Procedure for Insertion of a PVC - Royal Devon & Exeter Hospital

PROCEDURE FOR INSERTION OF A PERIPHERALVENOUS CANNULA (PVC)Post holder responsible for Policy:Directorate/Department responsible for Policy:Lead Nurse/Director of Infection Prevention& ControlInfection Prevention & ControlContact details: Ext. 2355Date written: July 2011Date revised:Approval route (names of committees):Level of Impact Assessment(Screening or Full – attach to policy)N/AInfection Prevention & Control GroupScreeningDate of final approval: 11 th August 2011Date due for revision: August 2013Date policy becomes live: August 2011This document replaces:N/AControlled documentThis document has been created following the Royal Devon and Exeter NHS FoundationTrust Policies, Procedures, Protocols, Guidelines and Standards Policy.It should not be altered in any way without the express permission of theauthor or their representative.Please specify standard/criterionnumbers and tick other boxesas appropriateMonitoring InformationThe Strategic Directions 2007-2012 were agreed by the Board of Directors inOctober 2007 to support the Trust’s vision “Respond, Deliver, Enable”. The KeyMilestones below will ensure there is a shared understanding about what needs tobe delivered.Strategic Directions – Key MilestonesPatient ExperienceWaitingAssurance FrameworkPrivacy and DignityMonitor/Finance/PerformanceEfficiency and EffectivenessCare Quality CommissionDelivery of Care Closer to Home8Outcomes:Infection ControlNHSLA Risk Management Standards for Acute TrustsNHSLA CNST Maternity Clinical Risk Management Standards:Other (please specify):Note: This policy has been assessed for any equality, diversity or human rights implicationsProcedure for Insertion of a PVCApproved by Infection Prevention & Control Group: 11 th August 2011Review date: August 2013 Page 1 of 3

PROCEDURE FOR INSERTION OF APERIPHERAL VENOUS CANNULA (PVC)This procedure should be read in conjunction with the Vascular Access Device policySection 6.3Equipment• Clean tray• Clean gloves• 2% chlorhexidine in alcohol wipe ( e.g. PDI wipe)• Cannula• IV cannula dressing ( e.g. IV Opsite 3000)• Extension set with needlefree connector• 0.9 % normal saline for injection• 10ml syringe and needle• TubifastProcedureThis procedure is undertaken using an aseptic non touch technique, the key partsbeing:• Clean tray• Cannula shaft and tip• Disinfected insertion site• Dressing• Tip of syringe• Hub of needle• Extension set and needle free connector.• Sharps bin1) Explain procedure to patient and obtain verbal consent2) Clean hands using alcohol gel or soap and water.3) Open the cannula and needle free connector device packaging ready for usewithout touching the key parts. Draw up saline flush using a needle and primethe needle free extension line/lines again without touching key parts.4) Position patient comfortably and select most appropriate site for insertion.5) Place the single use tourniquet.6) Disinfect insertion site using wipe, ensuring a contact time of 30-60 secondsand allow to thoroughly dry.7) Cleanse hands with hand rub gel and put on clean non-sterile gloves.8) Remove the cannula from the packaging. Ensure the stylet moves freely bybriefly withdrawing it no more than 2mm. Bend the wings through 180degrees so that they will lie flat after insertion.Procedure for Insertion of a PVCApproved by Infection Prevention & Control Group: 11 th August 2011Review date: August 2013 Page 2 of 3

9) Without retouching the planned insertion point, apply skin tension and anchorvein with one hand.10) Insert cannula a short distance into the vein at a low angle with the beveluppermost.11) The entry of the needle tip into the vein is indicated by the presence of bloodin the flashback chamber.12) Advance the cannula a few millimetres further into the vein to ensure thatcannula is positioned within the lumen of the vein.13) Avoid any contamination by holding the hub by the wing or protection cap.14) Withdraw the stylet partially (5mm) to avoid exit through the posterior veinwall. Advance the cannula off the stylet into the vein. Release tourniquet.15) Raise the patient’s arm to avoid blood spillage, withdraw stylet and placedirectly into sharps bin. If raising the arm is not possible, press on the veinabove the cannula tip.16) Attach appropriate IV connector.17) Flush cannula with 5mls 0.9% sodium chloride to confirm patency through theneedle free connector using an aseptic non-touch technique.18) Apply cannula dressing19) Cover with tubifast.20) In the event of failing to cannulate a vein, apply sterile gauze swab andremove the cannula, applying pressure for 2 minutes. If patient coagulationscreen is prolonged or platelets are low then a longer period of pressure isrecommended.21) Subsequent attempts must be made proximal to previous attempts or cannulasites, i.e. higher up the arm.22) Dispose of equipment, remove gloves and cleanse hands.Procedure for Insertion of a PVCApproved by Infection Prevention & Control Group: 11 th August 2011Review date: August 2013 Page 3 of 3