INSERTING I.V. CANNULA 8. Don clean/sterile gloves.

Rationale: Both hand hygiene and clean glove use are strategies to prevent
1. Recheck the written prescription for I.V. therapy and materials needed.
transmission of infections through hand contact. In the context of patient care, it
Rationale: Taking medicine on time, as prescribed, is essential to making sure your
makes sense to think of glove use and hand hygiene as complementary strategies to
body has an effective amount of the drug at all times. If not, this can cause the
prevent transmission of pathogens.
disease to develop a resistance to the medicine or simply prolong the amount of
9. Clean the I.V. site according to hospital policy.
time it takes to feel better.
Rationale: There is a risk that bacteria will travel along the tube and into your
body. Information: IV lines are useful but can cause problems. They can become
2. Explain procedure to reassure the patient and significant others
blocked, leak fluid into the skin and cause infection.
Rationale: The ability to clearly describe procedures to patients is another crucial
skill for the health care professional, since patient understanding is likely to
10. Pierce skin using the appropriate I.V. cannula observing the correct
encourage compliance and, assuming the advice is sound, patient wellbeing.
technique.
Rationale: Apply digital pressure over the catheter tip and remove the needle.
3. Do hand hygiene before and after the procedure.
Attach the giving set or bung.
Rationale: A number of infectious diseases can be spread from one person to
another by contaminated hands. These diseases include gastrointestinal infections,
11. Continue inserting the catheter into the vein once blood backflow is noted.
such as salmonellosis, and respiratory infections, such as influenza, colds and
Rationale: This indicates that the catheter has entered the vein.
coronavirus (COVID-19)
12. Position IV catheter parallel to the skin.
4. Observe the 14 Rs
Rationale: Keeping the hub parallel to the skin minimizes vein trauma during
Rationale: the 14 rights of medication administration help protect both the patient
removal of the device.
and the nurse administrating from a platitude of errors.
12.1 Hold stylet stationary
12.2 Slowly advance the catheter until the hub is 1mm to the puncture
5. Choose the I.V. site.
Site
Rationale: The regular assessment of the insertion site and the surrounding areas
for signs of complications is necessary to prevent IV catheter complications,
13. Slip sterile gauze under the hub
including infiltration, phlebitis, infection, extravasation, or catheter dislodgement.
Rationale: Dressings provide protective function to prevent catheter migration via
stabilizing and protection from microorganisms. If the patient's skin is not intact
6. Apply the tourniquet 5 – 12cm. (2 – 6 inches) above insertion site.
and/or there is allergy, consult agency guidelines for appropriate IV site dressing.
Rationale: By applying a tourniquet, your goal is to restrict blood flow
If gauze is needed under the dressing, change dressing q48 hours.
7. Check the pulse below the tourniquet.
14. Release the tourniquet while applying digital pressure over the I.V. site
Rationale: A tourniquet will enable the veins to fill; however, the nurse should be
Rationale: Pressure from the placement of the tourniquet may cause the client's
aware that it is important not to over-tighten the tourniquet or keep it in place for
delicate vein to blow out upon puncture.
too long. If no radial pulse can be felt, this indicates the tourniquet is too tight.
15. Connect the infusion tubing of the prepared IV fluid aseptically to the IV 22. Discard sharps and waste according to Health Care Waste Management
catheter Rationale: Sharps waste is a subset of infectious waste and comprises syringes,
Rationale: Intravenous fluids are administered through thin, flexible plastic tubing needles, lancets, broken glass and any other materials that can pierce the skin. The
combination of contamination with pathogens and the ability to break through the
called an infusion set or primary infusion tubing/administration set The infusion
skin's protection make them one of the most dangerous wastes produced in
tubing/administration set connects to the bag of IV solution. healthcare.

16. Open the clamp. Regulate the fluid as prescribed by the physician. 23. wash hands thoroughly
Rationale: Used to regulate the speed of, or to stop or start, a gravity infusion. Rationale: hand washing can prevent infection and It stops the spread of
bacteria and viruses
17. Anchor the IV Catheter securely in place with the use of transparent
tape/dressing directly on the puncture site. 24. Document in the patient’s chart and endorse to incoming shift
Rationale: it's clear now that most dressings need additional securement to hold the Rationale: Nursing documentation is essential for good clinical
IV and any attached tubing to the skin. This extra securement of the catheter communication. Appropriate documentation provides an accurate reflection
prevents not just the line falling out of the vein, but also 'micro-movement' of the
of nursing assessments, changes in clinical state, care provided and
pertinent patient information to support the multidisciplinary team to deliver
device within the vein.
great care. Endorsement will enable nurses to supply a range of medicines,
including a full course of certain antibiotics. This means that the endorsed
18. Tape a small loop of IV tubing for additional anchoring. Splint if
nurse may need to order pathology tests and access the results.
necessary.
Rationale: The use of time taping an IV helps ensure that an IV solution is being
infused at the prescribed rate. It also helps facilitate calculation of fluid intake
19. Label the IV catheter according to the following:
Rationale:
19.1 Date and time of insertion
19.2 Type and gauge
19.3 Countersign

20. Label the IV tubing with date and time (to determine when to change)
Rationale: The iv tubing is labeled in order to inform the nurse when the next
dressing change is due.

21. Observe and reassure the patient and report any untoward reactions
Rationale: Reporting adverse drug reactions medical device incidents and other
patient safety incidents. Early, routine reporting of adverse reactions, incidents and
near misses involving medicines and devices can ensure performance and systems
issues are investigated, problems rectified and lessons learned.