BASINGSTOKE AND NORTH HAMPSHIRE NHS FOUNDATION TRUST. Clinical Policy for Peripheral Venous Cannula Insertion and Management (Adults)
|
|
- Dorthy Warner
- 6 years ago
- Views:
Transcription
1 BASINGSTOKE AND NORTH HAMPSHIRE NHS FOUNDATION TRUST Clinical Policy for Peripheral Venous Cannula Insertion and Management (Adults) Reviewed in accordance with The Health and Social Care Act 2008: Code of Practice for health and adult social care on the prevention and control of infections and related guidance as published 16 December Summary This policy will provide information about the correct technique for peripherally cannulating a vein aseptically and the subsequent care of the peripheral venous cannulae. By using this policy the user will act to reduce the risks to patients and staff associated with peripheral venous cannulation. These include thrombosis, pain, local or systemic infection; occupational sharps injury and inappropriate cannula insertion. Aseptic peripheral venous cannulation is undertaken to provide venous access for either diagnostic or therapeutic purposes: a) Short-term intravenous fluid therapy of usually less than 3-4 days (if intravenous access is needed for longer periods, other options should be considered). Page 1 of 11
2 b) Administration of bolus injections in outpatients or in day case surgery c) Vascular access for fluids or drugs at time of particular procedure e.g. surgery, endoscopy The implementation of this policy will be monitored using clinical audit (Appendix B) Implementation Plan There will be a week long launch of the Policy, including teaching sessions for staff. Managers and Link Personnel to disseminate Policy to non- attenders of teaching sessions. Information regarding the new Policy will be issued in PULSE. Posters will be displayed in all clinical areas, outlining the basis of Peripheral Vascular Catheter care, and assessment tools. Implementation of Peripheral Venous Catheter Care plans. Regular Audits of Peripheral Venous Catheter care (including documentation) Summary of changes This is a new policy therefore there are no changes. Action needed and owner of action Staff are required to adhere to new Trust Guidelines. In order to ensure staff comply: Table of Contents Page No 1. Purpose 3 2. Responsibilities 3 3. Definitions 3 4. Clinical Practice 4 5. Training 6 6. References 7 7. Contributors 7 Appendix A: Abbreviated guide to peripheral venous cannulation 8 Appendix B: Cannula Insertion and Management form Purpose Page 2 of 11
3 To inform best practice on the aseptic insertion of peripheral venous cannulation of adults. The implementation of this policy will reduce the risks associated with this procedure including thrombosis, pain, local or systemic infection; occupational sharps injury and inappropriate cannula insertion. 2. Responsibilities Supervisors of clinical practice will be responsible for monitoring compliance with the policies on an ongoing basis. The IV therapy Nurse will audit compliance as part of the infection control clinical practice audit process. A snapshot audit to monitor clinical practice during cannula insertion and subsequent care will be undertaken annually. Please refer to Paediatric Policy for cannulation in paediatric areas, 3. Definitions Aseptic Technique Clinical practices used to protect the patient from micro-organisms by preventing contamination of wounds, manipulated devices and other susceptible sites. Aseptic technique involves the use of appropriate hand hygiene, use of sterile equipment, no touch technique and robust patient skin / site disinfection. Venous Cannulation Procedure for insertion of a hollow fine bore tube into the venous system Health care professional A registered or trained member of staff, including but not exclusively nurses, doctors and operating department practitioners. Infection Entry of a harmful microbe into the body and its multiplication in the tissues Peripheral cannula A specifically-designed flexible tube designed for insertion into a blood vessel, with a proximal connector to allow injection or infusion of liquids. Sizes range from Yellow 24g Blue 22g Pink 20g Green 18g Grey 16g Orange 14g 22-20g are optimal for administration of intermittent medications g are routinely used to administer fluids in acute situations i.e. haemorrhage. Phlebitis Inflammation of a vein Thrombosis Formation, development or existence of a blood clot within the vascular system Page 3 of 11
4 4. CLINICAL PRACTICE Action Rationale Identify clinical need for cannula insertion To prevent inappropriate insertion and exposure to associated risks. Collect equipment needed including: To ensure procedure is performed without disruption Dressing trolley (Cleaned) White tray (cleaned) Gauze Single use tourniquet Clean gloves Sharps box 2% Chlorhexidine and 70% alcohol (Sanicloth CHG 2%) Local anaesthetic (1% Lidocaine) orange needle and Choice of cannula must be based on clinical need 2ml syringe but the smallest cannula should be chosen to reduce Cannulae - IV dressing risk of complications associated with larger bores. Saline flush Identify patient by surname, first name and date of birth To ensure correct identification of the patient Wash hands with soap and water as per the Trust Hand Hygiene Policy Place White tray onto clean dressing trolley. Open To ensure patient is informed of procedure and the equipment into the clean tray. risk of allergic reaction is minimised Explain to the patient the importance of keeping the site To ensure patient compliance and reduce risk of clean and dry and advise of risks of infection infection Decontaminate hands with alcohol gel or wash with soap and water Palpate potential sites these include: The hand - a lower risk of phlebitis The wrist or upper arm increasing risk The lower limb has a higher risk than the upper limb When potential site is identified position patient comfortably with appropriate limb below the level of the heart. Removing excess hair (shaving is not recommended clippers are better) Apply proximal single use tourniquet, without obstructing arterial flow Optimal time for application is 3 to 5 mins if additional time is needed release tourniquet as vein will tend to disappear. Encourage patient to exercise limb muscles (e.g. repeatedly making a fist and opening hand) Decontaminate hands with alcohol gel or wash with soap and water and don clean gloves Clean insertion site using a spiral motion from the proposed puncture site outwards with 2% chlorhexidine in 70% alcohol (from pre-soaked wipe Sani cloth CHG 2%) for 30 seconds and then allow to dry Administer local anaesthetic (1% Lidocaine) which should be encouraged in all but the most urgent of cases. Alternatively apply prescribed topical local anaesthetic cream 45mins prior to procedure To reduce risk of arterial rather than venous cannulation, and reduce risk of infection. To allow dependent veins to fill with blood Local trauma can be caused by shaving, increasing risk of infection To distend veins Muscle pump forces blood into veins to distend them further To reduce risk of infection To ensure patient comfort Page 4 of 11
5 Action Inserting the cannula: Gently pull on skin, distal and lateral to insertion site. Do not touch the cannula or the insertion site. Insert cannula (bevel uppermost) through the cleaned skin area at an angle of 20 degrees. Advance until just in the vein and then lower the cannula until it is parallel with the skin (a flashback of blood is usually but not always seen at this point) Then, either; a) Pull the needle back 1cm and push the cannula/needle into the vein up to the hilt Or; b) Hold the needle still and advance the cannula over the needle until the cannula is inserted up to the hilt In the event of unsuccessful cannulation of the vein withdraw the cannula from the puncture site and apply pressure with non woven swab Prior to subsequent attempts at cannulation it is the responsibility of the individual practitioner to risk assess the difficulty of further attempts against their own registered competence and experience. If the practitioner anticipates the difficulty level to be beyond their scope of practice, then referral to more experienced, competent practitioners should be made Remove the tourniquet and apply pressure on the proximal vein, close to the tip of the cannula a second person may be required for this Remove needle and dispose of immediately into sharps container, cap off cannula with a sterile cap or attach intravenous fluids as appropriate Secure cannula with a recognised, sterile cannula dressing, ensuring it is applied correctly (non-sterile, sticky-tape fixation or bandage is NOT acceptable). Place date for cannula review sticker to outside of dressing Flush cannula with 1-2 mls saline if not being attached to infusion. Document cannula insertion by completing a Cannula insertion and management form for each separate cannula inserted. Once cannula has been removed this document is filed in the patients medical notes. Rationale To fix the skin and the superficial veins underlying it. To use the sharpened needle to introduce the plastic cannula into the vein. To introduce the cannula fully into the vein To minimise haematoma formation and /or excessive bruising To ensure cannulation is always undertaken by competent practioners and minimise risks associated with failed attempts at gaining venous access To prevent excessive bleeding during needleremoval. To reduce risk of needle stick injury and prevent blood spillage To reduce risk of infection and secure cannula in position To ensure timely review To ensure cannula patency To establish an audit trail and monitor management of cannula Page 5 of 11
6 Action Ongoing cannula management: Decontaminate hands before and after each patient contact. Use correct hand hygiene procedure as per trust policy. Always access cannula by cleaning with 2% chlorhexidine and 70% isopropyl alcohol (Sani cloth CHG 2%), and allow to dry before administering fluid or injections. Needle free bungs should NOT be applied directly onto cannula; single or double lumen extensions should be applied. Cannula site should be inspected three times a day (8 hourly). Cannula dressing should be, intact, dry and adherent. A date and time of insertion must be applied at point of insertion. Remove cannula if there is no continuing clinical indication and document date and time of removal on cannula management form. Replace cannula in a new site after 72 hours (3 days), earlier if clinically indicated. Administration sets should be replaced immediately after blood and blood product administration, intermittent IV antibiotics and medicines. Heparin infusion lines should be replaced every 24 hours. All other fluid sets should be replaced after 72 hours. ALL giving sets should be labelled with date and time on commencement of use. All disconnected giving sets should be disposed of and cannot be reattached. Rationale To prevent unwanted movement of cannula in the vein. Thus causing phlebitis. Observe for signs of infection or phlebitis. To ensure that the cannula is replaced or removed on time, thus reducing the risk of infection. 5.Training Prior to undertaking any cannulation procedure, all staff must be able to demonstrate clinical competence and a clear understanding of the underlying principles of practice. This will be achieved by: Nursing and other health care staff a) complete the Trust venous cannulation competency pack b) attend a cannulation study day c) complete a period of supervised clinical practice (Staff who have been trained and practised in a previous post may be allowed to demonstrate an equivalent level of competence through a period of supervised practice only). Medical staff Post registration house officer (PRHO) induction will include training by Trust trainers on local Policies and principles of practice. Senior House Officer s and Registrars will be assumed competent unless identified otherwise by their supervisor. If problems are identified, the staff member will be required to: Page 6 of 11
7 a) complete the Trust venous cannulation competency pack b) attend a cannulation study day c) complete a period of supervised clinical practice 6. References Department of Health (2001) The epic Project: Developing National Evidence based Policys for Preventing healthcare associated Infections Journal of Hospital Infection (2001) 47 (supplement) Donaldson I. (1999) Intravenous therapy in critically ill adults: developing a clinically and cost- effective approach Intensive and Critical Care Nursing No 15, Dougherty L, Mallett J (2001) The Royal Marsden Hospital Manual of Clinical Nursing Procedures Fifth edition. Blackwell Science Fletcher SJ; Bodenham A (1999) Catheter related sepsis: an overview Part 1 British Journal of Intensive Care. March/April Infection Control Nurses Association (2001) Policys for preventing intravascular catheter related infection NICE (2003) (No. 4) Care of patients with central venous catheters Clinical policy 2 Infection control, June 2003 Polderman KH; Girbes AR (2002) Central venous catheter use. Part 2: infectious complications Intensive Care medicine 2002, Jan; 28(1): RCN (March 2004) Good practice in infection control Guidance for nursing staff RCN (Oct 2003) Standards for infusion therapy DoH ( July 2006) Winning ways high impact working together to reduce healthcare associated infection in England-intervention 2b 7. Contributors Sandy Kirk, IV Nurse Specialist Appendix A Abbreviated guide to peripheral venous cannulation (adult) Page 7 of 11
8 Clinical Practice Policy (abbreviated) Action Identify clinical need for cannula insertion Collect equipment needed including: Dressing trolley White Tray Single use tourniquet Clean gloves Sharps box 2% Chlorhexidine and 70% alcohol skin preparation (Sanicloth CHG 2%) Local anaesthetic (1% Lidocaine) orange needle and 2ml syringe Cannulae - IV dressing Saline flush Identify patient by surname, first name and date of birth Wash hands with soap and water as per the Trust Hand Hygiene Policy Place White tray onto clean dressing trolley. Open equipment into the clean tray. Explain the procedure to the patient, discuss the need for a cannula, obtaining verbal consent for procedure establishing whether patient has any known allergies Explain to the patient the importance of keeping the site clean and dry and advise of risks of infection Decontaminate hands with alcohol gel or wash with soap and water Palpate potential sites these include: The hand - a lower risk of phlebitis The wrist or upper arm increasing risk The lower limb has a higher risk than the upper limb When potential site is identified position patient comfortably with appropriate limb below the level of the heart. Removing excess hair (shaving is not recommended clippers are better) Apply proximal single use tourniquet, without obstructing arterial flow Optimal time for application is 3 to 5 mins if additional time is needed release tourniquet as vein will tend to disappear. Encourage patient to exercise limb muscles (e.g. repeatedly making a fist and opening hand) Decontaminate hands with alcohol gel or wash with soap and water and don sterile gloves Clean insertion site using a spiral motion from the proposed puncture site outwards with 2% chlorhexidine in 70% alcohol (from a pre-soaked wipe Sani cloth CHG 2%)) for 30 seconds and then allow to dry Administer local anaesthetic (1% Lidocaine) which should be encouraged in all but the most urgent of cases. Alternatively apply prescribed topical local anaesthetic cream 45mins prior to procedure Inserting the cannula: Gently pull on skin, distal and lateral to insertion site. Do not touch the cannula or the insertion site. Insert cannula (bevel uppermost) through the cleaned skin area at an angle of 20 degrees. Advance until just in the vein and then lower the cannula until it is parallel with the skin (a flashback of blood is usual but not always seen at this point) Page 8 of 11
9 Then, either; b) Pull the needle back 1cm and push the cannula/needle into the vein up to the hilt Or; b) Hold the needle still and advance the cannula over the needle until the cannula is inserted up to the hilt In the event of unsuccessful cannulation of the vein withdraw the cannula from the puncture site and apply pressure with non woven swab Prior to subsequent attempts at cannulation it is the responsibility of the individual practitioner to risk assess the difficulty of further attempts against their own registered competence and experience. If the practitioner anticipates the difficulty level to be beyond their scope of practice, then referral to more experienced, competent practitioners should be made Remove the tourniquet and apply pressure on the proximal vein, close to the tip of the cannula a second person may be required for this Remove needle and dispose of immediately into sharps container, cap off cannula with a sterile cap or attach intravenous fluids as appropriate Secure cannula with a recognised, sterile cannula dressing, ensuring it is applied correctly (non-sterile, sticky-tape fixation or bandage is NOT acceptable). Place date for cannula review sticker to outside of dressing Flush cannula with 1-2 mls saline if not being attached to infusion. Document cannula insertion by completing a Cannula insertion and management form for each separate cannula inserted. Once cannula has been removed this document is filed in the patients medical notes. Ongoing cannula management: Decontaminate hands before and after each patient contact. Use correct hand hygiene procedure as per trust policy. Always access cannula by cleaning with 2% chlorhexidine and 70% isopropyl alcohol, and allow to dry before administering fluid or injections. Needle free bungs should NOT be applied directly; single or double lumen extensions should be applied. Cannula site should be inspected at least three times a day. (8 Hourly) Cannula dressing should be, intact, dry and adherent. A date and time of insertion must be applied at point of insertion. Remove cannula if there is no continuing clinical indication. Replace cannula in a new site after 72 hours, earlier if clinically indicated. Administration sets should be replaced immediately after blood and blood product administration, intermittent IV antibiotics and medicines. Heparin infusion lines should be replaced every 24 hours. All other fluid sets should be replaced after 72 hours. ALL giving sets should be labelled with date and time on commencement of use. Page 9 of 11
10 Appendix B Patient Hospital Number Cannula Insertion and Management Form Date of Birth Ward WARD Consultant GAUGE Observation Shift What is the continuing clinical Indication? SJK/07/2009 INSERTION Lot No CONSENT Informed Implied Unable INSERTION REASON IV Fluids IV Antibiotics Blood Chemotherapy Surgery Other ADHERED TO Aseptic Technique Skin Prep IV 3000 Dressing Extension Single Double Local Anaesthetic used? Yes No Cannula Timed & Dated Yes No Day 1 Early Late Night Day 2 Early Late Night Day 3 Early Late Night Date and Time Inserted BY Signature Status Date and Time Removed BY Signature Status Number of attempts- Standard: Hand Hygiene must be performed before and after accessing cannula. Is the dressing Intact? Administration set replacement needed? V.I.P. Score Action taken REMOVAL REASON Not Required Phlebitis Infiltration Extravasation By Patient V.I.P Score on removal Other COMMENTS Date and Signature
11 Visual Infusion Phlebitis Score (V.I.P) (Adapted with permission from: Jackson. A. 1999) Signs & Symptoms Score Action to be Taken IV cannula site healthy 0 One of the following is present: Slight pain Redness around IV site 1 No signs of phlebitis Observe and document cannula each shift First signs of phlebitis. Remove & replace cannula in alternative site. Observe both sites and document. Two of the following are present: Pain Redness Swelling All of the following are present: Pain along path of cannula Redness around site Swelling All of the following are present and extensive: Pain along path of cannula Redness around site Swelling Palpable venous cord All of the following are present and extensive: Pain along path of cannula Redness around site Swelling Palpable venous cord SJK/07/2009 Pyrexia Early stage of phlebitis. Remove & replace cannula in alternative site. Observe both sites and document. Medium stage of phlebitis. Remove cannula, inform doctor. Document and complete Incident Form. Consider treatment. Inform IV Nurse Specialist Advanced stage of phlebitis or start of thrombophlebitis. If pyrexia present take blood cultures from alternative site. Inform doctor. Document and complete Incident Form. Inform IV Nurse Specialist Advanced stage of thrombophlebitis Remove and send tip for culture and sensitivity, swab site. Inform doctor. Resite cannula and initiate treatment. Complete Incident Form. Inform IV Nurse Specialist.
Date Authorised 28 September 2015 Dissemination Target Audience All Trust Staff Dissemination and Implementation Plan Action Owner Due by
Peripheral Venous Cannula Insertion and Management (Adults) Policy HH(1)/IC/636/15 Previous document(s) being replaced Location Policy No Policy Name HHFT HH(1)/IC/636/13 Peripheral Venous Cannula Insertion
More informationSuccessful IV Starts Revised February 2014
Successful IV Starts Revised February 2014 Why Intravenous Therapy? Used for access to the body s circulation Indications: Administer fluids, blood, medications, and nutrition Obtain laboratory specimens
More informationIf viewing a printed copy of this policy, please note it could be expired. Got to to view current policies.
If viewing a printed copy of this policy, please note it could be expired. Got to www.fairview.org/fhipolicies to view current policies. Department Policy Code: D: PC-5575 Entity: Fairview Pharmacy Services
More informationHOSPITAL INFECTION CONTROL POLICY. Insertion and maintenance of peripheral intravenous cannulae
HOSPITAL INFECTION CONTROL POLICY Policy no: ICU 03Pol2011v02.0 Insertion and maintenance of peripheral intravenous cannulae TITLE SUMMARY Policy & Procedures for the Insertion and Maintenance of Peripheral
More informationPeripheral Intravenous Devices
SH CP 140 Peripheral Intravenous Devices Procedures for Peripheral intravenous cannula and Midline intravenous catheters Summary: Keywords (minimum of 5): (To assist policy search engine) Target Audience:
More informationCurraheen, Co. Cork. Guidelines on the Management and Care of Central Venous Access Devices
Curraheen, Co. Cork. Guidelines on the Management and Care of Central Venous Access Devices Date re-approved: 27 th Jan 2015. Version No: 2 Revision Due: 2018 Index code: CLIN028 Disclaimer: The information
More informationVenepuncture and Cannulation. Louise Smith Clinical Nurse Specialist
Venepuncture and Cannulation Louise Smith Clinical Nurse Specialist Outcomes By the end of this session you will be aware of: Basic anatomy Preparation procedures including patient identification Equipment
More informationIV Link Staff. Infection Prevention & Control A Learning Package for IV Link Staff
IV Link Staff Infection Prevention & Control A Learning Package for IV Link Staff Purpose This learning package provides key infection prevention messages and direction for knowledge that you require as
More informationPREPARATION OF FISTULA NEEDLES TO COMMENCE HAEMODIALYSIS VIA AVF OR GRAFT AND REMOVAL OF NEEDLES AT END OF DIALYSIS SESSION
Nephrology Directorate Lower Lane Fazakerly L9 7AL PREPARATION OF FISTULA NEEDLES TO COMMENCE HAEMODIALYSIS VIA AVF OR GRAFT AND REMOVAL OF NEEDLES AT END OF DIALYSIS SESSION A) PREPARATION Wash hands
More informationNOTTINGHAM CHILDREN S HOSPITAL Nursing Guideline. P07 Care and Management of Children with a Totally Implantable Venous Access Device (Portacath).
NOTTINGHAM CHILDREN S HOSPITAL Nursing Guideline P07 Care and Management of Children with a Totally Implantable Venous Access Device (Portacath). Introduction A Portacath is a central venous access device
More informationPATIENT CARE PLAN FOR CARE OF PERIPHERAL MIDLINE. Manufacturers specific recommendations should be noted and adhered to by individual practitioners.
PATIENT CARE PLAN FOR CARE OF PERIPHERAL MIDLINE The care plan is designed to be used in conjunction with CINS Guidelines for vascular devices. Manufacturers specific recommendations should be noted and
More informationGuidelines for the Care and Maintenance of Intravenous Access Devices in Paediatric Patients
Guidelines for the Care and Maintenance of Intravenous Access Devices in Paediatric Patients These guidelines have been adapted for local use from the Collaborative Intravenous Nursing Services regional
More informationATI Skills Modules Checklist for Central Venous Access Devices
For faculty use only Educator s name Score Date ATI Skills Modules Checklist for Central Venous Access Devices Student s name Date Verify order Patient record Assess for procedure need Identify, gather,
More informationPeripheral Cannulation. Procedural guidelines for use with adult patients in community and community hospital settings.
Peripheral Cannulation. Procedural guidelines for use with adult patients in community and community hospital settings. Description: The document describes how clinicians will prepare for and carry out
More informationSt George Hospital Renal Department Internal Only
RENAL VASCULAR ACCESS CANNULATION POLICY AND PROCEDURE SUMMARY: A functioning arteriovenous fistula (AVF) or arteriovenous graft (AVG) is paramount in the maintenance of regular and optimal haemodialysis
More informationSOUTHERN HEALTH & SOCIAL CARE TRUST. Children & Young People s Directorate Procedure/Guidelines/Protocol Checklist & Version Control Sheet
Children & Young People s Directorate Procedure/Guidelines/Protocol Checklist & Version Control Sheet 1 Name of Procedure/Guidelines/ Protocol: PROCEDURE FOR PERIPHERAL ARTERIAL CANNULATION 2 Purpose of
More informationBLOOD CULTURE POLICY FOR PAEDIATRICS
BLOOD CULTURE POLICY FOR PAEDIATRICS 1. INTRODUCTION Blood culture to detect bacteraemia is an important investigation with major implications for the diagnosis of patients with infection and the selection
More informationCentral venous access devices for children with lysosomal storage disorders
Great Ormond Street Hospital for Children NHS Foundation Trust: Information for Families Central venous access devices for children with lysosomal storage disorders This information explains about central
More informationIf viewing a printed copy of this policy, please note it could be expired. Got to to view current policies.
If viewing a printed copy of this policy, please note it could be expired. Got to www.fairview.org/fhipolicies to view current policies. Department Policy Code: D: PC-5555 Entity: Fairview Pharmacy Services
More informationCannulating AV Fistula using Buttonhole Technique
Nephrology Directorate Subject: Objective: Prepared by: Cannulating AV Fistula using Buttonhole Technique To enable the safe insertion and removal of needles into arteriovenous fistulae using the buttonhole
More informationHome Health Foundation, Inc. To create more permanent IV access for patients undergoing long term IV therapy.
PROCEDURE ORIGINAL DATE: 06/99 Revised Date: 09/02 Home Health Foundation, Inc. SUBJECT: PURPOSE: MIDLINE CATHETER INSERTION To create more permanent IV access for patients undergoing long term IV therapy.
More informationKINGSTON GENERAL HOSPITAL NURSING POLICY AND PROCEDURE
KINGSTON GENERAL HOSPITAL NURSING POLICY AND PROCEDURE SUBJECT Sample (Adult): Advanced Competency (AC) for Nurses (Registered Nurses and Registered Practical Nurses) PAGE 1 of 5 ORIGINAL ISSUE 1985 January
More informationBiovalve. A Guide to Peripheral IV Cannulation CANNULATION
Biovalve A Guide to Peripheral IV Cannulation CANNULATION vygon@vygon.co.uk www.vygon.co.uk Biovalve Peripheral IV Cannulation from Vygon (UK) Ltd The information provided here is intended as guidance
More informationIV Catheter Placement
Year Group: BVSc3 + Document number: CSL_A06 Equipment for this station: Equipment list: IV catheter model, with giving set and red fluid bag IV catheter Bung or T-port Tape two strips cut to size before
More informationCore procedures assessment form
1. Venepuncture guidance choose appropriate needle or cannula have appropriate vials to hand choose a suitable, palpable vein after applying tourniquet insert needle with bevel upwards and advance 2-3mm
More informationPeripherally Inserted Central Catheter (PICC) Booklet
Aintree University Hospital FT PICC Booklet: a real world example This local booklet is an example used in the NICE medical technology guidance adoption support resource for SecurAcath for securing percutaneous
More informationMANITOBA RENAL PROGRAM
SUBJECT Venipuncture of Arteriovenous Fistula/Graft MANITOBA RENAL PROGRAM SECTION CODE 30.30.01 30.30 Vascular Access AUTHORIZATION Professional Advisory Committee, Manitoba Renal Program Nursing Practice
More informationMANITOBA RENAL PROGRAM
SUBJECT Venipuncture of Arteriovenous Fistula/Graft MANITOBA RENAL PROGRAM SECTION CODE 30.20.01 30.20 Vascular Access AUTHORIZATION Professional Advisory Committee, Manitoba Renal Program Nursing Practice
More informationStandard Operating Procedure for cannulation
Standard Operating Procedure for cannulation Effective date: 26.07.2017 Review due date: 31.03.2019 Original Author Name: Richard Metcalfe Position: PhD Student Date: 05.12.2012 Reviewer Name: Pippa Heath
More informationSALEM HOSPITAL SALEM, OREGON 97309
SALEM HOSPITAL SALEM, OREGON 97309 Department: Phlebotomy TITLE: BLOOD COLLECTIONS, VENIPUNCTURE Area: Phlebotomy Effective Date: 04/01/96 Authored By: Cindy Humphrey, Diane Duncan Revised: 09/26/2000,
More informationBlood Sampling: Venipuncture
Approved by: Blood Sampling: Venipuncture Gail Cameron Senor Director, Operations, Maternal, Neonatal & Child Health Programs Dr. Paul Byrne Medical Director, Neonatology Neonatal Nursery Policy & Procedures
More informationHigh Impact Intervention Peripheral intravenous cannula care bundle
High Impact Intervention Peripheral intravenous cannula care bundle Aim To reduce the incidence of peripheral intravenous cannula infections. Introduction The aim of the care bundle, as set out in this
More informationSpecimen Collection Policies
Specimen Collection Policies Purpose Great River Medical Center Laboratory is a hospital-based and outreach laboratory with specific standards of excellence. To best serve our patients, all specimens will
More informationVenesection Nursing Guidelines
Venesection Nursing Guidelines Rationale Patients requiring venesection on the Day Treatment Unit (DTU) fall into 3 main categories; patients diagnosed with: Polycythemia Rubra Vera Haemachromatosis Transfusion
More informationEducation for Self Administration of Intravenous Therapy HOME IV THERAPY PICC. Portacath
HOME IV THERAPY PICC Portacath Who To contact Cardio-Respiratory Integrated Specialist Services (CRISS) Office hours 0800 1630 hours Ph: 364 0167 Weekends and after hours, phone Christchurch Hospital operator
More informationSouth Staffordshire and Shropshire Healthcare NHS Foundation Trust
South Staffordshire and Shropshire Healthcare NHS Foundation Trust Document Version Control Document Type and Title: Authorised Document Folder: New or Replacing: Document Reference: Policy for the Insertion
More informationPeripheral Venous Cannula (PVC) Management Guidelines
Peripheral Venous Cannula (PVC) Management Guidelines This procedural document supersedes: PAT/T 45 v.2 Peripheral Venous Cannulation (PVC) Insertion and Management Guidelines Did you print this document
More informationVascular access in practice: best practice update
Vascular access in practice: best practice update Nicola York Clinical Nurse Manager Vascular Access Oxford University Hospitals NHS Foundation Trust June 2016 Objectives Patient assessment Best practice
More informationPolicy for Peripheral Cannulation
Policy Number 102 This document has been reviewed in line with the Policy Alignment Process for Liverpool Community Health NHS Trust Services. It is a valid Mersey Care document, however due to organisational
More informationReview of Clinical Guideline Contributes to CQC Core Standard No: 9, 12
` CANNULATION BY NON-MEDICAL PERSONNEL IN MATERNITY SERVICES CLINICAL GUIDELINE Register No: 08050 Status: Public Developed in response to: NICE Guidelines Review of Clinical Guideline Contributes to CQC
More informationCENTRAL VENOUS ACCESS DEVICES. BETHANY COLTON
CENTRAL VENOUS ACCESS DEVICES. BETHANY COLTON Aims and Objectives To know what central venous access devices (CVAD) are. Types of CVADS used in haematology. To understand why we use them To know the complications
More informationInfusion Skills Competency Checklist To be used at annual skills fair or at any other time for IV Competency
Employee Profile Infusion Skills Checklist Last Name First Name Middle Initial Employee Number Employee Discipline Check one: RN LPN Per state specific LPN Practice Acts Direct Supervisor s Name: Date
More informationBLOOD COLLECTION GUIDELINES
I. Patient Identification Lee Memorial Health System Lee County, FL CLINICAL LABORATORY BLOOD COLLECTION GUIDELINES A. Inpatient / Outpatient with armband 1. When possible, ask patient to state their name
More informationStandard operating procedures for preparation and administration of intramuscular injections. No Action Rationale
Standard operating procedures for preparation and administration of intramuscular injections Preparation Overview No Action Rationale 1 Collect and check all equipment 2 Check that the packaging of all
More informationInsertion and Monitoring of Intravenous and Subcutaneous Cannula and Infusions: Standard Operating Procedures
Clinical Insertion and Monitoring of Intravenous and Subcutaneous Cannula and Infusions: Standard Operating Procedures Document Control Summary Status: Replacement. Replaces: Insertion and Monitoring of
More informationEmergency clamp should always be readily available in case of accidental catheter fracture
Note: Please see individual policies for further information. Flushing best practice: Always use a 10 diameter syringe or larger when first accessing and when flushing vascular access device (VAD) Use
More informationVascular access device selection & placement. Alisa Seangleulur, MD Anesthesiology Department, Faculty of Medicine, Thammasat University
Vascular access device selection & placement Alisa Seangleulur, MD Anesthesiology Department, Faculty of Medicine, Thammasat University How to make the right choice of vascular access device.. Peripheral
More informationBUTTONHOLE CANNULATION
BUTTONHOLE CANNULATION What is a Buttonhole? Technique in which an AV fistula is cannulated in the exact same spot, at the same angle and at the same depth of penetration every time. Benefits Reduction
More informationOverview of CVADs. Type of device commonly used. Dwell time Flushing requirement Associated complications. lumens
Source: Clinical Skills Management of Vascular Access Devices Pre-course handbook. Adapted with permission from NHS Lothian Employee and Education Development Team. Overview of CVADs Type of device Veins
More informationArterial Line Insertion Pre Reading
PROCEDURE ACCREDITATION THE CANBERRA HOSPITAL EMERGENCY DEPARTMENT Arterial Line Insertion Pre Reading Indications Requirement for continuous blood pressure monitoring (all patients on pressors, inotropes,
More informationCollection of Blood Specimens. To provide instructions on correctly collecting blood specimens via vacutainer.
Page 1 of 9 Purpose: To provide instructions on correctly collecting blood specimens via vacutainer. Equipment: Tourniquet-one time use only Vacutainer holder Sterile multi-specimen needle Gauze swab Appropriate
More informationAnaesthetic Procedure Packs Ensuring maximum barrier precautions
Anaesthetic Procedure Packs Ensuring maximum barrier precautions vygon@vygon.co.uk www.vygon.co.uk Anaesthetic Procedure Packs Ensuring maximum barrier precautions It has been estimated that infections
More informationSCIG INFUSIONS A PRACTICAL GUIDE FOR PATIENTS
PRIMARY IMMUNODEFICIENCIES SCIG INFUSIONS: A PRACTICAL GUIDE FOR PATIENTS SCIG INFUSIONS A PRACTICAL GUIDE FOR PATIENTS 1 PRIMARY IMMUNODEFICIENCIES ABBREVIATIONS IG IVIG PID SCIG Immunoglobulin Intravenous
More informationPatient/Carer instructions for the administration of Subcutaneous Cytarabine
Patient/Carer instructions for the administration of Subcutaneous Cytarabine This document covers the following information: What cytarabine is What subcutaneous means What happens if you decide to inject
More information2. Need for serial arterial blood gas determinations. 2. Anticipation of the initiation of thrombolytic therapy
I. Subject: Arterial Cannulation II. Policy: Arterial cannulation will be performed upon a physician's order by Cardiopulmonary and Respiratory Therapy personnel certified in the arterial catheterization
More informationNHS GREATER GLASGOW & CLYDE CONTROL OF INFECTION COMMITTEE STANDARD OPERATING PROCEDURE (SOP) INSERTION & MAINTENANCE OF INDWELLING
Page Page 1 of 6 AIM STATEMENT REQUIREMENTS LOCATION TIMING PROCEDURE To minimise the risk of secondary infection as a result of urinary catheterisation. A urinary catheter bypasses the body s normal defence
More informationValue Life Lifecath Midli n e uide to Lifecath Midline rse s G u N A
Value Life Lifecath Midl ine A Nurse s Guide to Lifecath Midline www.vygon.co.uk vygon@vygon.co.uk Useful Information Lifecath Midline Lifecath Midline Catheter Code: 1296 Peelable Cannula Introducer
More informationCentral Venous Catheter Care and Maintenance (includes catheter troubleshooting guide)
Central Venous Catheter Care and Maintenance (includes catheter troubleshooting guide) A Guide for Patients in the Home Phone Number: Nurse/Contact: Central Venous Catheters This manual is a guide for
More informationChildren s Acute Transport Service
Children s Acute Transport Service Vascular Access Document Control Information Author Ramnarayan Author Position Consultant, CATS Document Owner Polke Document Owner Position CATS Co-ordinator Document
More informationPROCEDURE FOR THE CARE AND MAINTENANCE OF CENTRAL INTRAVENOUS ACCESS DEVICES
PROCEDURE FOR THE CARE AND MAINTENANCE OF CENTRAL INTRAVENOUS ACCESS DEVICES First Issued Issue Version Purpose of Issue/Description of Change Planned Review Date One To ensure a safe and effective procedure
More information1.0 Purpose The purpose of this guideline is to ensure the safe administration of intramuscular injections to Cheshire Ireland service users.
Status: Guideline: offers direction and guidance on good practice, need not necessarily be strictly adhered to. Page 1 of 5 Title: Guidelines for Administration of an Intramuscular Injection Written by:
More informationLatex and Occupational Dermatitis Policy Incorporating Glove Selection
Latex and Occupational Dermatitis Policy Incorporating Glove Selection DOCUMENT CONTROL: Version: 3 Ratified by: Risk Management Sub Group Date ratified: 17 July 2013 Name of originator/author: Health
More informationCHEMOTHERAPY NETWORK GROUP POLICY FOR ADMINISTRATION OF CYTOTOXIC CHEMOTHERAPY
CHEMOTHERAPY NETWORK GROUP POLICY FOR ADMINISTRATION OF CYTOTOXIC CHEMOTHERAPY Version 4.0 March 2016 Review date March 2018 Introduction It is the purpose of this policy to provide clear guidelines that
More informationEducation for self administration of intravenous therapy HOME IV THERAPY. 30 minute - Baxter Pump Tobramycin
HOME IV THERAPY Tobramycin Tobramycin Check the order on the drug chart This can change when the results from your blood test come through. Your doctor will change the order, if required. A copy of the
More informationNational Clinical Procedural Guideline for Nurses and Midwives undertaking Venepuncture and/or Peripheral Intravenous Cannulation in
Section 6 National Clinical Procedural Guideline for Nurses and Midwives undertaking Venepuncture and/or Peripheral Intravenous Cannulation in Neonates For local adaptation by the Health Service Provider
More informationCentral Venous Line Insertion
Central Venous Line Insertion Understand the indications and risks of CVC insertion Understand and troubleshoot the seldinger technique Understand available sites and select the appropriate site for clinical
More informationThe Impact of Healthcare Associated Infection (HCAI)
Instructions for use Save this presentation Feel free to add or delete slides as necessary, change information to suit local needs and as new guidance or evidence is published Disclaimer: Whilst the working
More informationPeripheral Cannulation
Contents... 1 Purpose... 1 Scope... 1 Associated documents... 1 Certification Requirements for RN, EN, RM, IV and Anaesthetic Technicians... 1 Peripheral IV Cannulation Requirements... 2 Vein Assessment:...
More informationBeing a phlebotomist is a rewarding career. The correct term for the procedure that the phlebotomist performs is known as
PHLEBOTOMY WINTER, TEST 1 NAME: 1. Being a phlebotomist is a rewarding career. The correct term for the procedure that the phlebotomist performs is known as a. Removing blood b. Venipuncture c. Intrapuncture
More informationGUIDELINES FOR THE PREVENTION OF INFECTIONS ASSOCIATED WITH PERIPHERAL VENOUS CATHETERS
Edition No: 6 ID Number: GUCPCM007 Dated: August 2016 Review Date: August 2019 Document ID: Corporate Document Type: Guideline Directorate: Nursing Category: Patient Care & Management Department(s): Infection
More informationLABORATORY SERVICES TECHNICAL PROCEDURE
LABORATORY SERVICES TECHNICAL PROCEDURE TITLE: BLOOD CULTURE COLLECTION PROCEDURE NUMBER: SC050.4 PERFORMING SITE(s): University Hospital, Drake Center SITE EFFECTIVE DATE 8/8/13 SUPERSEDES: 1/5/2012 RETIRED
More informationSTEP-BY-STEP GUIDE TO SELF-INFUSION. Subcutaneous Administration of GAMMAGARD LIQUID
STEP-BY-STEP GUIDE TO SELF-INFUSION Subcutaneous Administration of GAMMAGARD LIQUID This handy guide will help you manage your subcutaneous administration of GAMMAGARD LIQUID. If you have questions on
More informationPer-Q-Cath* PICC Catheters with Excalibur Introducer* System
Bard Access Systems Per-Q-Cath* PICC and Catheters with Excalibur Introducer* System Instructions For Use Table of Contents Table of Contents Page Contents 1 Product Description, Indications & Contraindications
More informationSterile Technique & IJ/Femoral Return Demonstration
Sterile Technique & IJ/Femoral Return Demonstration Sterile Technique Description: This is a return demonstration checklist used to evaluate participants in the simulated hands on skills portions for certification
More information2. Indications Infusion of hyperosmolar medication, e.g. TPN. Administration of vasoactive/irritant drugs.
Policy and Procedure for Insertion and care of Peripherally Inserted Central Catheters by Neonatal Staff (see Ch 8 TPN) 1. Introduction The peripherally inserted central catheter (PICC) is an intravenous
More informationProcedure for removal and reinsertion of an indwelling urethral catheter (female)
Procedure for removal and reinsertion of an indwelling urethral catheter (female) Refer to National Infection Prevention and Control Manual for information on aseptic technique/cleaning equipment. Equipment
More informationCentral Venous Catheter Insertion: Assisting
Approved by: Central Venous Catheter Insertion: Assisting Gail Cameron Senior Director, Operations, Maternal, Neonatal & Child Health Programs Dr. Santiago Ensenat Medical Director, Neonatology Neonatal
More informationSt George Hospital Renal Department Internal Policy
SUMMARY: TROUBLESHOOTING POOR BLOOD FLOW IN VASCATHS: Please see the flow chart at the end of the protocol describing possible causes to be considered and how to deal with these in a systematic fashion.
More informationUrinary Catheter Passport SAMPLE COPY. A guide to looking after a urinary catheter. (for service users and healthcare workers) 2nd Edition
Urinary Catheter Passport A guide to looking after a urinary catheter (for service users and healthcare workers) 2nd Edition Contact details Urinary Catheter Passport Service user Name Address Postcode
More informationClinical Guidelines Intravenous Access Care and Maintenance for Adult Patients in hospital and at home
Policy Number LCH-140 This document has been reviewed in line with the Policy Alignment Process for Liverpool Community Health NHS Trust Services. It is a valid Mersey Care document, however due to organisational
More informationTable of Contents. Dialysis Port Care Chemotherapy Port Care G-Tube Care Colostomy Bags Wound Dressings
Table of Contents Dialysis Port Care Chemotherapy Port Care G-Tube Care Colostomy Bags Wound Dressings Dialysis Port Care Know What Type of Vascular Access You Have. Fistula: An artery in your forearm
More informationPhlebotomy Blood Sampling From the Arm by Venipuncture
REB SOP 03 Page 1 of 9 Short Title Arm Venipuncture Effective Date May 4, 2017 Approved by REB May 4, 2017 Version Number 1 A. PURPOSE AND BACKGROUND 1. Venipuncture is the transcutaneous puncture of a
More informationCredentialing for Insertion of Adult Peripheral Intravenous (IV) Cannula
F Policy Compliance Procedure Credentialing for Insertion of Adult Peripheral Intravenous (IV) Cannula This PCP relates to HNEH Policy HNEH 07/XX: HNEH Adult Peripheral IV Cannulation PCP Number Sites
More informationA. Complications With Intravenous Catheters FHI B. Central Line Protocol Management of Site Complications C. Intravenous Catheter Complications
Department Policy Entity: Fairview Pharmacy Services Department: Fairview Home Infusion Manual: Policy and Procedure Manual Category: Home Infusion Subject: Peripheral Venous Access Purpose: Fairview Home
More informationA patient guide to administration of subcutaneous immunoglobulin replacement therapy - using manual push technique
A patient guide to administration of subcutaneous immunoglobulin replacement therapy - using manual push technique This piece of patient information is a step by step guide to administering your immunoglobulin
More informationSPECIMEN COLLECTION-WAIVED TESTING
SPECIMEN COLLECTION-WAIVED TESTING POLICY 1. Application for waived testing will be submitted to CLIA (Clinical Laboratory Improvement Amendments) on a yearly basis. 2. All laboratory specimens: PURPOSE
More informationIV Fluids Nursing B23 Objectives Serum Osmolality 275 to 295 Isotonic
1 IV Fluids Nursing B23 2 Objectives 3 Serum Osmolality Serum osmolality solute concentration of a solution Higher osmolality means greater pulling power for water Normal serum osmolality is 275 to 295
More informationPROCEDURE FOR BLOOD GLUCOSE MONITORING
PROCEDURE FOR BLOOD GLUCOSE MONITORING First Issued Issue Version Two Purpose of Issue/Description of Change Planned Review Date To promote safe and effective blood glucose monitoring using Trust equipment
More informationIV Fluids. Nursing B23. Objectives. Serum Osmolality
IV Fluids Nursing B23 Objectives Discuss the purpose of IV Discuss nursing interventions in IV therapy Identify complications of IV therapy Differentiate between peripheral line, central line, and PICC
More informationSARASOTA MEMORIAL HOSPITAL. NURSING PROCEDURE INTRAOSSEOUS NEEDLE: INSERTION, CARE, AND REMOVAL (inv08) 12/18 12/18 1 of 7 RESPONSIBILITY:
SARASOTA MEMORIAL HOSPITAL TITLE: ISSUED FOR: NURSING PROCEDURE INTRAOSSEOUS NEEDLE: INSERTION, CARE, AND REMOVAL (inv08) Nursing DATE: REVIEWED: PAGES: 12/18 12/18 1 of 7 RESPONSIBILITY: PS1094 Insertion-
More informationChapter 14: Arterial Puncture Procedures
Objectives Chapter 14: Arterial Puncture Procedures 1. Define the key terms and abbreviations listed at the beginning of this chapter. 2. State the primary reason for performing arterial punctures and
More informationInsertion of a totally implantable vascular access device (TIVAD)
Insertion of a totally implantable vascular access device (TIVAD) What is a TIVAD? A TIVAD is a long hollow tube that is inserted into one of the large veins in your body. One end of the tube sits in a
More informationStandard Operational Procedure. Drainage of Malignant Ascites (Abdominal Paracentesis)
Standard Operational Procedure Drainage of Malignant Ascites (Abdominal Paracentesis) Background Cancers that involve the peritoneum can cause fluid to build up within the abdominal cavity. This is most
More informationEVOGAM. Information for patients Evogam 2014 NZ Patient Brochure Update v11
EVOGAM Information for patients 11881 Evogam 2014 NZ Patient Brochure Update v11 Information for patients and caregivers about EVOGAM This booklet is designed to help you follow the training you will have
More informationSARASOTA MEMORIAL HOSPITAL
SARASOTA MEMORIAL HOSPITAL TITLE: NURSING PROCEDURE BLOOD CULTURE COLLECTION PROCEDURE (spe20) DATE: REVIEWED: PAGES: 6/10 2/19 1 of 6 PS1094 ISSUED FOR: Nursing/Lab RESPONSIBILITY: RN, LPN II, select
More informationCentral Line Care and Management
Central Line Care and Management What is a Central Line/ CVAD? (central venous access device) A vascular infusion device that terminates at or close to the heart or in one of the great vessels (aorta,
More informationBPG 03: Continuous Renal Replacement Therapy (CRRT)
BPG 03: Continuous Renal Replacement Therapy (CRRT) Statement of Best Practice Patient s requiring Continuous Renal Replacement Therapy (CRRT) will receive appropriate therapy to meet their individual
More informationWhat is a catheter? What do I need to learn about catheter care?
Catheter care What is a catheter? A catheter is a tube that drains urine from your child s body. The catheter is connected to tubing and a bag to collect the urine. Catheters come in different sizes and
More informationPREOPERATIVE ANAEMIA PATHWAY
PREOPERATIVE ANAEMIA PATHWAY Surname: Unit No. Forename: DOB: / / Age: NHS Number: Likes to be called: Address: Tel. No. Religion/Spirituality: GP Name: GP Practice: Planned Operation: Postcode: Mobile
More informationProcedure for removal and reinsertion of a supra pubic catheter
Procedure for removal and reinsertion of a supra pubic catheter Equipment required collect prior to procedure Perform this procedure as an aseptic technique to minimise the risk of introducing Clean the
More information