Implementation of a safe and effective intravenous iron infusion protocol to prevent skin staining

"To avoid medicolegal action and patient dissatisfaction, it is essential that patients are informed of potential skin staining and an evidence-based administration protocol is utilised" Crowley et al (2020).
Abstract:

PURPOSE: To implement a safe and effective intravenous iron infusion protocol to prevent skin staining.

DESIGN/METHODOLOGY/APPROACH: Mixed methods approach was utilised including education, auditing, self-reported survey, patient information leaflet and patient feedback. In total 25 healthcare professionals completed the survey and 15 patients provided feedback.

FINDINGS: No skin staining or severe adverse reactions were observed over eight weeks. Audit results found 53 per cent of staff were compliant with the recommended IV iron infusion protocol and 46 per cent informed patients of skin staining risk. Self-report surveys indicated 92 per cent flushed the cannula with sodium chloride before starting the infusion, 88 per cent flushed the cannula after the infusion and 76 per cent informed patients of skin staining risk. Patient feedback was largely positive and constructive.

RESEARCH LIMITATIONS: Limitations include self-reported bias, short audit time interval, missing data and discrepancy between audit and survey results.

ORIGINALITY/VALUE: This quality improvement project was developed following two skin staining incidences at our maternity hospital. Although rare, skin staining after intravenous iron infusion is potentially permanent and may be distressing for some patients. Intravenous iron is considered safe and effective to treat anaemia during pregnancy and is often prescribed for this patient cohort. To avoid medicolegal action and patient dissatisfaction, it is essential that patients are informed of potential skin staining and an evidence-based administration protocol is utilised.

Reference:

Crowley, C.M., McMahon, G., Desmond, J. and Imcha, M. (2020) Preventing skin staining: an effective iron infusion protocol. International Journal of Health Care Quality Assurance. March 6th. doi: 10.1108/IJHCQA-10-2019-0177. (epub ahead of print).

Safety IV catheter