PRCEDURES ON IVF

Procedure 1: A. Setting up B. Inserting IV Utilizing the Dummy Arm C. changing an IV Solution D. Discontinuing an IV infusion. Steps I.A SETTING UP 1. Verify written prescription and make IV label. 2. Observe ten (10) Rs when preparing and administering IVF. 3. Explain procedure to reassure patient and/or significant other, secure consent if necessary. 4. Assess patients vein; choose appropriate site, location, size/condition. 5. Do hand hygiene before and after the procedure. 6. Prepare necessary materials for procedure (IV tray with IV solution, administration set, IV cannula, forceps soaked in anti-septic solution, alcohol swab or cotton balls soaked in alcohol with cover (this should be exclusively used for I.V.), plaster, tourniquet, gloves, splint and IV hook), sterile 2x2 gauze or transparent dressing. 7. Check the sterility and integrity of the IV solution, IV set and other devices. 8. Place IV label on IVF bottle duly signed by RN who prepared it (patients name, room no., solution, time and date). 9. Open IV administration set aseptically following the infection control measure. 10. Open the IV administrations set aseptically and close the roller clamp and spike the infusate container aseptically. 11. Fill drip chamber to at least half and prime it with IV fluid aseptically. 12. Expel air bubbles if any and put back the cover to the distal end of the IV set (get ready for IV insertion). I.B INSERTING IV CANNULA UTILIZING DUMMY ARM Prepare complete IV tray with IV infusions; Dummy Arm and over-the-needle catheter or Butterfly needle.

1. Verify the written prescription for IV therapy; check prepared IVF and other things needed. 2. Explain procedure to reassure the patient and significant and others and observe the 10 Rs. 3. Do hand hygiene before and after the procedure. 4. Choose site for IV. 5. Apply tourniquet 5 to 12 cm. (2-6 in) above injection site depending on condition of patient 6. Check for radial pulse below tourniquet. Prepare site with effective topical antiseptic according to hospital policy or cotton balls with alcohol in circular motion and allow 30 seconds to dry (No touch technique). Note: Universal persecution: Always wear gloves when doing any venipuncture. 7. Using the appropriate IV cannula, pierce skin with the correct technique. 8. Upon block flow visualization, continue inserting the catheter into the vein. 9. Position the IV catheter parallel to the skin. Hold stylet stationary and slowly advance the catheter until the hub is 1mm to the puncture site. 10. Slip gauze under the hub. Release the tourniquet; remove the stylet while applying the digital pressure over the catheter with one finger about 1-2 inches from the tip of the inserted catheter. 11. Connect the infusing tubing of the prepared IVF aseptically to the IV catheter. Note: when steel winged needle (butterfly) is used: a. Connect the IV tubing to the steel winged needle connector and prime the needle with IV fluid. b. Using the steel-winged needle, pierce skin with the needle bevel up, positioned on a 5-10 degree angle. c. With steel-winged needle, parallel to the skin enter the vein directly and advance needle inch after successfully performing venipuncture check for back flow. Remove tourniquet.

d. Do not reinsert stylet once pulled out to prevent breakage of catheter that may cause embolism. 12. Open the clamp and regulate the flow rate. Reassure patient. 13. anchor needle firmly in place with the use of: a. Transparent tape/ dressing directly on the puncture site. b. Tape (using any appropriate anchoring style) c. Band-Aid Note: Never place unsterile tape directly on the IV insertion site. Instead place a small piece of sterile OS and then secure it with adhesive tape. 14. Tape a small loop of IV tubing for additional anchoring. Apply splint, if needed. 15. Calibrate the IV battle and regulate flow of the infusion according to the prescribe duration. 16. Label on IV tape near the IV site to indicate the date of insertion, type and gauge of IV catheter and countersign. 17. Label with plaster on IV tubing to indicate when to change the IV tubing. 18. Observe patient and report any untoward effect. 19. Document the patients chart and endorse to incoming shift. 20. Discard sharps and waste according to Health Care Waste Management (DOH/ DENR). I.C CHANGING AN IV SOLUTION 1. Verify doctors prescription in doctors order shift; counter check IV label, IV card, infusate sequence, type, amount, additives (if any), and duration of infusion. 2. Observe 10 Rs 3. Explain the procedure to reassure the patient and the significant others and assess IV site for redness, swelling, pain, etc 4. Check IV tubing and cannula if 48-72 hours has lapse after IV insertion. Prepare necessary materials; place on an IV tray 6. Check sterility and integrity of IV solution. 7. Place IV label on the IV bottle.

8. Wash hands before the procedure. 9. Calibrate new IV bottle according to duration of infusion as per prescription. 10. Open and connect the IV tubing into the solution bottle. 11. Closer the roller clamp. 12. Regulate the flow rate according to the prescribed infusion rate. Expel air bubbles, if evident. 13. Reiterate assurance to patient and significant others. 14. Discard sharps and waste according to Health Care Waste Management (DOH/ DENR). 15. Document and endorse accordingly. I.D DISCONTINUING AN IV INFUSION 1. Verify written doctors doctor to discontinue IV including IV medications. 2. Observed 10 Rs 3. Assess and inform the patient of the discontinuation of IV infusion. 4. Prepare the necessary materials; IV tray or injection tray with sterile cotton balls with alcohol, plaster, pick-up forceps in antiseptic solution, kidney basin and Band-Aid. 5. Wash hands before and after procedure 6. Close the roller clamp of the IV administration set. 7. moisten adhesive tapes around the IV catheter with cotton ball with alcohol; remove plaster gently.(never use alcohol to clean the site) 8. Use pick-up forceps to get cotton ball with alcohol and without applying pressure, remove needle or IV catheter then immediately apply pressure over the venipuncture site. 9. Inspect IV catheter for completeness. 10. Place dressing over the venipuncture site. 11. Discard all waste materials including IV cannula according to Health Care Waste Management (DOH/ DENR). 12. reassure patient, 13. Document time of discontinuance, status of insertion site and integrity of IV catheter and endorse accordingly.

Steps