Intravenous Therapy – Peripheral Guidelines

1.   Peripheral IV Site Maintenance:

      a.     IV sites should be changed every 96 hours and prn. If the procedure is delayed beyond this time frame, documentation should reflect the rationale and the physician should be informed.

      b.     Site prep should be done for at least one minute using 10% betadine solution or 70% alcohol. The site should be allowed to dry for 30 seconds after prep. A chlorhexidine prep may be used as well.

      c.     IV sites should be dressed with an occlusive transparent dressing. IV site should be labeled with start date/time, catheter gauge, nurse’s initials. The dressing may be left in place for the 96 hour duration of the IV site if intact.

      d.     IV site assessment should be done at least every 8 hours. Gloves should be worn when contact with blood is likely.

2.   IV Fluid Maintenance:

      a.     Each IV bag/bottle should have a label identifying client, medication, additive and flow rate.

      b.     A bag/bottle of IV fluid should not hang longer than 24 hours. Bags should be inspected for expiration dates.

3.   IV/IVPB Tubing Maintenance:

      a.     Tubing should be changed every 96 hours. This should be corresponded with the site change when possible.

      b.     All tubing should be labeled with the date/time of change and the nurse’s initials.

      c.     Piggyback tubing should be changed every 96hours. Piggyback fluids should be administered with the same tubing after backflushing with primary fluid.

      d.     TPN tubing should be changed every 24 hours.

      e.     Blood tubing should be changed prn or after every 2nd unit.

4.   Nursing interventions for inflammation of IV site may include:

a.   DC present IV site.

b.   Notify physician of inflammation.

c.   Elevate the extremity.

d.   Apply warm packs.

5.   Documentation concerning IV placement, assessment and discontinuation will be done on the IV Flow Sheet.