Title Page

  • Prepared by

  • Hospital/Clinic

  • Conducted on

  • Location

PVC Audit Skill Checklist

  • Checked physician's order, gathered equipment and supplies, introduced self to patient and explained what procedure was to be done and why.

  • Performed hand hygiene, followed infection control measures, and verified patient's identity. Assessed patient for allergies (Latex, Tape, Antiseptics).

  • Provided comfort and safety for patient and self, including raising bed to appropriate height for procedure.

  • Assisted the patient to a comfortable position, either sitting or lying. Exposed the limb to be used but provided for client privacy.

Selecting venipuncture site

  • A. Used patient's non-dominant arm. Identified possible venipuncture sites by looking for veins that are relatively straight.

  • B. Checked agency protocol about shaving if site is very hairy.

  • C. Placed towel or bed protector under extremity to protect linens.

Dilating the vein

  • A. Placed extremity in a dependent position.

  • B. Applied tourniquet firmly 15 to 20cm (6 to 8in.) above venipuncture site.

  • C. Explained that tourniquet may feel tight.

  • D. For elders, placed arm in dependent position and did not use a tourniquet.

  • E. If vein did not sufficiently dilate, the nurse massaged or stroked the vein distal to site and in the direction of venous flow towards the heart.

  • F. Encouraged the patient to clench and unclench fist

  • G. Lightly tapped vein with fingertips

  • H. If preceding steps failed to distend vein, removed tourniquet and wrapped the extremity in a warm, moist towel for 10 to 15 minutes

  • Minimized insertion pain as much as possible using ice, transdermal analgesic creams, or intradermal injection.

Sanitation and hygiene

  • Applied clean gloves and cleaned venipuncture site

  • Cleaned skin at site of entry with a topical antiseptic swab

  • Used a back-and-forth motion for a minimum of 30 seconds to scrub the insertion site and surrounding area

  • Permitted solution to dry on skin

  • Prepare equipment aseptic technique (set aside catheter, tegaderm, flush the extension set tubing)

Catheter insertion and infusion

  • A. Removed catheter assembly from sterile packaging

  • B. Used non-dominant hand to pull skin taut below entry site

  • C. Held the over-the-needle catheter at a 15-to-30 degree angle with needle bevel up, insterted catheter through skin and into vein.

  • D. Once blood appeared in the lumen of the needle, lowered the angle of the catheter until almost parallel with the skin, and advanced needle and catheter approximately 0.5 to 1 cm further.

  • E. Held needle assembly steady, then advanced catheter until the hub was at the venipuncture site

  • F. If hematoma occured, release tourniquet, removed needle, and applied pressure

  • G. Put pressure on vein proximal to catheter to eliminate or reduce blood oozing out of catheter; stabilized hub with thumb and index finger of non-dominant hand

  • H. Carefully removed stylet, engaged needle-safety device, and connected distal end of extension set tubing to the hub.

  • G. While maintaining sterility, connected distal end of the extension set to the IV tubing before initiating infusion.

Dressing, labeling, and securing venipuncture site

  • A. Labeled dressing with date and time of insertion, type, gauge of catheter used, and nurse's initials

  • B. Applied an IV site protector if available

  • C. Looped any tubing and secured it with tape

  • D. Discarded tourniquet and removed and discarded gloves

  • E. Discarded all used disposable items in appropriate receptacles, cleansed any blood spills according to agency policy

  • F. Returned bed to lowest height, removed gloves, and performed hand hygiene.

  • Full name and signature of observer

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