1 IV Access and Safety Fundamentals

Safety principles

IV procedures should be performed only by trained, authorized personnel. Follow the patient’s care plan, facility policy, and the instructions for the devices and products being used. Safe preparation depends on checking the patient and order, selecting appropriate access, preserving asepsis, and verifying the complete setup before starting.

Choosing an access site

For a short-term peripheral IV in an adult, choose a suitable upper-extremity vein. Peripheral IV site selection should account for the prescribed therapy, expected duration, patient factors, and the clinician’s experience. When a better option is available, avoid sites that interfere with movement or make securement difficult.

Do not select a site solely because a vein is visible, or choose the smallest vein or a site over a joint without considering whether it suits the therapy and patient.

Verifying the patient and preparing supplies

Before preparing the IV, verify the patient with at least two approved Patient identifiers and match the intended care to the correct patient. A room or bed number does not identify a person. If the patient expresses uncertainty or any identity, order, or medication discrepancy arises, stop and clarify it before proceeding.

Gather the necessary, in-date supplies and inspect packaging and solutions for damage or unexpected appearance. Do not use items with compromised packaging, unreadable labels, or unexpected appearances. Arrange supplies on a clean work surface to reduce interruptions and contamination risk, and follow product instructions and facility policy.

Maintaining asepsis

Perform hand hygiene before insertion and maintain Aseptic technique. Protect sterile or critical parts, keep connection points protected, and do not touch the prepared insertion site. Touching the site after Antisepsis can reintroduce microorganisms.

If the prepared site is accidentally touched, re-clean it using the approved antiseptic procedure and allow it to dry as directed before insertion. For peripheral IV insertion, clean gloves are permitted when the site is not touched after antisepsis. Replace any contaminated or dropped item rather than using it; do not reuse a dropped cap merely because it appears clean.

Preparing the tubing

Use the Administration set specified for the device and therapy. Keep its connection points protected and use aseptic technique when connecting them. Prime the tubing according to the set and pump instructions while preventing air from entering the patient’s line.

Do not touch tubing ends or connect a contaminated end. Do not connect the tubing until the order and equipment requirements have been checked; if the setup does not match them, stop and resolve the issue.

Checking the pump

Before starting a prescribed pump infusion, check that the Infusion pump and compatible tubing are set up correctly. Verify that the programmed dose or rate and volume match the order and product label. Use the drug library when applicable and follow facility policy for required independent double-checks, including checks for high-risk infusions.

Do not use a damaged or malfunctioning pump, ignore alarms, or turn down the alarm volume to reduce disturbance. Escalate concerns according to facility policy.

Final verification before starting

Treat any mismatch as a stop point. Just before starting, verify the patient, order, solution, route, and setup. If a bag label does not match the intended therapy, do not connect or start the infusion until the discrepancy has been resolved with the appropriate clinician.

Do not guess, relabel a bag from memory, or begin at a slower rate while seeking clarification. Pause and clarify anything that does not match before proceeding.

• Priming