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Development of an Evidence-Based List of Noncytotoxic Vesicant Medications and Solutions

Gorski, Lisa A. MS, RN, HHCNS-BC, CRNI®, FAAN; Stranz, Marc PharmD; Cook, Lynda S. MSN, RN, CRNI®; Joseph, James M. MPH, BSN, RN, CRNI®, VA-BC; Kokotis, Kathy MBA, BS, RN; Sabatino-Holmes, Pam MSN, ARNP, CRNI®; Van Gosen, Lori MSN, RN, PCNS-BC, CRNI®, VA-BC Infusion Nurses Society Vesicant Task Force

doi: 10.1097/NAN.0000000000000202
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Infiltration of a vesicant medication, defined as extravasation, may result in significant patient injuries. The first step in preventing extravasation is the identification and recognition of vesicant medications and solutions. Because there is no list of noncytotoxic vesicants as established by a professional organization, the Infusion Nurses Society, as the global authority in infusion nursing, identified the need to address this gap. A task force was formed for the purpose of creating an evidence-based list of noncytotoxic vesicant medications and solutions.

Lisa A. Gorski, MS, RN, HHCNS-BC, CRNI®, FAAN, has worked as a clinical nurse specialist at Wheaton Franciscan Home Health and Hospice since 1985. She served as president of the Infusion Nurses Society between 2007 and 2008, is the chairperson of the 2016 INS Standards of Practice Committee, has published multiple journal articles and books, and presents nationally and internationally on a variety of infusion nursing topics.

Marc Stranz, PharmD, is vice president of the Elwyn Pharmacy Group in Philadelphia. He is a nationally recognized speaker and authority on infusion care, including clinical services and regulatory compliance. He has served on many committees for a variety of professional organizations, including INS, National Home Infusion Association, Association for Vascular Access, National Quality Forum, and American Society for Parenteral and Enteral Nutrition.

Lynda S. Cook, MSN, RN, CRNI®, is a clinical outcomes specialist for 3M Critical and Chronic Care Solutions Division where she serves as a nurse educator focusing on intravenous site management and outcomes. She is also a speaker and author and addresses many areas of infusion care.

James M. Joseph, MPH, BSN, RN, CRNI®, VA-BC, is the coordinator for vascular access services at Ohio State University Wexner Medical Center and The Ross Heart Hospital in Columbus, Ohio. He has implemented multiple clinical practice initiatives and guidelines in the organizations, including ultrasound-guided short peripheral catheter placement, a database for peripherally inserted central catheters and short peripheral catheters, vascular access device selection guidelines, and declotting protocols.

Kathy Kokotis, MBA, BS, RN, is a published author and has presented nationally and internationally on a variety of topics related to vascular access, including peripherally inserted central catheter teams, vascular access assessment, and economics. She is an employee of Bard Access Systems.

Pam Sabatino-Holmes, MSN, ARNP, CRNI®, is the advanced vascular access clinical nurse educator at Baptist Hospital of Miami. She has conducted multiple research studies. She started the South Florida INS Chapter and served as its president and presidential advisor from 2012 to 2017. She has written and implemented multiple vascular access practice guidelines, policies, and procedures in Baptist Health System.

Lori Van Gosen, MSN, RN, PCNS-BC, CRNI®, VA-BC, is a pediatric clinical nurse specialist who built the pediatric vascular access team at the Johns Hopkins Children's Center. She has written and implemented pediatric vascular access policies, practice guidelines, and clinical practice initiatives for the Children's Center. She is a published author and has presented at a national vascular access conference.

Corresponding Author: Lisa A. Gorski, MS, RN, HHCNS-BC, CRNI®, FAAN, 12403 N Hawks Glen Ct, Mequon, WI 53097 (lisagorski@hotmail.com).

The authors have completed and submitted a form for disclosure of potential conflicts of interest. L.G. reported relationships with ivWatch, BD, 3M, Covidien, and Genentech.

© Copyright 2017 by Infusion Nurses Society