Collaborative Intravenous Nursing Service (CINS) Guidelines

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solution or open Chlorhexidine impregnated applicator.Decontaminate handsPut on sterile gloves connect the needle/filter straw to the syringeWith a piece of sterile gauze pick up the 0.9% Sodium Chloride (saline) ampule, draw up10ml. Repeat for Heparinised saline. If a needle is used dispose directly into the sharpscontainer. Place the filled syringes on the sterile field.Prime the non-coring needle device including its tubing with 0.9% Sodium Chloride andclamp extension tube, remove syringe.Remove anaesthetic cream if used, locate septum of TIVAD by palpation, remove gloves.Decontaminate hands and put on new pair of sterile gloves.Place dressing towel as near as possible to TIVAD siteClean the skin covering the TIVAD with gauze soaked in Chlorhexidine Gluconate 2% in70% Isopropyl alcohol or Chlorhexidine Gluconate 2% in 70% Isopropyl alcoholimpregnated applicator. Allow to dry Remove needle cover from non-coring needle device. Insert the non-coring needle at 90-degree angle through the skin into the septum of the TIVAD until the needle comes intocontact with the metal backing.Needle free device must be cleaned prior to reattaching syringe – thoroughly clean thehub of the needle free system with 2% Chlorhexidine impregnated wipe or sterile gauzesoaked in 2% Chlorhexidine, rubbing the top of the needle free connector to the sides.This should be done 3 times over a period of 30 seconds. Allow to dry. Attach syringe with 0.9% Sodium Chloride, aspirate enough blood to colour the solutionand inject the flush using a push pause action clamping as the last ml of the solution isinstilled into the catheter. Remove the syringe and discard.If there is no flash back of blood or if there is swelling around the TIVAD site assess forcorrect needle placement, remove the needle and re-access.Following successful 0.9% Sodium Chloride for injection flush, administerantibiotics/infusion/additives as prescribed following local Trust PolicyFlush the catheter again with the appropriate volume of 0.9% Sodium Chloride forinjection, using a push/pause action, clamping as the last ml of the solution is instilled intothe catheterRepeat the flushing technique using Heparin 100units/ml in 0.9% Sodium Chloride, usinga push/pause action, clamping as the last ml of the solution is instilled into the catheter.63The CINs group hereby assert their moral rights tothe works herein in accordance with the Data Protection Act 1988.Policy review date 01/10/10
64If TIVAD was accessed for flushing purposes only, remove the needle and apply pressureover puncture site for a few minutes until bleeding stops.If the needle is to remain in situ ensure the needle is secured using steri-strips andappropriate highly permeable dressing.Remove dressing towel and discard. Remove gloves. Wash handsClear away equipment used. Dispose of contaminated waste as per organisational policyDocument care in patient’s recordsThe CINs group hereby assert their moral rights tothe works herein in accordance with the Data Protection Act 1988.Policy review date 01/10/10
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Intravenous Access Care and Mainten
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4Cheshire and Merseyside NHS North
Page 8 and 9:
Open sterile pack, allowing inner p
Page 10 and 11:
Ensure all equipment is gathered be
Page 12 and 13:
Skin Tunnelled Catheters - Blood Sa
Page 14 and 15: catheter.• Ensure that the cathet
Page 16 and 17: • Open sterile pack allowing inne
Page 18 and 19: Algorithm persistent withdrawal occ
Page 20 and 21: The CINs group hereby assert their
Page 22 and 23: Care and Maintenance of a non tunne
Page 24 and 25: Central Non-Tunnelled Catheters - S
Page 26 and 27: Central Non-Tunnelled Catheters - B
Page 28 and 29: Central Venous Non-Tunnelled Cathet
Page 30 and 31: Algorithm persistent withdrawal occ
Page 32 and 33: 31References.1. Department of Healt
Page 34 and 35: • Open sterile pack, allowing inn
Page 36 and 37: • Open out sterile pack to create
Page 38 and 39: 37Peripherally Inserted Central Cat
Page 42 and 43: • Place 0.9% sodium chloride (sal
Page 44 and 45: References431. Department of Health
Page 46 and 47: Care and Maintenance of a Periphera
Page 48 and 49: Peripheral Midline - 0.9% Sodium Ch
Page 50 and 51: 49Peripheral Midline -Administratio
Page 56 and 57: Put on sterile glovesPlace sterile
Page 58 and 59: ampoule(s) near to the working area
Page 60 and 61: 59Totally Implanted Venous Access D
Page 62 and 63: If TIVAD was accessed for flushing
Page 66 and 67: 65Care and Management of Peripheral
Page 68 and 69: 67Changing a Needle-free I/V access
Page 70 and 71: 69EXIT SITE INFLAMMATION/PHLEBITISP
Page 72 and 73: SYSTEMIC INFECTION71Signs & Symptom
Page 74 and 75: FOR CARE OF PERIPHERAL VENOUS CANNU
Page 76 and 77: Bleeding from site / lineitself.Lin
Page 78 and 79: 77Type of device Risks Actions Vari
Page 80 and 81: EVALUATION RECORD79DATE EVALUATION
Page 82 and 83: Type of device Risks Actions Variat
Page 84 and 85: EVALUATION RECORD83DATE EVALUATION
Page 88 and 89: 87EVALUATION RECORDDATE EVALUATION
Page 92 and 93: 91EVALUATION RECORDDATE EVALUATION
Page 94 and 95: 2List of contributors to the Venous
Page 96 and 97: 4PCTcoordinatorMalcolm Smith Mid Ch
Page 98 and 99: 6University Hospital Aintree NHS Fo
Page 100 and 101: 81. IntroductionThe purpose of this
Page 102 and 103: venous shock, flare or phlebitis. S
Page 104 and 105: 12Hyaluronidase: Dilute 1500 units
Page 106 and 107: scheme is co-ordinated through the
Page 108 and 109: 16Appendix 2Specific antidotes in t
Page 110 and 111: experience. Due to the volume of th
Page 112: 20G. Infiltrate the site with 1-3ml
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Collaborative Intravenous Nursing Service (CINS) Guidelines

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