminishing the potential for complications. When complications do occur, they tend to be the consequence of a series of events. Recognising problems at an early stage means they can be addressed sooner and improves the chances of resolving them without any long-term consequences.

Long-term central venous access device selection.

Infusion therapy is often viewed as a means to an end - a way to administer medications and fluids. It is one of the few specialties that affect almost all areas of healthcare. Safe, effective and reliable vascular access should be the goal of every health professional who is starting a patient on a prescribed course of intravenous therapy, especially if that patient is undergoing a prolonged course.

The use of subcutaneous infusion in medication administration.

The subcutaneous administration of medications is an area that receives little attention compared with other types of parenteral therapy. Parenteral administration is used by many thousands of patients who self-administer their medication on a daily basis-for example, those using insulin to manage diabetes, recipients of some types of hormone therapy and so on. It is also an effective route for the continuous administration of medication(s) in individuals who are terminally ill.

Subcutaneous infusion in palliative care: the neria soft infusion set.

Patients approaching the end of their life may be unable to tolerate the administration of oral medication owing to their underlying disease and/or symptoms, such as nausea and vomiting. Subcutaneous infusion is an alternative route of administration that offers a number of advantages over oral and intravenous routes. This product focus article provides an overview of subcutaneous infusion, including how the selection of the most appropriate infusion device can greatly contribute to the overall comfort of the patient.

Subcutaneous infusion in palliative care: the neria soft infusion set.

Patients approaching the end of their life may be unable to tolerate the administration of oral medication owing to their underlying disease and/or symptoms, such as nausea and vomiting. Subcutaneous infusion is an alternative route of administration that offers several advantages over oral and intravenous routes. This product focus article provides an overview of subcutaneous infusion, including how the selection of the most appropriate infusion device can greatly contribute to the overall comfort of the patient.

Sharps injuries and their prevention: what the new European legislation may mean for palliative care services.

Approximately 3 million health-care workers throughout the world, and more than 1 million in Europe, experience a percutaneous injury each year as a result of accidents with needles or other sharps. The consequences of this can be devastating, ranging from fear, anxiety, discomfort, and embarrassment to contraction of blood-borne infections. A new European Union Directive on the prevention of sharps injuries that must be implemented by May 2013 aims to ensure that health-care workers throughout Europe have access to safer sharps and needle-free devices.

Vascular access devices: securement and dressings.

Many patients admitted to hospital will require a vascular access device (VAD). Insertion of VADs is often viewed as a routine procedure, with little attention given to the importance of appropriate securement and dressing and how these factors can affect patient outcomes. This article discusses the types of VAD available and the rationale for VAD securement and appropriate dressings to minimise complications.

Infusion therapy. Part two: Prevention and management of complications.

In the second of two articles, the author identifies common complications associated with intravenous (i.v.) therapy and discusses preventive measures.