Name: ___________________________
Columbus State Community College
Nursing Department
Critical Item ChecklistINITIATING INTRAVENOUS THERAPY
_____1. Wash hands, gather equipment, and explain procedure. _____2. Select distal site of vein to be used. _____3. Select appropriate IV needle or over the needle catheter. _____4. If possible place extremity in a dependent position (use appropriate measures to dilate vein). _____5. *Place tourniquet 5 to 6 inches (2 to 4 in children) above chosen insertion site. Venous obstruction should occur not arterial.
Check distal pulse._____6. Apply disposable gloves. _____7. * Cleanse insertion site with Alcohol (X 3) using a circular motion. Allow site to dry for 30 seconds. Avoid touching insertion site. _____8. *Perform venipuncture: Butterfly: Hold needle at a 20 to 30 degree angle, bevel up. Pierce the skin distal or parallel to the vein, then the vein. ONC: Insert bevel up at a 20 to 30 degree angle to skin directly into the vein or slightly distal then piercing the vein. _____9. Assess for blood return, and then pull stylet back slightly. _____10. * Advance the catheter off the stylet into the vein until the hub rests at the venipuncture site. Never reinsert stylet. _____11. * Stabilizing the catheter/needle with one hand, release the tourniquet with the other. If using an ONC remove the stylet. Quickly connect the distal end of the IV administration tubing or saline well. _____12. * Release roller clamp to adjust infusion rate of fluid or flush fluid filled lock if not beginning fluid. _____13. * Secure IV with appropriate taping and dressing. (Do not tape over site.) May use povidone-iodine ointment at the insertion site. _____14. Date and time dressing. _____15. Clean up supplies, wash hands. _____16. Chart procedure.
S __________ U __________ Faculty Signature ________________________ Referral ________________________________
