GUIDELINES RELATED TO

INTRAVENOUS THERAPY
DISASTER NURSING
 The following are general guidelines for IV therapy:
 IV fluid therapy is ordered  IV therapy is an invasive procedure;
by a physician or nurse therefore, significant complications
practitioner. The order can occur if the wrong amount of IV
must include the type of fluids or the incorrect medication is
solution or medication, given.
rate of infusion, duration,
date, and time. IV therapy
may be for short or long
duration, depending on
the needs of the patient
(Perry et al, 2018).
 The following are general guidelines for IV therapy:

 Principles of asepsis must be maintained throughout all IV therapy

procedures, including initiation of IV therapy, preparing and
maintaining equipment, and discontinuing an IV system. Always
perform hand hygiene before handling IV equipment. If the
connectors in the administration set and/or the solution become
contaminated, they should be replaced with new ones to prevent
introducing bacteria or other contaminants into the system and,
thus, the patient (Centers for Disease Control [CDC], 2017).
The following are general guidelines for IV therapy:

 Understand the indications and duration for IV therapy for each

patient. Practice guidelines recommend that patients receiving
IV therapy for more than six days should be assessed for an
intermediate or long-term venous access device (CDC, 2017).
The following are general guidelines for IV therapy:

Complications may occur with

 If a patient has an order IV therapy, including but not
to keep a vein open, or limited to localized infection,
“TKVO,” the usual rate catheter-related bloodstream
of infusion is 20 to 50 infection (CR-BSI), fluid
ml per hour (Fraser overload, and complications
Health Authority, 2014). related to the type and
amount of solution or
medication given (Perry et al.,
2018).
The following are general guidelines for IV therapy:

 IV access devices are chosen based on need. A few of the

reasons include if the solution or drugs have high or low pH or
high osmolality. If so, a device where the tip of the catheter is
in a large vessel that allows for high hemodilution is necessary.
The anticipated length of treatment is another deciding factor
because some devices have a longer dwell time than others—
PVAD-short catheters have a shorter dwell time than CVADs
(Perry et al., 2018). There are a variety of CVAD choices that
allow treatment to better meet the needs of the situation.
 The following are general guidelines for IV therapy:
 IV sites must be assessed regularly. Check your agency for specific
guidelines. Some guidelines may suggest every 5 minutes, others hourly,
others every 12 hours (Gorski et al., 2012; RCH, n.d.; RNAO, 2005). In the
absence of guidelines, exercise some clinical judgement and consider that
sites requiring more frequent assessment include those that have an
infusion versus those that are locked; in an acute care environment versus
a home environment; patient conditions where cognitive and sensory
changes inhibit their ability to voice concerns; types of solutions—
vesicants require more frequent site assessment than solutions with less
potential for harm if infiltrated; location and type of catheter—areas of
flexion have higher risk of infiltration; central venous access have higher
risk of air emboli if equipment fails (Gorski et al., 2012).
 The PIV5 RIGHTS BUNDLE
Patient Safety & Quality Healthcare- (October 2020)
By: Lee Steere, RN, CRNI, VA-BC

The PIV Five Description

Rights
P Right A skilled inserter who demonstrates 1st needlestick success at least 90% of the time and is proficient in
ultrasound-guided peripheral catheter assessment and placement.
Proficiency
I Right The use of ultrasound or vein viewer equipment for vessel selection and needle guidance to avoid “blind
sticks.” The use of an evidence-based aseptic no touch insertion technique (ANTT) to minimize site
Insertion contamination.

V Right Vein Place peripheral catheter in the forearm cephalic vein about 3” below the antecubital fossa and 2” above the
wrist whenever possible to avoid joints and danger zones as well as optimize vessel health and adequate
hemodilution.
5 Right 5 Procedural kit for protocol compliance: 22g or longer catheter(forearm) to optimize the vein to catheter ratio;
CHX Antimicrobial bordered securement dressing to reduce infection and dislodging; Anti-reflux needless
Supplies & connector designed to eliminate occlusions; Alcoholic chlorhexidine skin preparation and alcohol disinfecting
cap to provide immediate bacterial reduction.
Technology
R Right Routine assessment by proficient nurse to avoid unnecessary catheter replacements leaving in place until
clinically indicated to remove. Hub disinfection with passive port protectors between access, routine pulsatile
Review flushing, and dressing changes at 7 days for all catheters to maintain the life of catheter.
 THANK YOU
and
Godbless Everyone!!