Title Policy for Peripheral Cannulation Policy reference number Reference Number: 102 Aim and purpose of the policy To provide guidance to Liverpool Community Health staff undertaking peripheral Cannulation Author Community Intravenous Therapy Team Type New document Reviewed document Review Date February 2014 Person/group accountable for review Intravenous Therapy Team Lead Type of evidence base used C: Evidence includes published and/or unpublished studies and expert opinion Issue date March 2011 Authorised by Clinical Policies Group March 2011 (Virtual Method) / Re-authorised at meeting on 13/4/12 Impact Assessment Undertaken Yes March 2011 Evidence collated No
5.2.5. INSERTION PROCEDURE INSERTION PROCEDURE RATIONALE 1. Identify the patient as per Liverpool Community Health NHS Trust policy. To ensure correct patient. 2. Explain the procedure to the patient; ask for preference regarding site and obtain verbal consent and co- operation. To ensure patient understanding Link to consent policy. 3. Discuss previous experiences and check need for local anaesthetic. To establish venous history. 4. Prior to selection of equipment: Hand wash with soap and water. Select the correct cannula size choosing the smallest gauge that will accommodate the patient’s infusion needs. To minimise risk of cross infection To reduce unnecessary trauma to the vein. 5. Decontaminate hands using alcohol hand rub or by hand washing with liquid soap as per Liverpool Community Health NHS Trust Hand Hygiene Policy To minimise risk of cross infection. 6. Check integrity of packaging and expiry date before opening pack onto clean trolley/surface. To maintain asepsis. 7. Wash and dry patients arm if visibly dirty. Clean skin required. 8. Position the patient with arm supported by pillow or if required ensure assistance from a colleague. Place the drape under the patients arm. To ensure patient comfort and safety. 9. Choose site according to patient condition and apply tourniquet at least 10cms above selected site. To dilate veins by obstructing venous return. 10. Find the PALPABLE vein. To reduce trauma to the vein. 11. Decontaminate hands using alcohol hand rub; To minimise risk of cross infection.
Appendix 2 VIIAD 1 Peripheral Cannula Note: Use appropriate form for central lines. Peripheral IV Cannula Visual Inspection of Intravenous Access Devices (VIIAD) Ensure that this form is completed each shift by registered nurse. Document any variance overleaf. Use separate form for every peripheral IV cannula. ……………………………… Indication for Insertion……………………………………………………….. Unit No. ………………………………….. Insertion date …………………… Time …………………………… Ward ……………………………………… Cannula size/colour/type …………………. …………………………… Site ……………………… Inserted by…………………………… Designation ……………………… Skin disinfected with …………………………. Date V.I.P. Score 0 – 5 (see overleaf) Flushed? Yes/No/NA Flow problems? Yes/No/NA Yes/No/NA Shift Time E L N E L N E L N Rationale for keeping cannula over 72 hrs. ………………………………… ………………………………… …………. Signature………………. Is venous access required for longer? Yes No Moisture/leak from site? Yes/No/NA Needle-free device/Octopus used? e.g bionector Yes/No/NA Registered Nurse Signature Printed Name TO BE COMPLETED ON TIME ON TIME OF REMOVAL. Date line removed ……/…../…… Time ……………….………………….. Reason for removal (circle) Elective VIP > 1 Dislodgement Other ……………………… Removed using aseptic technique by……………………………… Signature ……………………… If yes, refer to IV Therapy Team on 285 4696. Referred by ……………………….. Referred on .…/…/….
Appendix 5 Record Peripheral IV Cannulation Instruction: Please tick (√) if performed, cross (X) if not performed, or write N/A if deemed not applicable Surname Forename Ward/Dept Assessment Dates Assessor(s) Skills Lab Correct equipment collected Clean tourniquet Sterile glove Syringe, needle and normal saline Cannula pack with appropriate size of cannula Checks packaging and expiry dates Transporting Safely transfers equipment to patient Preparing the patient Identifies patient and explains procedure Obtains consent from patient Encourages questions Establishes comfort and privacy of patient Hand washing Washes hands using the Ayliffe technique Performs procedure Selects appropriate limb Applies tourniquet safely and checks pulse. Supports patient’s arm Selects appropriate vein Loosens tourniquet Cleanses patient’s skin aseptically with chlorhexidine 2% and allows to dry Washes hands/ disinfects hands with alcohol hand gel Opens equipment maintaining sterile field Places blue towel under chosen limb Reapplies tourniquet Disinfects hands with hand gel Applies sterile gloves Introduces needle safely until flashback Removes/loosens tourniquet Introduces of cannula carefully and withdraws introducer at the right time Stabilises cannula Flushes cannula with normal saline Appropriate sterile dressing applied Patient comfort & safety Comfort of patient re-established Explains care of cannula to patient Safety Disposes of sharps appropriately Maintains aseptic technique throughout Hand washing Washes hands Documentation Applies “Review by date” sticker Completes cannula insertion record Completes VIIAD form