Abstract
Ambulatory infusion centers are required to infuse complex therapies within scheduled chair times while sustaining excellent patient-centered care. This project evaluated how advanced clinical nursing practices can optimize routine infusion workflows by improving drug-volume accuracy and standardizing post-infusion flushing.
Infusion times go beyond expected time when nurses program pumps using manufacturer-stated volumes rather than actual bag volume, which often contains significant overfill [3]. In addition, variation in flushing practices creates inconsistent timed dose delivery and potential drug loss [2,4]. These deviations contribute to prolonged chair time and patient dissatisfaction.
Evidence supports weighed volume accuracy as an essential safeguard for time-dependent infusions [1]. The interventions were - to weigh drug bags using a calibrated scale, subtract the bag’s dry weight and determine the weighed volume, adjust the infusion rate, and flush the administration set with 25-30 mL flush volume.
In the baseline phase, 42 infusions were observed over 3 days. On average, infusion times exceeded orders by 12.2 minutes. Post-intervention analysis of 105 infusions over 9 days showed a reduced average overrun of 6.1 minutes, with a 49–68% reduction in additional infusion minutes. Flushing adherence improved to almost 100%.
By focusing on precision and consistency, this project demonstrates how evidence-based practice can enhance ambulatory infusion care. Findings reinforce the ethical requirement of full-dose delivery, improve workflow efficiency, and patient care experience.
Notes
Disclosures:
This project was conducted as part of the Stanford S.C.I.E.N.C.E. (Stanford Champions for Implementation and Evaluation of Nursing Care Evidence) EBP Fellowship Program
2025 Alpha Alpha Lambda At-Large Chapter – Bachelor's Award, Sigma Theta Tau International
References:
1) Baumann, A. J., et al. (2023). Residual infusion performance evaluation (RIPE): A single-center evaluation of residual volume post-intravenous eravacycline infusion. Pharmacy, 11(2), 75. https://doi.org/10.3390/pharmacy11020075
2) Bolla, B., et al. (2020). Understanding IV antimicrobial drug losses: The importance of flushing infusion administration sets. JAC-Antimicrobial Resistance, 2(3). https://doi.org/10.1093/jacamr/dlaa061
3) Cohen, M. R., et al. (2014). Understanding and managing intravenous container overfill: Potential dose confusion. Hospital Pharmacy, 49(3), 221–226. https://doi.org/10.1310/hpj4903-221
4) Cooper, D. M., et al. (2018). Non-flushing of IV administration sets: An under-recognised under-dosing risk. British Journal of Nursing, 27(14), S4–S12. https://doi.org/10.12968/bjon.2018.27.14.s4
5) Harding, M., et al. (2019). Best practice for delivering small-volume intermittent intravenous infusions. Journal of Infusion Nursing, 43(1), 47–52. https://doi.org/10.1097/nan.0000000000000355
Sigma Membership
Alpha Alpha Lambda at-Large
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Translational Research/Evidence-based Practice
Keywords:
Implementation Science, Policy and Advocacy, Interprofessional and Interdisciplinary, Advancing Clinical Practice, Intravenous Therapy, Drug Administration
Recommended Citation
Saravanan, Sudha, "Advancing Clinical Practice Using Precision Infusion Delivery and Standardized Flushing Protocol" (2026). International Nursing Research Congress (INRC). 325.
https://www.sigmarepository.org/inrc/2026/presentations_2026/325
Conference Name
37th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Toronto, Ontario, Canada
Conference Year
2026
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2026-09-29
Advancing Clinical Practice Using Precision Infusion Delivery and Standardized Flushing Protocol
Toronto, Ontario, Canada
Ambulatory infusion centers are required to infuse complex therapies within scheduled chair times while sustaining excellent patient-centered care. This project evaluated how advanced clinical nursing practices can optimize routine infusion workflows by improving drug-volume accuracy and standardizing post-infusion flushing.
Infusion times go beyond expected time when nurses program pumps using manufacturer-stated volumes rather than actual bag volume, which often contains significant overfill [3]. In addition, variation in flushing practices creates inconsistent timed dose delivery and potential drug loss [2,4]. These deviations contribute to prolonged chair time and patient dissatisfaction.
Evidence supports weighed volume accuracy as an essential safeguard for time-dependent infusions [1]. The interventions were - to weigh drug bags using a calibrated scale, subtract the bag’s dry weight and determine the weighed volume, adjust the infusion rate, and flush the administration set with 25-30 mL flush volume.
In the baseline phase, 42 infusions were observed over 3 days. On average, infusion times exceeded orders by 12.2 minutes. Post-intervention analysis of 105 infusions over 9 days showed a reduced average overrun of 6.1 minutes, with a 49–68% reduction in additional infusion minutes. Flushing adherence improved to almost 100%.
By focusing on precision and consistency, this project demonstrates how evidence-based practice can enhance ambulatory infusion care. Findings reinforce the ethical requirement of full-dose delivery, improve workflow efficiency, and patient care experience.
Description
This project promoted autonomous clinical nursing practice in an ambulatory infusion center by implementing weighed volume-based infusion calculations and standardized flushing. The interventions assisted registered nurses to practice within their full professional scope of practice by programming corrected infusion rates and reduced excess infusion time by 49–68%. Results prove how nurse-driven practice strengthens safety, dose accuracy, workflow efficiency, and patient experience.