Procedures - IV Therapy Flashcards
Assessment
Perform 5 moments of hand hygiene
Patient assessment
* IV Cannula to check DDPP
- Date of insertion of cannula (within 72 hours)
- Dressing of IV site is clean and intact
- Patency of IV line is checked
- Signs of Phlebitis [POET: Pain, Oedema, Erythema, Temperature and Warmth]
Review doctor’s order in IMR and check for any drug allergy
Calculate IV drip rate based on doctor’s order in IMR
Planning and Preparatory
Perform 5 moments of hand hygiene
Identification – Use 2 patient’s identifier and check ID band against IMR
Explain purpose and indication of administering IV fluid to the patient
Requisites:
* IV Drip set
* IV solution
* Gauze
* Alcohol swabs
* Gloves
* ½ inch micropore tape
* Date change label
Implementation 1
1st and 2nd medication check (PMDTR)
Check IV solution for expiry date, clarity, consistency and any change in colour
Priming IV Drip
Use aseptic non touch technique when handling key parts and key sites
➢ Hand hygiene
➢ Remove metal seal from IV solution bottle without any contamination onto the surface of the rubber stopper.
➢ Disinfect the rubber stopper and then allow it to dry.
➢ Check IV administration set for expiry date and the package is intact before opening
➢ Open the IV administration set without any contamination
➢ Move the roller clamp nearer to the chamber and clamp the roller tight
➢ Remove the protective cap at the proximal end of the administration set (Key part) and spike into the bottle
➢ Check that the roller is clamped. Invert the IV solution bottle and hang it over the drip stand
➢ Press on IV tubing chamber till it is 1/3-filled with the solution
➢ Ensure the distal end of the administration set (key part) cover remains covered with protective cap, to prevent contamination during priming
➢ Place distal end inside the opened IV package or in a clean kidney dish
➢ Release the roller clamp slowly to allow the fluid to fill the tubing without trapping any air in the tubing
➢ Keep distal end at a lower level than the solution bottle to allow priming by gravity
➢ Clamp the roller clamp tight when the fluid has completely filled the tubing
➢ Check visually along the line for any air bubbles
➢ Remove air bubble if presence
Secure the IV tubing to the groove of the roller clamp after priming is completed
Implementation 2
Hand hygiene
Medication check 3
➢ Put on clean glove (based on hospital protocol)
➢ Disinfect the IV connection port with alcohol swab. Scrub the septum and thread of the injection hub for ten times each; using different part of the alcohol swap for septum and thread.
➢ Remove the cover of the IV tubing distal port and connect it to the patient’s IV connection port (key site)
Turn the three-way stopcock to open the line
➢ Remove glove
➢ Hand hygiene
➢ Release the roller clamp slowly and regulate the flow rate according the calculated drop rate
➢ Anchor the tubing to the patient’s hand
➢ Affix label indicating the date changed on the administration set (lower half of the chamber) and the
bottle (date and time).
Documentation and evaluation
Document the following in the patient’s medical records.
* Inpatient Medication Record
* Intake and Output Chart
Evaluation of Fluid Balance and Hemodynamic Status and
Assessment of the IV Site (at least once every shift).
How to calculate drip rate?
Drip rate (drops per min): (Vol in ml/ Time in min)/ Drop factor (how many drops per ml)
