Iv Insertion Checklist
Iv Insertion Checklist
Iv Insertion Checklist
NCM 109 RLE – Care of Mother and Child, at Risk and with Problems (Acute and
Chronic)
DIRECTIONS:Mark each step of the procedure following the rubric below denoting the
skill performance of the student. Total the scores and look for the equivalent grade on
the transmutation table. The Remark section is for suggestions that will help improve the
skills of students.
SCORE
STEPS 3 2 1 0 REMARKS
1. Verify written doctor’s order. Ensures correct procedure to
correct patient solution.
2. Observe ten (10) Rs when preparing and administering IVF.
Ensures correct procedure to correct patient with correct
solution.
3. Explain procedure to reassure patient and/or significant other,
secure consent if necessary. To allay patient’s anxiety and
foster his/her cooperation.
4. . Assess patient’s vein; choose appropriate site, location,
size/condition. The selection of an appropriate site decreases
discomfort and possible damage to patient’ s body tissue.
5. Prepare necessary materials for procedure: IV solution
prescribed, Infusion set, IV cannula, Micropore or IV dressing,
disposable gloves, IV stand, IV tray, kidney basin. Having
equipment available saves time and facilitates accurate skill
performance.
11. Expel air bubbles if any and put back the cover to the
distal end of the IV set. This removes air from tubing that can
in larger amounts act as air embolus.
INITIATING IV LINE
12. Loosen stylet and advance catheter into the vein until hub
rests on the IV site. Ensures proper placement of
catheter.
Note: Do not reinsert stylet after loosening to prevent
puncture to the catheter.
13. Hold thumb over the vein above catheter tip and release
tourniquet. Prevents blood leaking and reestablishes
venous blood flow.
19. Label the site with date and time of insertion and the size
and gauge of catheter. Serves as guide for next dressing
change. It is recommended to change IV site every 3
days to avoid infection and other IV complication.
Total
Equivalent Grade
___________________ _______________________________
Student’s Signature Name & Signature of Clinical Instructor