Name: ___________________________

Columbus State Community College
Nursing Department
Critical Item Checklist

INITIATING INTRAVENOUS THERAPY USING AN INTERMITTENT INFUSION DEVICE (IID)

_____1.	Wash hands, gather equipment (ONC, IV Start Kit, IID, syringe with 3.0 ml saline flush), explain procedure.
_____2.	Select appropriate venipuncture site.
_____3.	Place tourniquet 5 to 6 inches above site, check for arterial pulse.
_____4.	Apply disposable glove.
_____5.	* Clean insertion site using previously learned technique. (Refer to initiating IV therapy)
_____6.	* Perform venipuncture using previously learned technique. (Refer to initiating IV therapy)
_____7.	* Once you have assessed for flashback, advance the ONC fully into the vein. Remove the stylet and attach the fluid filled IID.  (Flush IID before attaching) Be sure to remove tourniquet.
_____8.	Stabilize ONC; anchor catheter using previously learned technique. * Flush the IID to establish patency. (Draw up 3 cc saline for flush. Be sure to clean saline solution and IID with alcohol)
_____9.	* Secure IV dressing using appropriate technique. Remember do not tape over site. Cover only with a sterile occlusive dressing or a sterile bandaide.
_____10.	Date and initial.
_____11.	Clean up supplies, wash hands.
_____12.	Chart procedure.

 

S __________

U __________

Faculty Signature ________________________

Referral ________________________________