/Safe IV Hydration/Safety standards/Intravenous Therapy Procedure

Intravenous Therapy Procedure

To ensure safe and effective intravenous therapy, this technique must follow the strict process outlined below to meet safety standards as regulated by the Ministry of Health.

The intravenous therapy process involves several steps to ensure safety and effectiveness for the patient.

  1. Preparation of the patient

  • Explain the upcoming procedure to the patient and family, inform them about the time it will take to complete the infusion.
  • Have the patient use the restroom before the infusion.
  • Record the vital signs before the infusion.
  1. Preparation of the nurse

  • The nurse must be in full medical attire and wear an identification card.
  • Perform routine handwashing.
  1. Preparation of IV supplies

Sterile tools:

  • Sterile box
  • Syringes and needles
  • Sterile gauze
  • IV tubing set
  • Butterfly needle
  • Catheter (if inserting a subclavian vein catheter, etc.)
  • Checked IV solution (name of solution, quantity, concentration, quality, preparation date, expiration date)
  • Medication (as prescribed)
  • Kocher clamp
  • Cotton container
  • Gloves
  • 70% alcohol bottle

Other tools:

  • IV stand with wheels (or bed with attached IV pole)
  • Two kidney trays
  • Adhesive tape, scissors
  • Armrest, tourniquet
  • IV infusion sheet
  • Emergency shock medication box
  • Blood pressure monitor, stethoscope, thermometer, pulse/breath rate clock…
  1. Intravenous therapy procedure

  • Place the IV pole next to the bed in a suitable position.
  • Disinfect the nurse’s hands.
  • Double-check the IV solution (name, quantity, quality, expiration date).
  • Disinfect the IV bottle cap.
  • Add medication to the IV bottle (if prescribed).
  • Insert the needle of the infusion set into the bottle (through the cap), lock it, hang the IV bottle, and expel air: Lift the drip chamber with the left hand, hold the infusion tube near the ambu with the right hand. Open the lock to let the solution fill about 1/3 of the drip chamber, then lower the drip chamber to let the solution continue flowing through the lower tube. When the solution reaches the ambu, let 1-2 drops flow into the kidney tray (avoid letting too much flow), then lock it, cover the needle, and maintain sterility.
  • Place an armrest under the infusion site.
  • Choose a vein entry point, tie the tourniquet 3 cm above the site.
  • Disinfect the site in a spiral motion from inside out.
  • Disinfect the nurse’s hands again.
  • Stretch the skin with one hand, and with the other hand, insert the needle at a 15-30° angle into the vein; when blood appears, release the tourniquet and open the lock to allow the solution to flow into the vein.
  • Insert the needle fully into the vein, and once blood appears, release the tourniquet and open the lock to allow the solution to flow.
  • Adjust the flow to a moderate rate.
  • Use adhesive tape to secure the needle hub to the patient’s skin, place sterile gauze over the needle site.
  • Remove the armrest and tourniquet from the infusion site.
  • Adjust the drip rate according to the prescription.
  • Position the patient comfortably to avoid discomfort during the infusion.
  • Record all information on the infusion sheet and hang it next to the IV bottle for monitoring.
  • Monitor the patient closely every 15 minutes to detect any complications during the infusion.
  • When the IV bottle has about 10-20 ml remaining, lock it, remove the needle, and disinfect the site (if continuing the infusion, change the bottle).
  • Document the patient’s condition from the start of the infusion until completion, and return the infusion sheet to the medical records.
  • Clean and sterilize the equipment.
  1. Calculating drip rate per minute and infusion time

Formula to calculate drip rate per minute for IV therapy:
Formula:
(Total IV volume x Drops/ml) ÷ Total minutes = Drops/minute
Example: Infuse 2000 ml over 8 hours (480 minutes), where 20 drops = 1 ml. How many drops per minute?
Applying the formula: (2000 ml x 20 drops/ml) ÷ 480 minutes = 83 drops/minute

  1. Formula to calculate infusion time:

Formula: (Total IV volume x Drops/ml) ÷ Drops/minute = Total time (minutes)
Example: Infuse 500 ml, with a prescribed flow rate of 50 drops per minute, and 20 drops = 1 ml. How long will it take to infuse the solution?
Applying the formula: (500 ml x 20 drops/ml) ÷ 50 drops/minute = 200 minutes

Source of reference: Bach Mai Medical College (Hanoi)

=>> READ MORE: IV THERAPY SAFETY STANDARDS

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