Title Page
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Prepared by
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Hospital/Clinic
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Conducted on
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Location
PVC Read-do Checklist
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Check physician's order, verify patient's identity, and gather the appropriate supplies for PVC administration
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Perform hand hygiene and check if patient has already been tested for allergies (Latex, tape, antiseptics)
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Confirm client's dominant hand (perform venipuncture on the non-dominant hand later)
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Apply clean gloves and clean venipuncture site
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Minimize insertion pain as much as possible by using ice, transdermal analgesic creams, or intradermal injection
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Perform venipuncture then dress insertion site
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Apply an IV site protector if available then loop tubing and secure with tape
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Label the dressing with date, time of insertion, type, gauge of catheter used, and nurse's initials
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Discard all used disposable items and appropriate receptacles
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Full name of nurse/medical practitioner who administered the PVC