iv therapy

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

COMPETENCY 18

• Intravenous Therapy (IVT) (management)

DEMONSTRATES

• The ability to effectively and safely manage intravenous therapy.

PERFORMANCE CRITERIA

• 1. Identifies Indication (2.5,4.2,9.5)

  Yes

  No

  N/A

• 2. Demonstrates therapeutic interaction with the patient, e.g. allays patient's<br>anxiety by adequately explaining the procedure (2.1,2.3,9.1,9.2)

  Yes

  No

  N/A

• 3. Assesses the patient, IV site (5.1,5.2,5.3,9.2,10.2)

  Yes

  No

  N/A

• 4. Gathers equipment (7.1,7.3)<br>- fluid balance sheet<br>- watch with a second hand<br>- gloves ( clean, disposable)<br>- sterile lint free dry gauze square<br>- dry dressing and tape<br>- volumetric pump as required

  Yes

  No

  N/A

• 5. Performs hand hygiene (7.1,9.5)

  Yes

  No

  N/A

• 6. Monitors or changes the flow rate (5.1,5.2,5.3,9.2,10.2

  Yes

  No

  N/A

• 7. Changes a gown/clothing for the client with an IV (7.1)

  Yes

  No

  N/A

• 8. Assists the client with an IV to ambulate (7.1)

  Yes

  No

  N/A

• 9. Changing solutions on an established IV (7.1,7.3)

  Yes

  No

  N/A

• 10. Discontinues IV therapy (7.1)

  Yes

  No

  N/A

• 11. Cleans, replaces and disposes of equipment appropriately (9.5,10.1)

  Yes

  No

  N/A

• 12. Documents relevant information (1.1,1.2,1.3,2.6,9.2,10.2)

  Yes

  No

  N/A

• 13. Demonstrates ability to link theory to practice(3.2,4.1,4.2 )

  Yes

  No

  N/A

STUDENT

EDUCATOR

DATE