Preventing Material-Induced Drug Loss in Intravenous Therapy: The Selwan Sorption-Safe Evidence-Based Framework for Nurse-Led Infusion Practice

Background: Material-induced drug loss during intravenous (IV) therapy has been documented for over four decades, particularly for hydrophobic and amphiphilic medications administered through plasticized infusion systems. Despite robust experimental and clinical evidence, drug–material sorption remains inconsistently addressed in bedside practice, institutional policy, and procurement decisions, resulting in preventable therapeutic inaccuracy, especially in high-risk populations. Purpose: This study aimed to develop the Selwan Sorption-Safe Framework for IV Drug Delivery, a universal, evidence-based, nurse-led conceptual model designed to systematically identify, predict, and mitigate drug–material sorption in clinical infusion practice. Methods: A conceptual framework design was employed, grounded in structured narrative and integrative evidence synthesis rather than systematic or scoping review methodology. Foundational experimental, mechanistic, molecular modeling, clinical, and policy-oriented studies addressing hydrophobic drug sorption, infusion-material performance, priming strategies, infusion-context modifiers, and DEHP-related safety were purposefully synthesized. Evidence was mapped across four analytical domains: drug-related risk, material-related risk, infusion-context modifiers, and patient vulnerability. Iterative abstraction was used to construct a decision-oriented framework integrating drug–material risk stratification, material performance categorization, and nurse-modifiable mitigation strategies. Results: The synthesis revealed consistent patterns of clinically significant drug loss associated with plasticized polyvinyl chloride (PVC), polyurethane, and silicone infusion components. Sorption effects were amplified by low flow rates, prolonged dwell times, and patient vulnerability. These findings were translated into the Selwan Global Sorption–Material Risk Matrix™ and an accompanying nurse-facing decision logic emphasizing material substitution, optimized priming, line configuration, and transition toward DEHP-free infusion systems. Conclusion: The Selwan Sorption-Safe Framework reframes material-induced drug loss as a predictable, preventable, and nurse-modifiable system risk rather than a technical anomaly. By integrating drug chemistry, material science, infusion engineering, patient vulnerability, and institutional policy into a unified conceptual model, the framework provides a robust foundation for improving infusion accuracy, patient safety, and alignment with green-hospital principles. Future implementation and validation studies are warranted to evaluate its clinical and organizational impact.