NURS FPX 9020 Assessment 2

Literature Synthesis: Organization

Inpatient infusion units continue to be quite problematic in relation to patient safety. There are standardized protocols of infusion care that have proven to decrease the number of phlebitis, infiltration, and catheter occlusions as well as other complications associated with the peripheral intravenous catheter (Demiroglu and Tosun, 2025; Nickel et al., 2024). The PICOT question which will inform the project is: In nursing staff working with adult patients undergoing outpatient infusion therapy (P), what effect does following Infusion Nurses Society guidelines regarding an infusion therapy environment using infusion therapy standards and structured IV site assessment paired with aseptic technique training (I) compared to the current practice (C) has on the occurrence of infusion-related complications (O), over 12 weeks (T)? The project, in the context of DNP, converts available evidence about the peripheral IV care to a practice-level, structured intervention that introduces standardized tools of assessment, a bundle of aseptic techniques, and competency-specific training on how to minimize avoidable complications of infusions. The work contributes to the role of the DNP of evidence-based leadership by bridging the gap between what has been identified as best practices and the clinical practice inconsistencies. The aim of the project is to introduce a standardized, INS-compatible infusion protocol that will go a long way in decreasing the cases of complications related to infusions in the nursing staff involving outpatient infusion patients.

Literature Search Strategy

Infusion-related complications issue is one of the most urgent patient safety issues involved in outpatient care in the field of medicine today and need to be addressed urgently and based on evidence. In a private outpatient infusion center, which is located at the project site, the baseline data show that 14% of all the infusion procedures had a complication such as phlebitis (6%), infiltration (5%), and occlusion (3%), with the catheter requiring reinsertion (Clinical Director, personal communication, January 15, 2026). A literature search was carried out to help find a solution to the practice problem. CINAHL, PubMed and Cochrane Library were used to search peer-reviewed papers, limited to those published since 2022 and 2026, respectively, to make sure that evidence is up-to-date. Inclusion criteria were that the study had to refer to an adult outpatient or ambulatory environment of infusion, peripheral intravenous catheter complications, standardized infusion regimens, and aseptic technique or site evaluation interventions. All studies were eliminated based on the following reasons: Only pediatric population, central venous access device, inpatient critical care units, and non-English studies were omitted. The most important search terms were: peripheral intravenous catheter complications, infusion therapy standards, INS phlebitis scale, aseptic technique, ANTT, IV site assessment, outpatient infusion safety, phlebitis, infiltration, and catheter occlusion. Terms were joined with the help of the use of the so-called Boolean operators, i.e., the following terms were applied: peripheral intravenous catheter AND complications, INS standards AND infusion therapy, aseptic technique OR ANTT and nursing compliance, and IV site assessment AND documentation practices. Also, the MeSH terms infusions, intravenous, catheter-related infections, aseptic techniques, patient safety, and nursing assessment were used. One thousand five hundred articles have been retained out of 1,500 articles that were found upon screening of titles, abstracts, and full contents.

Analysis of Evidence

Outpatient care is a continuing safety issue due to peripheral IV complications, where growing attention is given to nurse-led prevention due to its prevalence. Patient safety and decreased complications are enhanced with the help of standardized IV assessment tools and INS-aligned guidelines as well as bundles of aseptic techniques (Nickel et al., 2024). Cited results are a decrease of 20-40 percent in phlebitis, a greater number of catheter outcomes, and an increase in adherence to aseptic (Thompson et al., 2026). Training about competencies and documentation supplemented with EHR increased compliance and the early identification of complications. Nevertheless, there is still a lack of sustainability over the long-term, scalability in outpatient contexts, workload, and affordability of bundled interventions.

Organization of Literature According to the Main Themes

The literature dealing with issues of standardized peripheral intravenous catheter (PIVC) care, aseptic technique, competency development, and standardization of protocols was grouped into four themes, which are interrelated. The initial theme is that catheter-related complications could be prevented and catheter failure early detected by using standardized IV site assessment and monitoring practices (Paterson et al., 2022; Marsh et al., 2024; Teixeira et al., 2025; Zingg et al., 2023; Nickel et al., 2024). The second theme is that it is crucial that aseptic technique is strictly followed when inserting and maintaining a peripheral intravenous catheter, which helps to avoid infection (Kent et al., 2025; Calderwood et al., 2023; Costa et al., 2022; Malhi et al., 2025; Nickel et al., 2024). The third theme proves that competency-based education and evidence-based skills validation increase the amount of knowledge in nursing, create confidence in clinical performance, and foster compliance with evidence-based practices (Sultan et al., 2025; Ray et al., 2022; Tegegne et al., 2025; Hawker et al., 2022; Feng et al., 2025). The fourth theme has to do with the idea that standardized patterns of delivering infusion require changes, such as care bundles and compliance with Infusion Nurses Society guidelines, resulting in fewer complications with infusion (Nickel et al., 2024; Demirooglu and Tosun, 2025; Wolie et al., 2024; Staples et al., 2022; Young et al., 2023). The combination of the themes provides a comprehensive strategy for enhancing the safety and consistency in outpatient infusion care.

Conclusion

It is evident in the literature that variability in IV assessment, aseptic technique, and clinical training has a role to play in avoidable infusion-related complications. The monitoring systems and standardized tests are more effective in the early detection of catheter problems. The tools increase the amount of patient safety. Given the high level of evidence in support of strict aseptic technique and infection prevention bundles as the key to the minimization of bloodstream infections and phlebitis, bigger and more comprehensive studies are recommended to enhance the intervention’s effectiveness.