1. Evaluate the order - Name of solution, Volume, Rate
2. If infusate is to contain medication note - Unabbreviated name of med, Exact dosage, Exact route of med, Frequency of administration
3. Identify patient - Proper patient identification is mandatory. If an inpatient is able to respond, ask for a full name and always check the armband for confirmation. DO NOT DRAW BLOOD IF THE ARMBAND IS MISSING. Additional information may be used. Ask the patient his birthdate using requisition for reference.
4. Assess patient - current status (stable, alert), note allergies to meds, iodine, tape.
5. Hadwashing - (15-20 seconds) before equipment preparation, before insertion, following procedure.
6. Gather equipment and supplies
7. Prepare patient - Explain goal of IV therapy, Allergies (drugs, tape), Assess patient's knowledgebase (War stories), Explain procedure in simple terms, Calm manner, alleviate fears.
8. Apply tourniquet. What arm/hand is dominant? Apply tourniquet tight, but still able to feel radial pulse. 4-6 inches above venipuncture site. Find vein of choice. Remove tourniquet.
9. Skin preparation - Shaving not recommended. Produces microabrasions-increased infection rates.
10. Cleansing - Facility policy: Soap & water, 1% to 2% tincture of iodine (preferred cleansing agent; but make sure p/t not allegeric to iodine, inward to outward, solution to remain with skin for 30 secs), Povidine-iodine (less irritation than other iodine solutions, inward to outward motion, time release effect), 70% alcohol (recommended for p/t allergic to iodine, cleanse in circular motion for 1min., repeat 2x, allow solution to remain with skin for at least 60 secs.)
11. Do not contaminate by touching.
12. Reapply touniquet. Put on gloves, anchor vein by stretching skin 2-3 in. distal to the site. Pulling the skin taut reduces rolling of vessel. Insert infusion device, bevel up, at 10-20 degree angle (depending on vein location).
13. Observe for blood return. Advance cannula. Release tourniquet. (no more than 2 attempts per person should occur)
14. Secure device.
15. Applying dressing. Regulate flow. Recheck every 30 min.
16. Needle disposal system.
16. Documentation - Insertion (type, size, guage), Type, Amount, Additives, Site of venipuncture, Flow rate, Type of controller or gravity, Patient's tolerance of procedure, Reason for discontinuing device, Any unsuccessful attempts, Your name and credentials.