Collaborative Intravenous Nursing Service (CINS) Guidelines

Type of device Risks Actions Variations / Comments SIGNInfection due to loss ofskin integrity • Site clean and protected with steriledressing as per CINS guidelines.• Minimum of 8 hourly inspection of exit sitefor signs of inflammation or infection. Donot remove dressing unless soiled.• Take swab for culture and sensitivity ifindicated• Check weekly or at each visit if incommunity settingVisual Infusion Phlebitis scored(VIP) See chart• Observe patient for signs of line infection(pyrexia / raised WCC)• If clinically unstable and patient has hadrigors, take blood cultures from line andindependent venous sample• Assess medical condition prior to removalof line• Send tip for culture and sensitivity• Ensure administration lines in placefollowing local policy.• Replace any infusates with additives andtheir administration lines up to a max of24hrs if constituted in ward environment.• Label infusion lines with date for renewal.• Change add-on devices at same time asadministration sets or as soon as integrityis compromised. Use needle-free systemsand avoid 3 way taps81Air embolus • Use Needle-free systems• Ensure air dispelled from medication/flushes/infusates prior to administration.• Assess need for infusion pumpOcclusion of lumen. • Maintain patency via 0.9% SodiumThe CINs group hereby assert their moral rights tothe works herein in accordance with the Data Protection Act 1988.Policy review date 01/10/10