Intravenous therapy needle choices in ambulatory cancer patients

The purpose of this research utilization project was to evaluate a set of research-based decision rules designed to guide needle choice for peripheral intravenous (i.v.) therapy in ambulatory cancer patients. A consecutive series of 100 patients receiving i.v. therapy for one day were assigned to receive either a plastic catheter or a steel needle using the decision rules based on age, weight, vein condition, solution to be administered, and infusion volume, and were evaluated for phlebitis, local or systemic infection, and extravasation. None of the patients experienced phlebitis or infection, and a 25% cost savings ($6,800 Canadian) was obtained. Two patients (5%) from the "steel needle group" experienced an extravasation of 5FU but neither required treatment nor experienced changes to subsequent peripheral i.v. therapy. Our nursing procedure for initiation of i.v. therapy has been changed to reflect the needle choice decision rules evaluated in this project.