The NIVAS Board responds:

Thank you for the opportunity to respond to the letter from our peers in South Africa outlining objections to the National Infusion and Vascular Access Society (NIVAS) flushing guidance, which was published last year.

It should be noted that the flushing guidance sets out four options for actions to take after an intravenous (IV) infusion has finished. The arguments raised relate to option one only. The document sets out very clear guidance on how to flush IV giving sets and administer the remaining fluid/drug. What the guidance does not do is mandate that all IV infusions must have their giving sets flushed. This was a deliberate action by the board so that hospital trusts could make a decision locally about what practice they need to adopt on an individual basis.

I appreciate that not everyone agrees with the position NIVAS took with this issue, but we considered that it was pragmatic until we could review more evidence. Our focus was to give IV teams in the UK enough information so that they could make a decision as to what their collective practice should be. The flushing of IV giving sets has not been routinely undertaken in general IV therapy for over 20 years in the UK (outside of oncology or paediatrics). Mandating that every IV giving set should be flushed represents a big change in practice.