Expert Nursing Consensus on Prevention of Intravenous Therapy Complications in Indian Corporate Hospitals

Background and Aims: Intravenous (IV) therapy is among the most frequently performed clinical procedures in hospital practice. Despite its routine nature, IV therapy is associated with preventable complications such as blood leakage during cannulation, needle-stick injury (NSI), chemotherapy extravasation and peripheral venous catheter-related bloodstream infection (PVC-BSI). Methods: A modified Delphi consensus process was conducted through two expert meetings held in September and October 2025 involving nursing leaders and experts in infection control, clinical education and healthcare quality from tertiary healthcare institutions across India. A targeted narrative literature review (2010–2025) was performed using PubMed, Scopus and Google Scholar, along with relevant national and international guidelines, to identify evidence gaps and define thematic domains. Twenty-eight draft consensus statements across four domains—blood leakage, NSI, chemotherapy extravasation and PVC-BSI—were developed and evaluated through anonymous Delphi voting using a 5-point Likert scale. Consensus was predefined as ≥90% agreement, with iterative revision and re-evaluation of non-consensus statements through controlled feedback and subsequent rounds. Results: A total of 28 consensus statements across four thematic domains—blood spillage during IV cannulation, NSI, chemotherapy extravasation and PVC-BSI—were evaluated through the modified Delphi process. Most statements achieved strong consensus, with agreement levels ranging from 90% to 100%. Key recommendations emphasised the need for standardised operational definitions, structured competency-based training, adoption of safety-engineered devices, strengthened infection prevention practices, routine root cause analysis (RCA) and corrective and preventive action (CAPA) processes and incorporation of IV therapy-related safety events into institutional quality indicators and surveillance systems. The consensus also highlighted blood spillage during cannulation as an under-recognised IV therapy-associated safety event with important occupational, clinical and operational implications. Conclusion: This consensus provides evidence-informed guidance to reduce preventable IV therapy-related complications in Indian corporate hospitals, emphasising nursing leadership, governance and accountability to improve patient safety and infection prevention.