Insertion of IV


Equipment:


  • Catheter needle
  • IV start kit
  • Alcohol swabs
  • Tegaderm
  • Tape
  • IV catheter extension
  • Normal saline flush
  • Gloves 

  1. Review patient’s EHR for accuracy of health care provider’s order.

  1. WIIAPA:
    1. Wash hands
    2. Introduce self
    3. Identify patient (use 2 identifiers)
    4. Allergies – don’t forget food allergies
    5. Plan of care
    6. Assess patient

  1. Perform hand hygiene. Select appropriate catheter size based on assessment; open sterile packaging using sterile aseptic technique.
  2. Prime IV catheter extension with normal saline flush, leave syringe attached to extension, and maintain extension sterility.
  3. Apply tourniquet 10-15 cm above potential insertion site and select a vein. Check for pulse distal to tourniquet. (Techniques to foster finding veins: apply dry heat and change limb position).
  4. Release tourniquet.
  5. Perform hand hygiene and apply clean gloves.
  6. Clean site with alcohol swab in concentric circle, moving from insertion site outward with swab.
  7. Reapply tourniquet.
  8. Perform venipuncture.
    1. Stabilize vein approximately 4-5 cm below insertion site.
    2. Insert catheter bevel-up at 10- to 30-degree angle into vein.
  9. Observe for blood return. Once blood return is present, advance IV catheter off needle and into arm all the way to the hub.
  10. Release tourniquet while stabilizing catheter by applying gentle but firm pressure with non-dominant hand approximately 3 cm above site.
  11. Connect the end of the extension set to IV catheter.
  12. Aspirate air, assess for blood return, and flush catheter.
  13. Apply Tegaderm and tape to hold IV catheter in place.
  14. Label with initials, date and time of IV insertion, catheter size and length.
  15. Dispose of IV trash and teach patient how to safely move without removing catheter.
  16. Perform hand hygiene.
  17. Document.

Reference: Perry, A. G., Potter, P. A., Ostendorf, W., & Laplante, N. (2022). Clinical Nursing Skills & Techniques (10th ed., pp. 853-865). Elsevier.