INTRAVENOUS INFUSION
CHECKLIST
NAME: DATE:
YEAR LEVEL AND BLOCK: FINAL GRADE:
PROCEDURE DEMONSTRATED REMARKS
YES NO
1. Gather all equipment and bring to the bedside. Check IV
solution and medication additives against physician’s order.
2. Explain the procedure to the patient.
3. Perform handhygiene. If using an anesthesia (numbing)
cream, apply cream a few potential insertion sites.
4.Prepare the IV solution and tubing.
5.Place patient in low Fowler’s position in bed. Place protective
towel or pad under patient’s arm.
6.Select an appropriate site and palpate accessible vein.
7. If the site is hairy and agency policy permits, clip a 2” area
around the intended site of entry.
8. Apply a tourniquet 5”- 6” above the venipuncture site to
obstruct venous blood flow and distend the vein. Make sure that
the radial pulse is still present.
9.Ask patient to open and close fist. Observe and palpate for a
suitable vein.
10. Don clean gloves.
11.Cleanse th site with an appropriate antiseptic solution.
12.Use nondominant hand, place about 1”-2” below entry
site.
13.Enter the skin gently, holding the catheter by the hub in
your nondominat hand, bevel side up, a 10 – 30 degree
angle. Advance the needle or catheter into the vein.
14.When blood returns through the lumen of the needle ,
advance 1/8 to ¼ further into the vein.
15. Release the tourniquet. Quickly remove the protective cap
from the Iv tubing and attach the tubing to the catheter or
needle. Stabilize the catheter or needle with your nondominant
hand.
16. Start the flow of solution promptly by releasing the clamp
on the tubing.
17. Secure the catheter with narrow nonallergenic tape 1/2 “
placed sticky side up under the hub and crossed over the top of
the hub.
18. Place a sterile dressing over the venipuncture site.
19. Mark the date, time, site, and type and size of the catheter
used for the infusion on the tape anchoring the tubing. Put on
the IV tag.
20. Remove all equipment and dispose properly. Remove gloves
and perform hand hygiene.
21. Anchor arm to an armboard for support if necessary, or
apply a site protector or tube-shaped mesh .
22. Adjust the rate of solution flow according to the amount
prescribed.
23. Document the procedure and patient’s response. Chart
the time, site, device used and solution.
24. Return to check flow rate and observe for infiltration 30
mins after starting infusion.