More than 90% of hospitalised patients receive some form of IV therapy. Unfortunately, about 1/5 of patients on IV therapy experience complication or death due to lack of administration care, especially since IV medication is administered directly into the venous system. This emphasises the importance of IV therapy safety.
High Risk Medication = drugs with a high potential of significant harm to the patient if administered incorrectly eg. Potassium Chloride, Glucose (50% or more), Sodium Chloride (more than 0.9%), anticoagulants (injectable), Vitamin K, Insulin and Opiates.
Label Medication = this can be beneficial especially in the case of multiple medication syringes. Label one medication at a time whilst preparing them (do not pre-label empty syringes) and take only labelled medication near your patient to avoid mistakes. Do not administer any unattended or unlabelled medications.
Flushing = use 10ml syringe for flushing, especially in Central Line; flush with double the medication amount using a bigger than needed syringe (eg. flush 5ml using a 10ml syringe)
Peripheral Venous Cannula (PVC) Site Care:
- use smallest cannula size possible
- label with date and time
- remove after 3 days
- use transparent dressings to assess site
- clean around cannula site using 2% Chlorhexidine in 70% Isopropyl
- do not attempt to cannulate more than two times, if unsuccessful seek assistance
- clean infusion equipment with Clinell (NOT an alcohol swab)
- IMPORTANT! a cannula infection can cause sepsis and even death…remove if unnecessary, do not leave in situ just in case
Fluid Therapy: 5 R’s of Fluid Management
- Resuscitation
- Routine Maintenance
- Replacement
- Redistribution
- Reassessment
Fluid therapy is administered as a continuous infusion for a maximum of 24 hours followed by a review, or a bolus. Always assess for dehydration and fluid overload!
IV Line Management
- replace IV tubings whenever cannula is changed
- do not disconnect tubing and lines unless really necessary
- change tubing every 96 hours
Below you can find a collection of videos that can help provide a more visual approach to IV Therapy Safety.
Committing To Patient Safety – IV Therapy Safety
IV Push / Bolus Infusion Administration
Intermittent IV Administration
Continuous IV Administration
Peripheral IV and Central Venous Line IV Administration
Aseptic Non Touch Technique To Administer IV Medication – IV Therapy Safety
Special thanks to the creators of the featured videos on this post, specifically Youtube Channels World Health Organisation (WHO), Equashield – Closed System Transfer Device, Sonia Dalai, University of Manitoba Nursing Skills, Santa Fe College Educational Media Studio and RNOHnhs.
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With formal nursing education and extensive clinical training at the University of Malta, Claire brings a strong foundation in healthcare to her work. Passionate about health education, person-centred care and lifelong learning, she uses her blog Student Nurse Life to share knowledge, encourage reflection and inspire a more informed, compassionate and positive approach to health and everyday life.
