INITIATING IV THERAPY Verify physician’s order. Provide privacy. Hi, my name is Jennifer. I am going to be your nurse today. Can you tell me your name and DOB? (Check ID bracelet). The Dr. has ordered an IV for you. Are you allergic to tape, iodine, or latex? Assist patient to comfortable sitting position or supine position. Perform hand hygiene. Organize equipment on clean over bed table. Open sterile packages using sterile aseptic technique. Prepare IV tubing and solution. Prime IV tubing with IV solution. Replace protector cap on end of infusion tubing. Apply clean gloves. Identify accessible vein for placement of IV cannula. Apply tourniquet on arm for initial vein selection. Palpate the vein. Release the tourniquet temporarily and carefully. Place adapter end of infusion tubing/injection cap for saline lock nearby. Cleanse site with alcohol, chlorhexidine, or povidone-iodine and allow to dry. (Side to side, Forward and Backward, Around in a circle) Refrain from touching the cleansed site unless using sterile technique. Reapply tourniquet 10 – 15 cm above anticipated insertion site. Check presence of distal pulse. OK. You are going to feel a sharp quick stick. Puncture skin with catheter at 10 – 30 degree angle with bevel up. Hold skin taunt. Advance catheter into the vein until hub is at the insertion site. Observe for blood return in flashback chamber of catheter. Stabilize cannula with one hand, and release the tourniquet with other. Retract stylet by pushing safety tab.
Quickly connect end of saline lock, or infusion tubing to the cannula. Flush injection cap. Secure the cannula. Observe site for swelling. Apply sterile dressing over the site. Do not apply tape on top of transparent dressing. Loop tubing alongside the arm, and place a second piece of tape directly over the tubing and secure. For IV fluid administration, recheck flow rate. Label IV: write date, time, and nurse initials on the dressing. Dispose of stylet in sharps container. Instruct client how to turn or move without dislodging IV catheter. If you are going to get up, either call for help or make sure you don’t get the tubing caught in the side rail. Then, you can wheel the pump with you to move around the room or go to the restroom. Do you have any questions? Record and report IV insertion and information about infusion and insertion site. Document: 04/14/2015, 1635, #22-gauge IV catheter inserted into left cephalic vein (1 attempt) with sterile occlusive dressing applied. IV D5LR infusing at 100 mL/hr per infusion pump without redness or edema at the site. Tolerated well without complications.