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e-Module
Purpose
The purpose of this e-learning module is to
educate the healthcare team on IV insertion and
management
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RN
MD
NP
PA
LPN * Check site and local policy
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Policy
Peripheral IV (PIV) catheters should be
changed to a new site every 96 hours.
The site must be assessed as per protocol
Frequency of monitoring a peripheral
intravenous site is determined by the
prescribed therapy (i.e. chemo, blood, TPN,
medications), the condition and age of the
patient and the practice setting
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Extenuating Circumstances
All PIV catheters should be changed to a new site
every 96 hours (4 days) or as needed
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Policy
All peripheral IVs used intermittently must be
flushed every 12 hours and after each use
with a prefilled 5ml syringe of sterile sodium
chloride 0.9% and clamped.
All IVs are started with an medlock extension
set attached to the catheter.
Medlock
Extension
set
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Site Selection
Carefully examine both arms for most
appropriate vessels
Most commonly used veins for placement of
IV catheters are:
Metacarpal
Cephalic
Basilic
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Lower Extremity
PIV insertion in a lower extremity:
requires a valid order
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Things to Consider
Location of vein
Condition of vein
Purpose and type of infusion
Duration of therapy
Catheter material
Catheter size needed to delivery therapy
Patients age, diagnosis, prior surgeries,
procedures
Patient activity
Patient preference
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Avoid
Do not use veins in affected arm of patients
with:
history of mastectomy
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Avoid
Joint regions
Sclerotic veins
Site near recent complication
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Getting Started
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Date
9/3/10
Time
1230
Order
IV Lock
Signature
Bob Cohen,MD
Contact #
Beeper 1913
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Wash Hands
Standard infection control practices require
the use of aseptic technique.
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Identify Patient
Every Patient - Every Encounter
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Equipment
IV start kit
Angiocatheter
CLAVE Extension Set
Saline IV flush
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Hubguard
Tourniquet
Alcohol prep
Gloves
Dressing
ChloraPrep
Label
2X2 gauze
Tape
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IV Angiocatheter
Open your angiocatheter
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Patients diagnosis
History of IV therapy
Patients activity level
Patients age
Venous status
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Rapid infusions
18 Gauge
Uses:
Surgery
Improved flow rate
for viscous solutions
and blood
transfusions
Rapid infusions
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20 Gauge
Uses:
Most routine infusions
Minor surgical
procedures
Routine outpatient
procedures requiring IV
access
Appropriate for blood
components, when
rapid rates are not
required
22 Gauge
Uses:
Most routine
infusions
Delivery of
antibiotics
Hydration
therapy at slower
rates
Small or fragile
veins
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IV INSERTION VIDEO
Click below to watch a 4 minute video of IV
insertion technique using the angiocatheter
utilized at NSLIJHS.
http://www.bd.com/infusion/products/ivcatheters/autoguard/flash/video.asp
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Remove gloves
Place all other used equipment in regular
garbage.
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Activity restrictions
Notify nurse if any pain, swelling, burning,
redness or discomfort at site, or if any blood
in IV lock or tubing
Avoid any pressure to IV site
Signs and symptoms of complications
What and when to report signs and symptoms to the health care team
Activity and restrictions
How to care for the line
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Date of insertion
Time of insertion (in military time)
Anatomic location of the insertion site
Type and gauge of catheter
Patient tolerance
Patient teaching
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An Untoward Event..
Provide appropriate
intervention
infiltration
Document in progress
notes
Include description of
event
.
multiple attempts
hematoma
infiltration
Vessicant
infiltration
hematoma
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Exceptions:
-PPN tubing every 24 hrs
-Blood and blood products every 4 hours or with each transfusion
-Lipid based medications every 12 hours.
-IV tubing used for intermittent administration of IV fluid and
medications will be changed every 24 hours.
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Attaching an IV infusion
IV fluid bag (per order)
IV tubing
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= # of gtts/min
= 16.6 or
17gtts/min
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IV Solution
Start IV solution and adjust flow rate.
Protect against accidental dumping of IV
fluids (leaving the roll clamp open and
allowing rapid infusion of fluid,
inadvertently).
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Labeling
Write date on IV tubing using a sticker
Write date and time on IV solution using a
sticker.
Include type and amount of solution hung, time
started and flow rate
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References
NSLIJHS System Nursing Policy and Procedure
Committee (2013, June 11). IV insertion
(peripheral) adult. Retrieved from:
https://nslijhp.northshorelij.com/NSLIJ/policies/
Pages/default.aspx
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Post Test
It is required that you take an online post test after
module completion.
Click on this Link to Access:
https://nslijhp.northshorelij.com/nursing/EWD/Pages/Nursing
QuizSystemSYS.aspx?user_facility=system&user_quiz=syste
m-IV-insertion
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