Coverage of a new national study of IV hydration clinics left many in the industry reeling earlier this month. NBC News coverage of the study, State Policies and Facility Practices of IV Hydration Spas in the US, published in JAMA, claims, “The IV hydration spa industry operates with virtually no oversight or data backing up its claims,” leaving readers concerned about safety and treatment effectiveness.
The actual study of 255 facilities in every state and in Washington, D.C., demonstrates what anyone in the industry already knows: “state-level policies governing IV hydration spas and facility practices vary widely.”
IV hydration has exploded in the United States since it was first introduced in 2012 as a hangover relief treatment in Las Vegas. Today, it’s popular in every state among everyone from elite athletes to those seeking an extra boost after a bout of flu, a tough workout in the sun or too much partying.
Why the Lack of National Standards Creates Challenges for IV Hydration Clinic Owners
The IV hydration industry has exploded in the last decade, leaving regulators playing catch-up. “The difficulty is that it involves multiple different regulatory agencies from each state, including the Board of Pharmacy, the Board of Medicine, the Board of Nursing and the Department of Health,” says David Light, PT, MBA, COO of American IV Association (AIVA).
Clinic owners and leaders in IV hydration are well aware of the need to establish practice standards and safety protocols. Jenny Haiar, RN, BSN, owner of iv&co, was the first in South Dakota to offer IV hydration over a decade ago. Her clinic hasn’t faced a severe adverse reaction, but she’s had to establish all the training and safety protocols for her staff on her own.
When Haiar first opened her clinic, she ran in circles trying to determine if compounding IV mixes was within her scope as a nurse. In an IV clinic, the pharmacy delivers the vitamins in powdered form or a vial. It’s technically considered compounding for a nurse to draw it out of the vial and inject it into a fluid bag. When Haiar asked the Board of Nursing for guidelines, they recommended she call the Board of Pharmacy. They, in turn, told her to ask the Board of Nursing if compounding is within her scope of practice. “States and the regulatory bodies really don’t know what to do with us, so there’s a lot of self-directed due diligence you have to do to stay informed as things are changing so fast in this industry,” says Haiar.
Haiar serves as the ambassador for the northern region of AIVA.
The Need to Standardize IV Hydration Therapy Practices for Safety and Compliance
Leaders at AIVA know better than anyone about the need to standardize IV hydration practice. “We at AIVA agree with the conclusion of the JAMA article that there are challenges throughout the United States because there are no federal guidelines or oversight. It’s all state-specific, and it varies quite a bit. We feel and are trying to help establish standardization and continuity between the states,” says Light.
The JAMA study found only four state policies addressed governance, prescriber credentials, dispensing practices and compounding practices.
How AIVA Supports Safe and Standardized IV Hydration Therapy
For its part, AIVA has a Scientific Advisory Board composed of leading experts in medical research, clinical practice and healthcare policy, which guides the association through IV therapy’s complexities with a commitment to evidence-based practices and research.
The AIVA website features a position paper to standardize best practices and improve patient safety. The clinical standards include the following:
- All practitioners providing elective IV therapy must be licensed clinical professionals
- Practitioners must operate within their scope of practice
- Practitioners must assess patients’ medical history and health status
- Practitioners must obtain valid informed consent from patients
- Treatments must be administered according to provider orders
- Patients must be monitored closely for signs of adverse symptoms
- Practitioners must maintain comprehensive medical records for each patient
- Practitioners must be equipped to handle medical emergencies
- Providers must adhere to rigorous quality assurance standards
- Practitioners should receive background training and continuing education
IV therapists can get certified through AVIA, demonstrating they’re prepared to practice according to the standards listed above.
While the vast majority of IV hydration therapists operate safely and adverse events are extremely rare, Light doesn’t doubt that the industry will see more standardization in the coming years. “This will continue to vary from state to state because what makes sense in Florida won’t work in Alaska, for example, but having something like accreditation requirements will help to standardize practice safety,” he says.
In the meantime, IV hydration therapy is likely to continue its upward trend in popularity with no plateau in sight.
Frequently Asked Questions
- Is IV hydration therapy regulated by state or federal law? IV hydration therapy is regulated at the state level, not federally. Each state’s Board of Medicine, Nursing, Pharmacy, and Health sets unique rules for licensing, compounding, and administering IV treatments. This lack of national regulation creates variation in clinic standards and oversight across the country.
- Who can legally administer IV hydration therapy? Only licensed healthcare professionals—such as registered nurses, nurse practitioners, or physician associates—can legally provide IV hydration treatments. Practitioners must operate within their scope of practice, assess patient health history, obtain informed consent, and follow provider orders to ensure safety and compliance.
- How can IV hydration clinics maintain safety and compliance? Clinics can maintain safety by following standardized best practices outlined by organizations like the American IV Association (AIVA). This includes requiring licensed staff, monitoring patients during treatment, maintaining accurate medical records, ensuring emergency preparedness, and pursuing AIVA certification to demonstrate compliance with industry standards.
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