STARTING AN INTRAVENOUS THERAPY

PROCEDURE CHECKLIST 1 2 3 4 5 PE
1. Assessment:
a. Check the physician’s or qualified
practitioner’s order for the type of therapy
planned to determine the optimal needle size
and type to use.
b. Review the information regarding the
insertion of the IV in order to insert the
catheter safely.
c. Know the agency’s policy regarding
who may start an IV because many agencies
require that nurses have special training
before they can perform this procedure.
d. Assess the client’s veins to optimize
planning of the IV site.
e. Assess the client’s understanding of
the purpose of the procedure so that client
teaching can be used to decrease anxiety.
2. Check the physician’s or qualified
practitioner’s order for an IV, and identify the
client.
3. Wash your hands and put on a mask and
gown if needed.
4. Organize all equipment at the bedside.
5. Explain the procedure and reason the
catheter is being inserted.
6. Inspect potential veins to be used:
a. Place a tourniquet around the upper
arm close to the axilla.
b. Examine the veins as they dilate.
c. Palpate the vein to test for firmness.
d. Release the tourniquet.
7. Methods to promote venous dilation are:
a. Stroking the extremity from distal to
proximal below the proposed venipuncture
site.
b. Opening and closing the fist.
c. Light tapping with two or three fingers
over the vein.
d. Applying a warm washcloth or other
heat to the extremity.
8. Select the vein for venipuncture:
a. Avoid bony prominences.
b. Avoid the client’s wrist or hand
c. Avoid the client’s dominant hand and
arm
d. Avoid the extremity with decreased
sensation
e. Avoid an area of skin affected by a
rash or infection.
9. Select an appropriate IV needle or catheter.
10.Prepare supplies:
Place a towel or drape on the table for the supplies.
Place the supplies on a towel.
Open the needle adapter end of the IV tubing set.
11.Clip hair on the skin at the site if necessary
12.Ask the client to rest the arm in a dependent
position, if possible.
13.Put on disposable gloves.
14.Prepare the insertion site:
a. Place an absorbent drape under the
arm.
b. Scrub the insertion site with three
alcohol swabs then three povidone-iodine
swabs.
c. Allow the povidon-iodine to dry.
15.Apply the tourniquet 5 to 6 inches above the
insertion site.
a. Secure it tightly enough to occlude
venous flow, not arterial flow.
b. Check the presence of distal pulse.
16.Perform the venipuncture:
a. Anchor the vein by placing the thumb
over the vein and stretching the skin against
the direction of insertion 2 to 3 inches distal
to the site.
b. Always insert the IV needle or catheter
in the direction of venous return (toward the
heart). To avoid damaging the venous valve.
c. Insert the stylet needle t a 20 to 30
degree angle with the bevel up.
d. Watch for a quick blood return through
the flashback chamber of the ONC.
e. Verify needle placement in a vein, not
artery.
f. Advance ONC ¼ inch into the vein
while it is parallel to the skin,
g. Loosen the stylet and advance the
catheter into the vein until the hub rests at
the venipuncture site.
h. Do not reinsert the stylet.
i. Release the tourniquet.
17.Attach the IV tubing to ONC.
a. Stabilize the catheter with one hand,
b. Remove the stylet from ONC.
c. Quickly connect the needle adapter of
the IV set to the hub of ONC.
d. Begin infusion at slow rate to keep the
vein.
18.Secure the catheter in place:
a. Place tape over the hub of the
catheter.
b. Place 2 x 2 gauze pads over the
insertion site and secure with tape or
transparent dressing.
19.Remove gloves and discard with all used
materials.
20.Place a label with the date and time of
insertion and size and gauge of the catheter on
 the dressing.
21.Wash your hands.
22.The client should be given instructions on
how to do daily activities without dislodging the
IV such as bathing and not getting the dressing
wet, properly positioning the limb with the IV site
and walking with an IV pole. The client also
should be told to watch for signs of
inflammation, clotting or leaking.
23.Documentation:
Note the date and time the IV was
inserted.
Document the type and gauge of the
catheter.
Record the date of dressing placement.
Describe the client’s reaction to the
procedure.

TOTAL SCORE

Date of Return Demonstration

Clinical Instructor Signature