Collaborative Intravenous Nursing Service (CINS) Guidelines

• Open out sterile pack to create a sterile field. Open remaining equipment ensuring nocontamination of sterile field.• Place 0.9% sodium chloride & Heparinised saline ampoule(s) near to the working areabut not on the sterile field. Pour out alcohol Chlorhexidine solution.• Ensure easy access to the needle free system.• Decontaminate hands.• Put on sterile gloves. Connect needle/filter straw to the syringe.• With a piece of sterile gauze pick up the 0.9% sodium chloride (saline) ampoule, drawup 10ml of solution. Repeat for Heparinised saline if open-ended catheter. If useddispose of the needle directly into sharps container, place the filled syringe(s) on thesterile field.• Place sterile towel as near as possible to the catheter.• Using a piece of sterile gauze soaked in alcohol Chlorhexidine solution, scrub the topthen the sides of the needle free system connection and allow to dry.• Alternatively, scrub the hub of the needle free system with Chlorhexidine impregnatedwipe, rubbing from the top of the needle free connector to the sides. Do this threetimes using different parts of the wipe, over a period of 30 seconds.• Allow to dry.• Attach syringe with 0.9% sodium chloride flush and inject the flush using a push/pauseaction, clamping as the last ml of solution is instilled into the catheter.• Remove the syringe and discard. Repeat flush now using Heparinised saline• NEVER FORCE THE SOLUTION INTO THE CATHETER, this can damage thecatheter.• Ensure that the catheter is secure and comfortable.• Remove dressing towel and discard. Remove gloves.• Wash hands• Clear away equipment used taking care to dispose of contaminated waste as perpolicy.• Document care in patient’s records.manufacturers recommendations(DOH 2001).The pulsated flush creates turbulencewithin the catheter lumen, removingdebris from the internal catheter wall(Goodwin & Carlson 1993, Todd1998).Positive pressure within the lumen ofthe catheter should be maintained toprevent reflux of blood (INS 2000).48The CINs group hereby assert their moral rights tothe works herein in accordance with the Data Protection Act 1988.Policy review date 01/10/10