A. STARTING THE PRIMARY INTRAVENOUS INFUSION 1. Verify written prescription and make IV label. 2.

Observe ten (10) Rs when preparing and administering IVF. 3. Explain procedure to reassure patient and/or significant others, secure consent if necessary. 4. Asses patients vein; choose appropriate site, location, size/condition. 5. Do hand hygiene before and after the procedure. 6. Prepare necessary materials for procedure. 7. Check sterility and integrity of IV solution, IV set and other devices; place IV label on IVF bottle. 8. Open IV administration set aseptically following the infection control measures. 9. Open IV administration set aseptically and close the roller clamp and spike the infusate container aseptically. 10 . Fill drip chambers to at least half and prime it with IV fluid aseptically. 11. Expel air bubbles if any and put back the cover to the distal end of the IV set (get ready for insertion). B. INSERTING IV UTILIZING THE DUMMY ARM 1. Verify written prescription; check prepared IVF and other things needed 2. Explain procedure to reassure patient and/or significant others and observe the 10 Rs 3. Do hand hygiene before and after the procedure. 4. Choose site for IV; apply tourniquet 5 to 12 cm (2-6 inches) above injection site depending on condition of patient. 5. Check for radial pulse below tourniquet. 6. Using the appropriate IV cannula, pierce skin with the correct technique. 7. Upon backflow visualization, continue inserting the catheter into the vein. 8. Position the IV catheter and slowly advance the parallel to the skin. Hold stylet stationary and slowly advance the catheter until the hub is 1 mm to the puncture site. 9. Slip a sterilize gauze under the hub. Release the tourniquet; remove the stylet while applying digital pressure over the catheter with one finger about 1 -2 inches from the tip of the inserted catheter. 10. Connect the infusion tubing of the prepared IVF aseptically to the IV catheter. 11. Open the clamp and regulate the flow rate. Reassure patient. 12. Anchor needle firmly in place with the use of transparent tape directly on the puncture site.

13. Tape a small loop of IV tubing for additional anchoring. Apply splint, if needed. 14. Calibrate the IVF bottle and regulate flow of infusion according to prescribed duration. 15. Label on IV tape near the IV site to indicate the date of insertion. 16. Observe patient and report any untoward effect. 17. Document in the patients chart and endorse accordingly and discard sharps and waste according to Health Care Waste Management. C. CHANGING AN IV SOLUTION 1. Verify doctors written order in doctors order sheet. 2. Explain procedure to reassure patient and/or significant others and assess IV site for redness, swelling, pain, etc. and observe the 10 Rs. 3. Do hand hygiene before and after the procedure. 4. Change IV tubing and cannula if 48-72 hours has lapsed after IV insertion. 5. Prepare the necessary materials needed for the procedure. 6. Check sterility and integrity of IV solution and place IV label on the IV bottle. 7. Calibrate new IV bottle according to duration of infusion as per doctors prescription. 8. Open and connect the IV tubing into the solution bottle. 9. Close the roller clamp; regulate the flow according to the prescribed infusion rate. Expel air bubbles if any. 10. Document in the patients chart and endorse accordingly and discard sharps and waste according to Health Care Waste Management. D. DISCONTINUING AN IV INFUSION 1. Verify doctors written order to discontinue IV including IV medications and observe 10 Rs. 2. Assess and inform the patient of the discontinuation of IV infusion. 3. Do hand hygiene before and after the procedure. 4. Prepare necessary materials for procedure. 5. Close the roller clamp of the IV administration set; moisten tapes around the IV catheter with cotton ball with alcohol; remove tape gently. 6. Inspect IV catheter for completeness; place dressing over the venipuncture site. 7. Reassure patient 8. Document in the patients chart and endorse accordingly and discard sharps and waste according to Health Care Waste Management. E. ADMINISTRATION OF BLOOD PRODUCTS

1. Verify doctors written order and make a treatment card according to hospital policy. 2. Explain procedure/rationale for giving blood transfusion to reassure patient and/or significant others; secure consent and observe the 10 Rs. 3. Do hand hygiene before and after the procedure. 4. Request prescribed blood/blood components from blood bank to include blood typing and Xmatching and blood result of transmissible disease. 5. Wrap blood bag with clean towel and keep it at room temperature. 6. Counter check the compatible blood to be transfused against the X-matching sheet noting ABO grouping and RH, serial no. of each blood unit and expiry date with the blood bag label and other laboratory blood exams as required before transfusion. 7. Get the baseline vital signs before transfusion. 8. Give pre-medication 30 minutes before transfusion as prescribed. 9. Prepare necessary equipment needed for BT. 10. Open compatible blood set aseptically and close roller clamp. Spike blood bag carefully; fill the drip chamber at least half full; prime tubing and remove air bubbles if any. Use needle gauze 18 or 19 for side drip (for adults) or gauze 22 (for pedia). 11. Disinfect the Y-infection port of tubing (Plain NSS) and insert the needle from BT administration set and secure with tape. 12. Close roller clamp of IV fluid of Plain NSS and regulate to KVO while transfusion is going on. 13. Transfuse the blood via the injection port and regulate at 10-15 gtts/min. Initially for15 minutes and then at the prescribed rate (usually based on the patients condition). 14. Monitor the patient within the first 5-10 minutes of transfusion and refer immediately to the MD for any adverse reaction (such as flushed skin, chills, elevated temperature, itchiness, urticaria and dyspnea). If any of these symptoms occur, stop the transfusion, open the IV line with Plain NSS and regulate accordingly. 15. Swirl the bag gently from time to time to mix the solid with the plasma. 16. When blood is consumed, close the roller clamp of BT, and disconnect from IV lines then regulate the IVF of Plain NSS. 17. Continue to observe and monitor patient post transfusion, for delayed reaction could still occur. 18. Discard blood bag and BT set and sharps according to Health Care Waste Management; document F. ADMINISTERING IV MEDICATION INCORPORATION OF DRUG INTO IV BOTTLE/BAG 1. Verify doctors written order and observe the 10 Rs.

2. Explain procedure to reassure patient and/or significant others; and check patency and IV site. 3. Verify for skin test of drug for IV incorporation (if skin testing is necessary). 4. Do hand hygiene before and after the procedure. 5. Prepare necessary materials needed for the procedure. 6. Remove the cover of the administration set, maintain sterility and incorporate prepared drug into the airway aseptically. Recap airway after. 7. Swirl the IV bottle to mix the drug with IVF and regulate the flow rate accordingly. 8. Document in the patients chart and endorse accordingly and discard sharps and waste according to Health Care Waste Management. G. ADMINISTERING IV MEDICATION PUSH THROUGH THE IV PORT 1. Verify doctors written order and observe the 10 Rs. 2. Explain procedure to reassure patient and/or significant others; and check patency and IV site. 3. Do hand hygiene before and after the procedure. 4. Check for skin test result of drug for IV push. 5. Prepare necessary materials needed for the procedure. 6. Clamp the IV tubing from the bottle and push IV drug aseptically and slowly. 7. Document in the patients chart and endorse accordingly and discard sharps and waste according to Health Care Waste Management. H. ADMINISTERING IV MEDICATION INCORPORATION INTO VOLUMETRIC CHAMBER 1. Verify doctors written order and observe the 10 Rs. 2. Explain procedure to reassure patient and/or significant others; and check patency and IV site. 3. Do hand hygiene before and after the procedure. 4. Prepare necessary materials needed for the procedure. 5. Check present IV fluid label and level, add desired IVF diluent into volumetric chamber; thru the rubber injection port of the volumetric chamber incorporate drug and mix gently. 6. Regulate flow rate of IVF infusion accordingly. 7. Document in the patients chart and endorse accordingly and discard sharps and waste according to Health Care Waste Management. I. ADMINISTERING IV MEDICATION PUSH THROUGH THE HEPARIN LOCK DEVICE

1. Verify doctors written order and observe the 10 Rs. 2. Explain procedure to reassure patient and/or significant others; and check patency and IV site. 3. Do hand hygiene before and after the procedure. 4. Prepare necessary materials needed for the procedure. 5. Fill the 3 cc syringe with normal saline solution 1 cc each. 6. Check the patency of IV site; give IV push (before and after drug administration flush with 2-3 cc saline solution). 7. Document in the patients chart and endorse accordingly and discard sharps and waste according to Health Care Waste Management.