Preparing an Intravenous Infusion

Name of Student: _____________________________

Group Number: ______________________________
Section: ____________________________________

Scoring:

4 - Performs action with great accuracy, completeness, confidence and consistency within the
time allotted to finish the step
3 - Able to compose oneself while doing the action with accuracy, completeness, confidence
and consistency within the time allotted to finish the step
2 - Has done every step of the procedure while showing a little unpreparedness while doing the
steps
1 - Shows unpreparedness, inaccuracy, incompleteness and inconsistency, and exceeds the time
allotted to finish the steps

STEPS 4 3 2 1
1. Verifies doctor’s orders of an intravenous
infusion
2. Performs hand hygiene and observes
appropriate infection prevention procedures
3. Prepares all equipment needed
4. Opens and prepares the infusion set
a. Removes tubing from the package and
straightens it out
b. Slides the tubing clamp along the tubing
until it is just below the drip chamber to
facilitate its access
c. Closes the clamp
d. Leaves the ends of the tubing covered with
the plastic caps until the infusion is started
5. Spikes the solution container
a. Exposes the insertion site of the bag or
bottle by removing the protective cover
b. Removes the cap from the spike and inserts
the spike into the insertion site of the bag
or bottle
c. Uses an air transfer system or a total
transfer lift (For client weighing more than
300 pounds)
6. Hangs the solution container on the pole
a. Adjusts the pole so that the container is
suspended about 1 m (3 feet) above the
client’s head
7. Partially fills the chamber
a. Squeezes the chamber gently until it is half
full of solution
8. Primes the tubing (Flushes the tubing to
remove air)
a. Removes the protective cap and holds the
 tubing over a container. Maintains sterility
of the end of the tubing and the cap
b. Releases the clamp and lets fluid run
through the tubing until all bubbles are
removed. Taps the tubing if the necessary
with the fingers to help the bubbles move
c. Re-clamps the tubing and replaces the
tubing cap, maintaining sterile technique
d. If an infusion control pump is used,
electronic device or controller is being
used, follow manufacturer’s directions for
inserting the tubing and setting the infusion
rate
9. Performs hand hygiene again prior to client
contact

_________________________________ ______________________
Signature of Student Over Printed Name Date

_________________________________ ______________________
Signature of Faculty Over Printed Name Date