PROCEDURE CHECKLIST FOR PRIMING IV TUBING/ CHANGING IV SOLUTION BAG/ IV

TUBING ADMINISTRATION SET AND IV SOLUTION CHANGE

STUDENT'S NAME: CI / EVALUATOR:

CHECKLIST: PRIMING IV TUBING COMPETENCY

PERFORMED

STEPS YES NO

1. Perform hand hygiene.

2. Check order to verify solution, rate, and frequency.

3. Gather supplies.

4. Remove IV solution from outer packaging and gently squeeze.

5. Remove primary IV tubing from outer packaging.

6. Move the roller clamp about 3 cm below the drip chamber and close the clamp.

7. Remove the protective cover on the IV solution port and keep sterile. Remove
the protective cover on the IV tubing spike.

8. Without contaminating the solution port, carefully insert the IV tubing spike into
the port, gently pushing and twisting.

9. Hang bag on IV pole.

10. Fill the drip chamber one-third to one-half full by gently squeezing the
chamber. Remove protective cover on the end of the tubing and keep sterile.

11. With distal end of tubing over a basin or sink, slowly open roller clamp to
prime the IV tubing. Invert backcheck valve and ports as the fluid passes through
the tubing. Tap gently to remove air and to fill with fluid.

12. Once IV tubing is primed, check the entire length of tubing to ensure no air
bubbles are present.

13. Close roller clamp. Cover end with sterile dead-ender or sterile protective
cover. Hang tubing on IV pole to prevent from touching the ground.

14. Label tubing and IV bag with date, time, and initials.
15. Perform hand hygiene.

CHECKLIST: CHANGING IV SOLUTION BAG

STEPS

1. Verify and select correct IV solution bag and compare to the medication
administration record (MAR) or physician orders.

2. Introduce yourself, identify patient, and explain procedure.

3. Perform hand hygiene.

4. Remove outer plastic packaging and squeeze bag to test for leaks and expiration
date. Assess for precipitates or cloudiness. Hang new IV solution on IV pole.

5. Pause the EID or close the roller clamp on a gravity infusion set.

6. Remove protective plastic cover from the new IV solution tubing port.

7. Remove the old IV solution bag from the IV pole. Turn IV bag upside down,
grasping the tubing port.

With a twisting motion, carefully remove IV tubing spike from old IV solution
bag.

8. Using a gentle twisting motion, firmly insert the spike into the new IV bag.

9. Fill the drip chamber by compressing it between your thumb and forefinger.
Ensure the drip chamber is one-third to one-half full. Check IV tubing for air
bubbles.

10. Open clamp and regulate IV infusion rate via gravity, or press start on the EID
as per physician orders.

11. Label new IV solution bag as per agency policy. Time tape gravity IV solutions
as per agency policy

12. Dispose of used supplies, perform hand hygiene, and document IV solution bag
change according to agency policy.

CHECKLIST : IV TUBING ADMINISTRATION SET AND IV SOLUTION

CHANGE

STEPS

1. Verify physician orders for the type of solution, rate, and duration. Collect
necessary supplies.

2. Perform hand hygiene.

3. Identify yourself, identify the patient using two identifiers, and explain the
procedure to the patient.

4. Prime new administration set using a new IV solution bag and new IV tubing.

5. Hang new administration set (primed primary line and IV solution) on IV pole.

6. Clamp old IV administration set. Remove IV tubing if on an EID.

7. Clean the connection between the distal end of old IV tubing and the positive
pressure cap. Scrub the area for 15 seconds and let it dry for 30 seconds.

8. Remove the protective cap on the distal end of the new IV administration set.

9. Carefully disconnect the old tubing from the positive pressure cap and insert the
new IV tubing into the positive pressure cap attached to the extension tubing.

10. Open the roller clamp on the new tubing to regulate flow rate, or insert new
tubing into the EID and restart IV rate.

11. Check IV site for patency, and signs and symptoms of phlebitis.

12. Discard old supplies and perform hand hygiene.

13. Document procedure as per agency policy.