Cannula Site Observation

Insertion of a Peripheral venous cannula

1. In adults, upper extremity insertion sites are preferable than lower extremity.

2. Hands should be washed with soap and water before and after insertion and between procedures.

3. Use a new pair of disposable clean gloves.

4. Selected insertion sites must be disinfected with 70% alcohol and allowed to dry.

5. After insertion, cannula must be secured, to stabilize it at the insertion site and covered with a sterile dressing.

6. The date of insertion must be recorded on the BHT and if possible on the dressing.

7. Cannula sites must be inspected daily for evidence of infection and recited at the first site of inflammation.

8. Gauze dressing should be changed in 48 – 72 hours or when damp, loosened or visibly soiled.

9. Flushing or irrigation of the system is preferably avoided.

10. The IV system must be maintained as a closed system. All entries should be at the injection ports.

Wipe port with 70% alcohol before and after use. All entry ports should be kept closed when not in use.

11. IV administration sets should be changed every 48 – 72 hours.

12. IV administration sets used for parenteral nutrition and administration of blood, blood products or lipids must be changed within 24 hours.

13. Peripheral cannulae are usually kept for no longer than 72 hours. If used for longer periods, they should be replaced every 48 – 72 hours in adults. However in children the cannula can be left in situ until IV therapy is completed or a complication occurs.

14. IV cannula should be removed as soon as possible and a sterile dressing should be applied.

As a part of development of quality and safety in Infection control, Cannula site observation chart to be maintained by nursing staff, for all patients who have a cannula in situ. This is in keeping with the international guidelines in maintenance of IV lines.

1. Cannula site observation form to be filled with the patients BHT by the Nursing Officer.

2. Nursing Officer in Charge of each ward/unit will be responsible for the implementation of this form.

3. SGNOO are requested to supervise the implementation of this important surveillance activity.

4. Medical staff need to ensure close observation of cannula sites in the daily rounds to detect and prevent cannula site infections.

5. Public Health Section of the planning and development unit will be tasked with the auditing the forms under the guidance of the Consultant Microbiologist.

Cannula site observation form and the internal circular regarding this- NIMH/PDU/PH/Gen/IC-01 dated 06.09.2016