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A nurse is preparing to insert an IV carther into a clients arm prior to initiating...

A nurse is preparing to insert an IV carther into a clients arm prior to initiating IV fluid therapy which of the following interventions should the nurse implement to prevent infection?

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Expert Solution

Intravenous (IV) insertion is a procedure wherein a vein is punctured through the skin by a cannula to provide venous access.

The nurse should implement the following interventions before inserting an IV catheter:

  • Wash hands and prepare all equipment at bedside which ensures asepsis and a smooth flow of procedure.
  • Perform hand hygiene with an alcohol based hand rub before inserting an IV device or having contact with the IV dressing, site, device or attachments.
  • Wear Personal Protective Equipment (PPE). IV catheter insertions require gloves and mask with face shield.
  • Select an optimal Insertion site. In an adult, the preferred IV site is the dorsum of the hand.
  • Prepare the skin at insertion site with an alcohol/chlorhexidine solution (70% alcohol, >0.5% chlorhexidine), such as ChloraPrep. Perform a 30 second back and forth scrub and then air dry. Use tincture of iodine, an iodophor, and/or 70% alcohol as alternatives if there is a contraindication to chlorhexidine (i.e., patient sensitivity, device manufacturer recommendations, neonates). Drying allows for complete microbicidal activity and scrubbing with friction allows for penetration into the cracks and fissures of the epidermal layer.
  • Apply tourniquet 5-6 inches above selected site, do not repalpate the cleaned skin.
  • Placing traction on the skin below the intended puncture site, insert the cannula with the bevel up at an angle of 30o into the puncture site.
  • Advance the cannula and observe flashback.
  • Hold the needle introducer still whilst advancing the cannula forward, over the needle and fully into the vein.
  • Release the tourniquet and dispose the needle into the sharps bin.
  • Connect bionector to the cannula.
  • Secure the cannula in place with the sterile dressing,ensure not to cover the puncture site with the tape when securing down, as this can cover up any possible phlebitis developing.
  • Flush the bionector and cannula with 5ml of saline, no resistance should be felt.
  • Check for any signs of extravasation / tissuing around the cannula site. Remove cannula if suspected.
  • Discard all waste into the correct disposal bins and ensure the patient is comfortable.
  • Remove your gloves and perform Hand hygiene.

Nightingale answered 2 years ago
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