According to the Nursing Standards on Intravenous Practice, IV (intravenous) insertion should be done safely in the nursing practice. The ANSAP believes that nurses who practice IV therapy nursing are only those registered nurses who have been adequately trained and completed the training requirements of the IV therapy Program and are certified IV therapy nurse.
In inserting IV(intravenous) line, the most important thing to do first is to check and verify for the physician’s written order and that the patient’s condition, age, vein size, duration of therapy and functional utilization of the hand shall be assessed to make sure the IV access is safe and ideal.
Here are the steps in inserting an IV (Intravenous) line:
- Ensure the physician’s written order for IV access or IV therapy.
- Check and make sure that all needed things are present (sterile/ clean gloves, IV cannula (Gauge size depends on patient’s age and condition), cotton balls with alcohol, dry cotton balls, sterile gauze, waste receptacle and/or sharps container, plaster, splint, tourniquet, and labels).
- Explain well the procedure to the patient and significant others and depending on institution, obtain consent from the patient.
- Observe proper hand hygiene before and after the procedure.
- Assess and choose for IV site, making sure that the working area is well lighted.
- Apply tourniquet to 5 to 12 cm above the injection site.
- Check for radial pulse below the tourniquet.
- Prepare the site with an effective antiseptic solution or with cotton balls with alcohol in circular motion and allow it to dry for 30 seconds (Always wear gloves when doing a venipuncture).
- With an appropriate IV cannula, pierce the skin with the correct technique.
- Upon visualization of back flow, continue inserting the cannula into the vein.
- Position the cannula parallel to the skin; holding the stylet stationary and slowly advance the cannula until the hub is 1mm to the puncture site.
- Carefully slip sterile gauze under the hub. Then release the tourniquet and remove the stylet while applying a digital pressure over the cannula with one finger about 1 to 2 inches from the tip of the inserted cannula.
- Then you may connect the specified infusion tubing or port prescribed by the physician.
- Anchor the cannula firmly with a transparent plaster or tape and a small piece of sterile OS; apply splint if needed.
- Label on the IV tape near the IV site to indicate the date of insertion, type and gauge of cannula and countersign.
- Observe the patient and encourage the patient to verbalize any discomfort. Report any untoward effect.
- Document the procedure in the patient’s chart and endorse thereafter to next shift.
- And lastly, discard sharps and waste properly according to protocol of institution.
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