PVC Audit Skill Checklist

Title Page

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.

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.

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)

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.

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