Insertion of IV
Equipment:
- Catheter needle
- IV start kit
- Alcohol swabs
- Tegaderm
- Tape
- IV catheter extension
- Normal saline flush
- Gloves
- Review patient’s EHR for accuracy of health care provider’s order.
- WIIAPA:
-
- Wash hands
- Introduce self
- Identify patient (use 2 identifiers)
- Allergies – don’t forget food allergies
- Plan of care
- Assess patient
- Perform hand hygiene. Select appropriate catheter size based on assessment; open sterile packaging using sterile aseptic technique.
- Prime IV catheter extension with normal saline flush, leave syringe attached to extension, and maintain extension sterility.
- 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).
- Release tourniquet.
- Perform hand hygiene and apply clean gloves.
- Clean site with alcohol swab in concentric circle, moving from insertion site outward with swab.
- Reapply tourniquet.
- Perform venipuncture.
- Stabilize vein approximately 4-5 cm below insertion site.
- Insert catheter bevel-up at 10- to 30-degree angle into vein.
- Observe for blood return. Once blood return is present, advance IV catheter off needle and into arm all the way to the hub.
- Release tourniquet while stabilizing catheter by applying gentle but firm pressure with non-dominant hand approximately 3 cm above site.
- Connect the end of the extension set to IV catheter.
- Aspirate air, assess for blood return, and flush catheter.
- Apply Tegaderm and tape to hold IV catheter in place.
- Label with initials, date and time of IV insertion, catheter size and length.
- Dispose of IV trash and teach patient how to safely move without removing catheter.
- Perform hand hygiene.
- Document.
Reference: Perry, A. G., Potter, P. A., Ostendorf, W., & Laplante, N. (2022). Clinical Nursing Skills & Techniques (10th ed., pp. 853-865). Elsevier.