Patient Education in Infusion Therapy

Mandates comprehensive, health-literacy-appropriate patient and caregiver education for all vascular access and infusion therapy encounters, defines the required educational content, and establishes the teach-back and return demonstration standards for verification of learning.

policies•Jan 2026•Patient Education

Patient Education in Infusion Therapy Policy

1. Policy Statement

It is the policy of this organization that every patient (and/or designated caregiver) receiving infusion therapy through a vascular access device shall receive comprehensive, individualized education regarding their device, its management, the recognition of complications, and the actions required in the event of an adverse occurrence.123 Education shall be tailored to the patient’s health literacy, cognitive status, preferred language, and learning style.456 Verification of learning through teach-back and, where applicable, return demonstration is mandatory and shall be documented in the health record.789 Passive listening does not constitute verified education for high-risk therapy.710

2. Purpose

This policy exists to:

  • Establish the patient as an active safety partner in the management of their vascular access device, recognizing that informed patients and caregivers serve as an essential “final check” in the safety chain.1113
  • Define the minimum required educational content that must be delivered and documented for every patient receiving infusion therapy.212
  • Mandate active verification of learning through the teach-back method and return demonstration, replacing passive educational approaches that have been shown to be insufficient for high-risk therapy.71089
  • Ensure that educational materials and delivery methods are accessible to patients of all health literacy levels, cognitive abilities, ages, and language backgrounds.425613
  • Improve clinical outcomes and increase clinician adherence to best practices through patient engagement and empowerment.141511

3. Scope

This policy applies to:

  • All licensed clinical personnel who provide care to patients with vascular access devices, including RNs, LPN/LVNs, APRNs, Physicians, PAs, and Vascular Access Specialists.
  • All patients with any indwelling vascular access device in any care setting, with enhanced requirements for patients being discharged to home or outpatient settings with a device in place.
  • All care settings, including inpatient, ambulatory infusion, home health, and skilled nursing.
  • All vascular access device types.

4. Policy Requirements

4.1 The Patient as a Safety Partner

4.1.1 Patient and caregiver education is classified as a primary clinical intervention—not an optional courtesy—that directly reduces vascular access-related complications.1216 All clinicians shall integrate education into every vascular access encounter, from pre-insertion consent through device removal.171819 Research consistently demonstrates that planned, structured patient education is associated with improved device self-management, reduced complication rates, and lower rates of unplanned healthcare utilization.8153

4.1.2 Clinicians shall actively engage patients in their own care by explaining what they are doing and why during every interaction with the vascular access device, using language the patient can understand.201814

4.1.3 Patients and caregivers who have been educated on device management shall be encouraged (but never obligated) to speak up if they observe a deviation from the care they were taught to expect (e.g., a clinician not performing hand hygiene or not disinfecting the needleless connector).11

4.2 Educational Framework and Content

4.2.1 Health Literacy and Individualization. Education shall be tailored to the individual patient’s assessed health literacy, cognitive status, age, developmental stage, preferred language, and preferred learning style (visual, auditory, kinesthetic, or written).422056 Written materials shall be available at or below a sixth-grade reading level in the primary language(s) of the patient population served.212223 Interpreter services shall be used when the patient’s preferred language differs from the clinician’s.613 Health literacy tools such as the Patient Education Materials Assessment Tool (PEMAT) shall be applied when developing and evaluating written and audiovisual patient education materials.2124

4.2.2 Minimum Required Educational Content. The following topics shall be covered and documented for every patient with an indwelling vascular access device:21225

Vascular Access Device (VAD) Rationale. A clear, jargon-free explanation of why a specific device (e.g., peripheral IV, PICC, port) was selected, what it is used for, where it is located in the body, and the expected duration of therapy.3

Maintenance and Protection. Instructions on how to protect the vascular access site during activities of daily living, including bathing or showering (e.g., covering the site with waterproof protection), dressing, sleeping, and physical activity.26 Patients shall be instructed to avoid submerging the access site in water.26

Signs and Symptoms of Complications. Patients and caregivers must be educated to recognize and immediately report the following:116

  • Pain, swelling, redness, or warmth at or near the insertion site.
  • Leaking of fluid or blood from the site or from the device.
  • Fever, chills, or rigors (potential signs of systemic infection).
  • Changes in heart rate, shortness of breath, or chest pain (potential signs of catheter malposition, air embolism, or thrombosis).
  • Numbness, tingling, or color changes in the extremity.
  • Displacement or visible migration of the catheter.
  • Cracking, leaking, or damage to any external portion of the catheter.

Medication-Specific Information. For patients receiving infusion therapy in home or outpatient settings, education shall include: the name and purpose of each medication being infused, potential side effects and expected therapeutic effects, what to do in the event of an adverse reaction (including when to seek emergency care versus when to contact the home health agency), storage requirements for medications and supplies, and proper disposal of sharps and biohazardous waste.272829

Emergency Actions. Patients and caregivers shall be instructed on: how to clamp the catheter in the event of damage or disconnection, how to apply direct pressure in the event of bleeding or dislodgment, when and how to contact the vascular access team, home health agency, or emergency services, and the location of emergency supplies provided at discharge (if applicable).3026

4.2.3 Educational Format and Modality. The organization shall maintain a library of evidence-based patient education materials in multiple formats to accommodate diverse learning preferences and literacy levels.313233 Available modalities should include: written materials at appropriate reading levels, illustrated guides, procedure-specific instructional videos, and tablet- or application-based interactive tools.32343035 Multimedia-based education has demonstrated advantages over print-only materials in promoting comprehension, retention, and patient satisfaction.3631323435 Augmented and virtual reality modalities represent emerging approaches with growing evidence of effectiveness in patient education contexts.373839

4.3 Verification of Learning

4.3.1 Teach-Back Method. Following each educational session, the clinician shall verify the patient’s (or caregiver’s) understanding using the teach-back method: asking the patient to explain the key concepts in their own words.789 Teach-back is not a test; it is a technique to confirm that the clinician communicated effectively.710 If the patient is unable to accurately explain a concept, the clinician shall re-teach using a different approach and re-assess.710 Teach-back has been associated with reduced hospitalization risk among patients with complex home care needs.8

4.3.2 Return Demonstration. For patients and caregivers who will be performing self-management tasks (e.g., home infusion patients managing their own dressing changes, flushing, or pump operation), the clinician shall require and observe a return demonstration of each critical skill before the patient is authorized to perform the task independently.4026 Return demonstration shall be assessed using a standardized checklist and shall include, at minimum: hand hygiene technique, aseptic technique during dressing or tubing changes, catheter flushing and locking procedure, infusion pump operation and common alarm troubleshooting, and emergency clamping of the catheter.26

4.3.3 Documentation of Education and Verification. The health record shall document: the date and time of each educational encounter, the topics covered, the method(s) used (verbal, written materials, video, demonstration), the patient’s or caregiver’s response and demonstrated understanding (teach-back results), return demonstration results (pass/needs re-instruction), identified barriers to learning and the strategies employed to address them, and the plan for follow-up education if needed.411225 Systematic documentation of patient education is essential to continuity of care and to quality monitoring of educational outcomes.4125

4.4 Special Populations

4.4.1 Pediatric Patients. Education shall be provided to both the parent/guardian and the child at a developmentally appropriate level.4243 School-aged children and adolescents shall be engaged in age-appropriate education about their device and should be able to verbalize basic safety information (e.g., “tell an adult if my arm hurts or looks red”).4216 Interactive, tablet-based educational tools have demonstrated particular effectiveness in the pediatric population.43 Caregivers of pediatric patients with central venous catheters benefit from structured, skill-focused education that addresses the specific challenges of home catheter management.16

4.4.2 Geriatric Patients. Education delivery shall account for potential sensory deficits (visual, auditory), cognitive changes, and manual dexterity limitations.4445 When the patient’s cognitive or physical status prevents them from managing the device independently, a designated caregiver shall be identified, educated, and documented as the responsible party.44 Systematic educational interventions for older adults with cancer or chronic conditions receiving vascular access-dependent therapies have demonstrated meaningful improvements in self-management and treatment adherence.4515

4.4.3 Patients with Limited English Proficiency. Qualified interpreter services (in-person or via telephone/video) shall be used for all educational encounters when the patient’s preferred language differs from the clinician’s.613 Translated written materials shall be provided. Family members or untrained staff shall not be used as interpreters for clinical education.6

4.4.4 Patients Receiving Hazardous Drug Therapy. Patients receiving chemotherapy, immunotherapy, or other hazardous drugs via vascular access devices shall receive specialized education from oncology-trained staff regarding the properties of their therapy, the heightened importance of site assessment and complication recognition, and the procedures for reporting concerns.272829

5. Compliance

5.1 Monitoring. Compliance shall be monitored through quarterly audits of patient education documentation completeness (topics covered, method, teach-back results, return demonstration results),4125 patient satisfaction surveys with questions specifically addressing the quality of vascular access education received, tracking of home care readmissions or complications attributable to patient/caregiver knowledge deficits, and direct observation of clinician educational interactions during rounding.4146

5.2 Key Performance Indicators.

  • Patient education documentation completion rate for patients with indwelling VADs (target: 100%).25
  • Teach-back documentation rate (target: ≥95%).79
  • Return demonstration completion rate for home infusion patients prior to discharge (target: 100%).4026
  • Patient satisfaction with vascular access education (target: ≥90% favorable response).3
  • Post-discharge complication rate attributable to patient/caregiver knowledge deficit (target: year-over-year reduction).15

5.3 Enforcement. Failure to provide and document required patient education shall be addressed through individual coaching and, if recurrent, through the progressive corrective action process. Discharge of a home infusion patient without documented return demonstration and teach-back is a serious policy violation that shall be escalated immediately to the unit manager and the VAGC.19

6. Exceptions

6.1 Education may be deferred in the following limited circumstances: the patient is sedated, unconscious, or in acute medical crisis. In these cases, education shall be provided to the designated caregiver (if available) and shall be delivered to the patient at the earliest clinically appropriate opportunity. The deferral and rationale shall be documented.12

6.2 For emergent vascular access insertions, pre-procedure education may be abbreviated, but post-procedure education covering all required content shall be completed within twenty-four (24) hours.12

  • SOP-VA-090: Patient and Caregiver Education for Vascular Access Devices Procedure
  • SOP-VA-091: Teach-Back and Return Demonstration Documentation Procedure
  • SOP-VA-092: Home Infusion Discharge Education Checklist
  • POL-001: Foundations of Clinical Practice and Specialized Population Management
  • POL-003: Evidence-Based Selection and Clinical Monitoring Standards
  • POL-011: Informed Consent for Vascular Access Procedures
  • Patient Education Materials Library (by device type and language)
  • Home Infusion Return Demonstration Checklist (FORM-VA-RETDEMO-001)
  • Organizational Health Literacy Policy
  • Organizational Interpreter Services Policy
  • Joint Commission Patient Education Standards (PC.02.03.01)
  • CMS Conditions of Participation: Patient Rights and Education

References

8. Revision History

VersionDateAuthor(s)Description of Change
1.02026-02-01D. Woo, M. Stern, I.M. WrightInitial policy creation and approval
1.12026-02-23D. Woo, M. Stern, I.M. WrightAdded comprehensive academic references
———Scheduled review date: 2027-02-01

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