Intravenous primary change | Summaries Health sciences

Rhodes State College Division of Health Sciences/Nursing

IV Primary Bag & Tubing Change Competency Check-off

Student: ____________________ Evaluator: ___________________ Date: _________ Course: _____

S/U Skill Critical Elements

In Pt.’s Room: WIEO:

W-Wash hands & identify yourself

I-Identify patient and allergies after logging in

E-Explain procedure & provide for privacy

O- Organize supplies

Scan patient

Skill time limit= 20 minutes

Hand hygiene (if this step is not completed

immediately upon entering the patient room

it is considered an automatic failure)

Patient identification after logging in to correct

patient

Check for allergies

Provide for privacy

Scan patient

 Check MAR

Perform calculation*

Obtain solution from cupboard.

Verbalize: Check IV bag for discoloration, leaking, and

expiration date.

Check MAR Must set up calculation correctly

and obtain correct answer

Verbalize IV bag inspection

 Scan medication but do not complete at this time.

Perform FIRST (1st) check of six rights by comparing the

solution selected against the MAR, as well as expiration

date. (DR TRIM)

D= Right dose, R= Right route, T= Right time

R=Right reason, I=Right individual, M=Right medication

Verbalize: Verify presently hanging IV solution is

compatible with the new IV solution.

Scan medication

First check of 6 rights, including expiration,

completed

Check compatibility

Perform SECOND (2nd) check of six rights

D= Right dose, R= Right route, T= Right time

R=Right reason, I=Right individual, M=Right medication

(DR TRIM)

Second check of 6 rights completed

 Verbalize: Assess IV site for heat/coolness,

redness/pallor, edema and pain.

Perform THIRD (3rd) check of six rights

D= Right dose, R= Right route, T= Right time

R=Right reason, I=Right individual, M=Right medication

(DR TRIM)

IV site must be assessed with all symptoms

listed prior to starting new IV bag

Third check of 6 rights completed All three

checks must be completed prior to

administration.

Close the roller clamp. Using aseptic technique, spike IV

solution. Apply label to tubing for the next tubing change

per facility procedure.

IV Bag is changed every 24 hours and IV tubing is changed

every 72 to 96 hours or according to agency policy.

Close roller clamp

Aseptic technique to spike IV bag

Apply label

Verbalize tubing and bag change per agency

policy

Squeeze drip chamber until approximately ½ full. Slowly

open roller clamp.

Prime tubing, removing all air, using aseptic

technique

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Rhodes State College Division of Health Sciences/Nursing IV Primary Bag & Tubing Change Competency Check-off Student: ____________________ Evaluator: ___________________ Date: _________ Course: _____ S/U Skill Critical Elements In Pt.’s Room: WIEO : W -Wash hands & identify yourself I -Identify patient and allergies after logging in E -Explain procedure & provide for privacy O - Organize supplies Scan patient Skill time limit= 20 minutes Hand hygiene (if this step is not completed immediately upon entering the patient room it is considered an automatic failure) Patient identification after logging in to correct patient Check for allergies Provide for privacy Scan patient Check MAR Perform calculation* Obtain solution from cupboard. Verbalize: Check IV bag for discoloration, leaking, and expiration date. Check MAR Must set up calculation correctly and obtain correct answer Verbalize IV bag inspection Scan medication but do not complete at this time. Perform FIRST (1st) check of six rights by comparing the solution selected against the MAR, as well as expiration date. (DR TRIM) D= Right dose, R= Right route, T= Right time R=Right reason, I=Right individual, M=Right medication Verbalize: Verify presently hanging IV solution is compatible with the new IV solution. Scan medication First check of 6 rights, including expiration, completed Check compatibility Perform SECOND (2nd) check of six rights D= Right dose, R= Right route, T= Right time R=Right reason, I=Right individual, M=Right medication (DR TRIM) Second check of 6 rights completed Verbalize: Assess IV site for heat/coolness, redness/pallor, edema and pain. Perform THIRD (3rd) check of six rights D= Right dose, R= Right route, T= Right time R=Right reason, I=Right individual, M=Right medication (DR TRIM) IV site must be assessed with all symptoms listed prior to starting new IV bag Third check of 6 rights completed All three checks must be completed prior to administration. Close the roller clamp. Using aseptic technique, spike IV solution. Apply label to tubing for the next tubing change per facility procedure_._ IV Bag is changed every 24 hours and IV tubing is changed every 72 to 96 hours or according to agency policy. Close roller clamp Aseptic technique to spike IV bag Apply label Verbalize tubing and bag change per agency policy Squeeze drip chamber until approximately ½ full. Slowly open roller clamp. Prime tubing, removing all air, using aseptic technique

Prime tubing at waist level using aseptic technique. (Do not remove end cap to prime the line). S/U Skill Critical Elements Do not remove tapes or blue sheath until priming is complete. Close roller clamp. Close roller clamp Remove blue sheath and paper tapes. Tubing should be hung on IV pole until ready to insert into existing line. Apply clean gloves. Apply gloves Pause the infusion pump. Close roller clamp on the patient’s presently hanging IV. Open the door of the infusion device and remove the old tubing from the pump. Inform patient that tubing change is occurring at this time. Unscrew and remove old IV tubing from INT device and hang on pole away from work area. Grasp new tubing and hold in your hand. Clean INT device with alcohol swab, allow to air dry. Remove the sterile end cap from new tubing and connect to existing INT using aseptic technique. Close roller clamp on current IV before removing from pump. Clean INT device with alcohol Speak directly to patient Connect new tubing using aseptic technique Insert the new tubing into the Alaris pump infusion device. Close the door of the infusion device. Open the roller clamp on the new administration set Calculation must be completed prior to the next step. Open roller clamp Calculation must be completed before moving to next step Set the prescribed rate on the infusion device (mL/hr.). Set correct rate Verbalize: Secure tubing appropriately with tape. Reassess IV site. Wash hands Reassess IV site Hand hygiene before documenting Complete 7th^ Right= Document then log out Document correctly and completely and log out Follows Professional Attire/Grooming/Conduct in RSC Student Handbook *Calculation of rate must be completed before setting rate on the IV pump but may be completed at any time before the infusion rate is being set. The student will demonstrate each of the steps identified in the criteria. There are many instances in which the steps do not have to be completed in the exact order listed, but must be performed prior to completing the skill. The student must define the six rights all three times during the procedure. Every element of the rubric must be completed successfully. The student may identify and correct most errors- up to two (2) times with not more than one being a critical element. More than two identified errors, even if identified and corrected, will be considered an unsatisfactory competency test. Delegation Considerations: The changing of an IV solution container and administration set is not delegated to nursing assistive personnel (NAP) or unlicensed assistive personnel (UAP). Be aware of your state’s licensure laws to determine if this task is part of scope of practice for LPN/LVN’s. Initiated: 8/12 Reviewed in Acad. Curr. 11/12, 5/21, 5/22, 12/22, 5/24, 12/

Intravenous primary change, Summaries of Health sciences

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