Peripheral access options.

With the dramatic downsizing of acute care facilities and shifting to alternate care settings, infusion therapy is a major aspect of outpatient and home health services. Health care reform has forced health care practitioners to make cost-driven clinical decisions, while at the same time demanding quality outcomes. Technology has advanced our capabilities to provide infusion therapies in all settings. Controversial questions are asked regarding the selection of the appropriate device, catheter tip position, tip position verification, and care and management techniques, which only well-designed research protocols can answer. In the meantime, clinical decisions must be based on current science and physiologic principles, rather than tradition, anecdotal observation, or competitive financial agendas. Peripheral access catheters, if widely used, afford a tremendous opportunity for positive outcomes and cost savings.