Choice of infusion site--differences in the references of staff (nurses and residents) and patients

Insertion of an intravenous (i.v.) line is a common and routine procedure in hospitalized patients. The literature recommends not to insert an i.v. line in a limb fold, but other than that there are no guidelines regarding optimal locations for the i.v. line. In this study we attempted to elucidate whether there are other possible preferences and guidelines for choosing the location of an i.v. line. We studied four groups: patients at the time of hospitalization, hospitalized patients, nurses and surgical interns on a surgical ward. We found that 91.8% of the patients request to take part in choosing the location of their i.v. line. Moreover, we found that most patients have a hand preference for the i.v., whereas, the ward staff has little location preference. Despite these findings, we discovered that, in practice, most patients were not asked to participate in the decision making process regarding their i.v. line location. Analysis of the results showed that there is a need to include the patient's preference in choosing the location for the i.v. line, whenever possible. If the patient doesn't have a preference, the i.v. line should be inserted in the non-dominant hand or the hand in the bed which is more accessible to the medical & nursing staff.