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International Accreditation of Healthcare Facilities

Ambulatory Clinic Standards · Standard 10

Longevity & IV Therapy

ASF-AMB-STD3-v3.0  ·  Published  ·  12 September 2026  ·  287 pages  ·  27 chapters

STANDARD 10

Longevity & IV Therapy

OPTIONAL ENDORSEMENT

Requires Standards 1–7 verified first

4 criteria

  Standard 10.1 NON-NEGOTIABLE · Standard 10: Longevity & IV Therapy
IV Line Insertion and Site Care Follow Recognised Infusion Standards
ASSESSMENT
ASF-AMB-STD10-v3.0
CR N/A TR FULL SM FULL ST FULL
10.1
NON-NEGOTIABLE
L1
THE STANDARD
IV Line Insertion and Site Care Follow Recognised Infusion Standards
IV line insertion, site selection, and ongoing site care follow a recognised, evidence-based infusion therapy standard — aseptic technique, appropriate site selection, and defined site monitoring — not informal practice varying by whoever happens to be inserting the line.
CLINIC SELF-ASSESSMENT Tick YES, PARTIAL, or NO for each question.
1 Does IV insertion follow a recognised aseptic technique standard, applied consistently by every staff member who inserts lines?
A recognised standard, applied consistently — not technique that varies by individual.
Doc: IV insertion protocol document
YES PARTIAL NO
2 Is the insertion site selected and assessed against defined criteria, not simply whichever vein is easiest to access?
Site selection based on vessel health and treatment need, not convenience alone.
Doc: N/A — tested directly
YES PARTIAL NO
3 Is the IV site monitored on a defined schedule for signs of complication, with a specific response if found?
A defined monitoring schedule and response, not informal checking.
Doc: Site monitoring record
YES PARTIAL NO

ALL YES Standard likely met. ANY PARTIAL Improvement plan required. ANY NO Blocks accreditation until resolved.

WHAT THE ASSESSOR DOES ON SITE no surprises, no hidden checks
OBSERVE
Insertion technique observation
Observes an actual IV insertion for aseptic technique and site selection practice.
DOCUMENT
Monitoring schedule review
Reviews the defined site monitoring schedule and recent monitoring records.
ASK
Complication response interview
Asks staff what happens when site monitoring identifies a possible complication.

REFERENCES

  1. [53] Gorski LA, Hadaway L, Hagle ME, Broadhurst D, Clare S, Kleidon T, et al. Infusion Therapy Standards of Practice, 8th Edition. J Infus Nurs. 2021;44(suppl 1):S1-S224.
  Standard 10.1 · Standard 10: Longevity & IV Therapy
Guidance & Learning
GUIDANCE
ASF-AMB-STD10-v3.0
WHY THIS STANDARD EXISTS

Peripheral IV access is one of the most common invasive procedures performed anywhere in healthcare, and despite how routine it feels, it carries a real, well-documented failure and complication rate — infection, phlebitis, infiltration — that a consistent, evidence-based technique measurably reduces.

The evidence: [53] Gorski LA, Hadaway L, Hagle ME, Broadhurst D, Clare S, Kleidon T, et al. Infusion Therapy Standards of Practice, 8th Edition. J Infus Nurs. 2021;44(suppl 1):S1-S224.
WHAT GOOD LOOKS LIKE
✓ Insertion technique is consistent and follows a recognised standard.
✓ Site selection is based on defined criteria, not convenience alone.
✓ Site monitoring happens on a defined schedule with a real response process.
WHAT FAILURE LOOKS LIKE
✗ Insertion technique varies significantly by individual staff member.
✗ Site selection has no defined criteria beyond ease of access.
✗ No defined monitoring schedule exists, or findings don't trigger any response.
MOST COMMON REASONS CLINICS SCORE PARTIAL

1 Technique is consistent for straightforward insertions but varies more for difficult access cases.

Difficult access is exactly where technique consistency matters most for reducing complications.

2 Monitoring happens but isn't documented, relying on staff memory.

Undocumented monitoring is difficult to distinguish from monitoring that didn't happen.

3 A response process exists for infection signs but not for infiltration or phlebitis specifically.

Each complication type has a real, distinct pattern staff should be watching for and responding to.

HOW TO IMPLEMENT IF YOU ARE STARTING FROM ZERO

Week 1 Review current insertion and site care practice against the recognised standard.

Week 2 Standardise technique and site selection criteria across all staff who insert lines.

Week 3 Establish a defined, documented site monitoring schedule.

Ongoing Audit monitoring documentation and technique consistency periodically.

FOR SURVEYORS — WHAT IS NOT OBVIOUS

Observe an actual insertion if timing allows, not just a description of policy.

Real practice sometimes diverges meaningfully from stated policy.

Ask about a specific difficult-access case and how it was handled.

This reveals whether the standard genuinely holds under real, harder conditions.

E-LEARNING academy.gmj.ge/amb-std10-1-iv-line-care — 30 min · complete before self-assessment
  Standard 10.2 NON-NEGOTIABLE · Standard 10: Longevity & IV Therapy
Hormone and Peptide Products Are Sourced From Licensed, Regulated Suppliers Only
ASSESSMENT
ASF-AMB-STD10-v3.0
CR N/A TR FULL SM FULL ST FULL
10.2
NON-NEGOTIABLE
L1
THE STANDARD
Hormone and Peptide Products Are Sourced From Licensed, Regulated Suppliers Only
Every hormone, peptide, or compounded product used is sourced exclusively from a licensed, regulated compounding or manufacturing facility recognized by the relevant national medicines regulatory authority — never from research-use-only vendors, overseas suppliers, or any source without verifiable regulatory standing, regardless of cost or convenience.
CLINIC SELF-ASSESSMENT Tick YES, PARTIAL, or NO for each question.
1 Is every hormone or peptide product sourced from a licensed, regulated compounding or manufacturing facility, verifiable by name?
A specific, named, licensed source — not "we have a supplier."
Doc: Supplier licensing verification
YES PARTIAL NO
2 Are research-use-only or overseas-sourced products genuinely excluded, not used under a different label?
Genuine exclusion, not the same product relabelled or described differently.
Doc: N/A — tested directly
YES PARTIAL NO
3 Does documentation retain certificates of analysis or equivalent verification for products used?
Real, retained verification, not assumed from the supplier's reputation alone.
Doc: Certificate of analysis records
YES PARTIAL NO

ALL YES Standard likely met. ANY PARTIAL Improvement plan required. ANY NO Blocks accreditation until resolved.

WHAT THE ASSESSOR DOES ON SITE no surprises, no hidden checks
DOCUMENT
Supplier licensing verification
Reviews documentation confirming every supplier's specific, current regulatory licensing status.
DOCUMENT
Certificate of analysis review
Reviews retained certificates of analysis or equivalent verification records.
ASK
Sourcing awareness interview
Asks staff to name the specific licensed source for a product currently in use.

REFERENCES

  1. [54] Unregulated peptide and hormone sourcing, including research-use-only vendors and overseas suppliers, is documented to carry real risks of incorrect product identity, contamination, and dosing error, with licensed, regulated compounding and manufacturing facilities recognized by the relevant national medicines regulatory authority representing the only verifiable, regulated sourcing channel.
  Standard 10.2 · Standard 10: Longevity & IV Therapy
Guidance & Learning
GUIDANCE
ASF-AMB-STD10-v3.0
WHY THIS STANDARD EXISTS

Products sourced outside licensed, regulated channels carry no verified purity, sterility, or dosing accuracy — documented cases include incorrect peptide identity, bacterial contamination, and mislabelled compounds, and "research use only" labelling does not provide any real protection when a product is actually used clinically.

The evidence: [54] Unregulated peptide and hormone sourcing, including research-use-only vendors and overseas suppliers, is documented to carry real risks of incorrect product identity, contamination, and dosing error, with licensed, regulated compounding and manufacturing facilities recognized by the relevant national medicines regulatory authority representing the only verifiable, regulated sourcing channel.
WHAT GOOD LOOKS LIKE
✓ Every product is sourced from a specifically named, licensed, verifiable supplier.
✓ Research-use-only and overseas sourcing are genuinely excluded.
✓ Certificates of analysis are retained and available for review.
WHAT FAILURE LOOKS LIKE
✗ Sourcing cannot be verified, or "we have a supplier" is the only answer given.
✗ Research-use-only products are used under a different clinical framing.
✗ No certificates of analysis or equivalent verification exist.
MOST COMMON REASONS CLINICS SCORE PARTIAL

1 Primary hormone products are properly sourced, but a newer peptide offering was added without the same verification.

Sourcing verification needs to apply to every product offered, not only the established ones.

2 A licensed source is used but certificates of analysis aren't consistently retained.

A legitimate source doesn't eliminate the value of retaining the actual verification documentation.

3 Staff know the practice sources responsibly in general but can't name the specific supplier.

General confidence isn't the same as specific, checkable knowledge.

HOW TO IMPLEMENT IF YOU ARE STARTING FROM ZERO

Week 1 Audit every hormone and peptide product currently offered against supplier licensing status.

Week 2 Discontinue or replace any product without a verifiable, licensed source.

Week 3 Establish retained certificate-of-analysis documentation for all products.

Ongoing Verify supplier licensing status periodically, not only at first sourcing.

FOR SURVEYORS — WHAT IS NOT OBVIOUS

Ask staff to name the specific supplier for a product currently in use, not describe sourcing generally.

Specificity is the real test of whether sourcing is genuinely verified versus assumed.

Ask directly whether any product offered is sourced as "research use only."

A direct, specific question often surfaces what a general policy question won't.

E-LEARNING academy.gmj.ge/amb-std10-2-product-sourcing — 30 min · complete before self-assessment
  Standard 10.3 NON-NEGOTIABLE · Standard 10: Longevity & IV Therapy
Physician Oversight of Hormone and Peptide Protocols Is Genuine, Not Nominal
ASSESSMENT
ASF-AMB-STD10-v3.0
CR N/A TR FULL SM FULL ST FULL
10.3
NON-NEGOTIABLE
L1
THE STANDARD
Physician Oversight of Hormone and Peptide Protocols Is Genuine, Not Nominal
A licensed physician genuinely evaluates and prescribes each patient's specific hormone or peptide protocol, based on that patient's actual results and history — not a standardised protocol applied uniformly with a physician's name attached after the fact.
CLINIC SELF-ASSESSMENT Tick YES, PARTIAL, or NO for each question.
1 Does a licensed physician genuinely evaluate each patient individually before prescribing a hormone or peptide protocol?
A real, individual clinical evaluation, not a standard protocol applied to everyone.
Doc: Individual evaluation record
YES PARTIAL NO
2 Is the protocol adjusted based on this specific patient's actual monitoring results, not applied uniformly regardless of results?
Genuine responsiveness to this patient's data.
Doc: Protocol adjustment record
YES PARTIAL NO
3 Can the physician describe their specific reasoning for a particular patient's protocol?
Real, individual clinical reasoning, not a general description of the standard approach.
Doc: N/A — tested directly
YES PARTIAL NO

ALL YES Standard likely met. ANY PARTIAL Improvement plan required. ANY NO Blocks accreditation until resolved.

WHAT THE ASSESSOR DOES ON SITE no surprises, no hidden checks
DOCUMENT
Individual evaluation review
Reviews records for evidence of genuine, individual patient evaluation before prescribing.
DOCUMENT
Protocol adjustment review
Reviews whether protocols are adjusted based on individual patient monitoring results.
ASK
Physician reasoning interview
Asks the physician to describe their specific reasoning for a particular patient's protocol.

REFERENCES

  1. [55] Physician-supervised prescribing, based on individual patient evaluation and monitoring rather than standardised protocols, is identified as the defining distinction between legitimate hormone and peptide therapy and unregulated wellness-market practice.
  Standard 10.3 · Standard 10: Longevity & IV Therapy
Guidance & Learning
GUIDANCE
ASF-AMB-STD10-v3.0
WHY THIS STANDARD EXISTS

A physician's name on a protocol means little if the actual prescribing decision was never genuinely made by that physician for this specific patient — real oversight requires a real, individualised clinical decision, not administrative sign-off on a template.

The evidence: [55] Physician-supervised prescribing, based on individual patient evaluation and monitoring rather than standardised protocols, is identified as the defining distinction between legitimate hormone and peptide therapy and unregulated wellness-market practice.
WHAT GOOD LOOKS LIKE
✓ Physician evaluation is genuinely individual, reflected in real, patient-specific documentation.
✓ Protocols are adjusted based on this patient's own monitoring results.
✓ The physician describes specific, real clinical reasoning for individual cases.
WHAT FAILURE LOOKS LIKE
✗ A standardised protocol is applied to all patients with a physician's name attached.
✗ Protocols never change regardless of individual monitoring results.
✗ The physician cannot describe specific reasoning beyond a general standard approach.
MOST COMMON REASONS CLINICS SCORE PARTIAL

1 Initial evaluation is genuinely individual but follow-up adjustments become more standardised over time.

Ongoing responsiveness to patient data matters as much as the initial evaluation.

2 Monitoring results are collected but don't consistently change the protocol when they should.

Data collected but not acted on doesn't provide the protection genuine oversight is meant to offer.

3 The physician is involved for complex cases but less so for routine ones.

Every patient's protocol deserves the same genuine individual evaluation, regardless of perceived routine-ness.

HOW TO IMPLEMENT IF YOU ARE STARTING FROM ZERO

Week 1 Review a sample of patient protocols for genuine individual evaluation versus standardisation.

Week 2 Establish a consistent process for adjusting protocols based on individual monitoring results.

Week 3 Brief the physician on documenting specific, individual clinical reasoning.

Ongoing Audit protocol individualisation periodically.

FOR SURVEYORS — WHAT IS NOT OBVIOUS

Compare two different patients' protocols and documented reasoning.

Genuinely different content reveals real individualisation; near-identical text reveals a standardised template.

Ask the physician to explain a specific protocol decision in detail.

Real clinical reasoning is specific and detailed; a formality reveals itself in vague or general answers.

E-LEARNING academy.gmj.ge/amb-std10-3-physician-oversight — 30 min · complete before self-assessment
  Standard 10.4 CORE · Standard 10: Longevity & IV Therapy
Baseline Screening Happens Before Any Protocol Begins, Not After
ASSESSMENT
ASF-AMB-STD10-v3.0
CR N/A TR FULL SM FULL ST FULL
10.4
CORE
L1
THE STANDARD
Baseline Screening Happens Before Any Protocol Begins, Not After
Every patient undergoes genuine baseline laboratory and clinical screening before a hormone or peptide protocol begins, with monitoring continuing at defined intervals — not a protocol started based on symptoms alone, with testing added only if a problem later emerges.
CLINIC SELF-ASSESSMENT Tick YES, PARTIAL, or NO for each question.
1 Does every patient undergo genuine baseline screening before any protocol begins, not after starting?
Testing before the first dose, not added only if a concern later arises.
Doc: Baseline screening record
YES PARTIAL NO
2 Is monitoring continued at defined intervals throughout the protocol, not only at baseline?
A specific, followed monitoring schedule, not a one-time check.
Doc: Ongoing monitoring schedule
YES PARTIAL NO
3 Are monitoring results actually reviewed and acted on, not just filed?
Genuine review that can change the protocol, not passive data collection.
Doc: N/A — tested directly
YES PARTIAL NO

ALL YES Standard likely met. ANY PARTIAL Improvement plan required. ANY NO Requires improvement plan.

WHAT THE ASSESSOR DOES ON SITE no surprises, no hidden checks
DOCUMENT
Baseline screening review
Reviews patient records for genuine baseline screening completed before protocol start.
DOCUMENT
Ongoing monitoring schedule review
Reviews the defined monitoring interval and adherence to it.
ASK
Result review interview
Asks staff for a real example where a monitoring result changed a protocol decision.

REFERENCES

  1. [56] Baseline laboratory assessment followed by monitoring at defined intervals — for growth hormone secretagogues, typically IGF-1 at baseline, six weeks, and every three to six months thereafter — is identified as a standard safety practice distinct from symptom-triggered testing alone.
  Standard 10.4 · Standard 10: Longevity & IV Therapy
Guidance & Learning
GUIDANCE
ASF-AMB-STD10-v3.0
WHY THIS STANDARD EXISTS

Starting a hormone or peptide protocol without a genuine baseline means there's no way to know what actually changed, for better or worse, and no way to catch an emerging problem before it becomes serious — monitoring only after symptoms appear is monitoring too late.

The evidence: [56] Baseline laboratory assessment followed by monitoring at defined intervals — for growth hormone secretagogues, typically IGF-1 at baseline, six weeks, and every three to six months thereafter — is identified as a standard safety practice distinct from symptom-triggered testing alone.
WHAT GOOD LOOKS LIKE
✓ Baseline screening is genuinely completed before every protocol begins.
✓ Monitoring continues at defined, followed intervals throughout.
✓ A real example exists of monitoring results changing a protocol decision.
WHAT FAILURE LOOKS LIKE
✗ Protocols begin based on symptoms or patient request, without baseline screening.
✗ No defined ongoing monitoring schedule exists beyond the initial visit.
✗ Monitoring results are collected but never lead to any protocol change.
MOST COMMON REASONS CLINICS SCORE PARTIAL

1 Baseline screening happens but the specific panel doesn't match what the protocol actually requires.

Generic baseline testing may miss the specific markers relevant to this particular protocol.

2 Monitoring intervals are followed initially but lapse as treatment continues.

Ongoing risk doesn't diminish just because a protocol has been running without incident so far.

3 Results are reviewed by staff but not consistently by the prescribing physician.

Genuine clinical review requires the person with prescribing authority to actually see and act on the data.

HOW TO IMPLEMENT IF YOU ARE STARTING FROM ZERO

Week 1 Review current screening practice against genuine pre-protocol baseline testing.

Week 2 Establish the specific baseline panel appropriate to each protocol offered.

Week 3 Establish a defined ongoing monitoring interval and physician review process.

Ongoing Audit monitoring adherence and evidence of results genuinely influencing protocol decisions.

FOR SURVEYORS — WHAT IS NOT OBVIOUS

Ask for a real example where a monitoring result changed what was done.

A real example reveals whether monitoring is genuine practice or a formality.

Check whether monitoring intervals are still being followed for patients further along in treatment.

This is where monitoring discipline most commonly erodes over time.

E-LEARNING academy.gmj.ge/amb-std10-4-baseline-screening — 30 min · complete before self-assessment

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