When a brisk blood return is not obtained from an implanted vascular access device (IVAD), infusion nurses are faced with difficult questions: Is it safe to use the device? Is starting a peripheral IV always the right answer? Because intermittent patency or occlusion of an IVAD can delay treatments and increase health care costs, infusion nurses are uniquely positioned to impact treatment planning when patency concerns arise. Individualized treatment planning may require deviation from algorithms and consideration of patient-specific factors such as medical history, clinical presentation, living situation, beliefs, and ability to participate in care decisions. In this session, we will critically examine IVAD clinical scenarios and consider potential interventions for suboptimal device patency. Learning Objectives: At the conclusion of this session, participants will be able to: Define patency and the three types of occlusions: complete, partial, and withdrawal. Describe the factors used to assess and individualize a patient's treatment plan when IVAD patency is lacking or intermittent. Identify evidence-based interventions for IVADs presenting without a brisk blood return. Contact Hours: 1 CRNI® RUs: 2