1
Perform hand hygiene
2
introduce yourself
3
verify pts name, DOB, allergies
4
review order for IV insertion
5
explain procedure to pt
6
gather supplies
-IV start kit
-VAD (over-the-needle catheter)
-short extension tubing
-5 ml syringe w flush agent
-bandage for stabilizing
-gloves
7
raise the bed to working height
8
don gloves
9
inspect the pt arm for potential venipuncture site.
assess for history of mastectomy, fistula, grafts, trauma, etc
10
place barrier under proposed site
11
open IV start kit
12
maintaining sterility of connectors
attach saline flush to extension tubing and prime tubing
13
apply tourniquet
gently palpate for vein
remove tourniquet
14
cleanse site w/ antiseptic agent
scrub area up and down, then back and forth across area for at least 30 seconds
Allow to dry naturally
15
reapply tourniquet
do not contaminate clean site
16
inspect catheter for possible defects
17
using non dominant hand, pull skin taut below targeted insertion site
being careful to avoid contamination
18
inform pt of immediacy of needle puncture
19
using dominant hand, aseptically insert catheter needle, bevel-side up at 10-15 deg angle
20
determine blood back flow in flashback chamber
21
lower the angle of the needle and advance needle 1/4 inch into vein
DONT move dominant hand until retraction of needle device
22
SLIDE
advance catheter into vein until hub is flush w/ the skin using non dominant hand
23
POP
release tourniquet using non dominant hand
24
PRESS
apply pressure 2 inches above insertion site w/ non dominant hand
25
PUSH
push white button to activate safety needle device using index finger of dominant hand
26
place j-loop into catheter hub but do not screw on
27
grip catheter hub w/ non dominant hand
careful not to contaminate insertion site
screw on j-loop w/ dominant hand
28
dont let go of catheter
use dominant hand to flush 3-5 ml of saline while observing insertion site for swelling
if no swelling, clamp line
29
using dominant hand, apply occlusive dressing making sure to not cover connection hub of j-loop
30
remove syringe from j-loop
31
stabilize catheter and extension tubing further w/ tape
DONT cover insertion site w/ tape
32
place needle in puncture-resistant container
33
dispose of used equipment
34
remove gloves and perform hand hygiene
35
label dressing w/ date, time, initials
36
lower bed and provide call light
37
document procedure
38
Integrate relevant nursing skills safely into the care of adult patients in uncomplicated clinical situations.