Hadaway, Lynn

Background/objectives: To develop expert consensus on peripheral venous access devices (PVAD) and associated care practices, and to formulate guidance recommendations aimed at improving peripheral venous access and management, including the integration of vein visualization technology. This is particularly important for patient populations with peripheral venous depletion, who often present with compromised vasculature that complicates successful PVAD access and increases the risk of complications. Preserving vascular integrity in these patients is essential for maintaining treatment pathways and preventing long-term vascular damage. Methods: A multi-phase approach to consensus development was used consisting of the following: (1) a literature review, (2) a survey and consultation with a vascular access expert panel ( n = 9), and (3) a consultation meeting with patient and public representatives ( n = 2). Results: Survey results and consultation findings from the expert panel demonstrated consensus for 14 of 24 statements. Further analysis resulted in a total of four key problem statements on peripheral venous access and care, and 11 recommendations for future development. Following review by patient and public representatives, three additional recommendations were added, and three existing recommendations were refined. The final consensus statement reflects four problem statements with 14 recommendations. Conclusion: This expert consensus presents 14 evidence-informed statements designed to strengthen practice, improve patient safety, and enhance clinician confidence and competence. Central to these recommendations is the adoption of routine structured pre-insertion vessel assessment using vein visualization technology where appropriate to minimize vessel trauma, and promote more consistent, high-quality vascular access care.

The need for filtering intravenous infusions has long been recognized in the field of venous access, though hard scientific evidence about the actual indications for in-line filters has been scarce. In the last few years, several papers and a few clinical studies have raised again this issue, suggesting that the time has come for a proper definition of the type of filtration, of its potential benefit, and of its proper indications in clinical practice. The WoCoVA Foundation, whose goal is to increase the global awareness on the risk of intravenous access and on patients’ safety, developed the project of a consensus on intravenous filtration. A panel of experts in different aspects of intravenous infusion was chosen to express the current state of knowledge about filtration and to indicate the direction of future research in this field. The present document reports the final conclusions of the panel.