Question

Place the following steps for discontinuing intravenous (IV) access in the correct order: A. Perform hand hygiene and apply gloves. B. Explain procedure to patient. C. Remove IV site dressing and tape. D. Use two identifiers to ensure correct patient. E. Stop the infusion and clamp the tubing. F. Carefully check the health care provider's order. G. Clean the site, withdraw the catheter, and apply pressure.

Short answer

Check provider's order (F), verify patient identity (D), explain to patient (B), hand hygiene and gloves (A), stop infusion and clamp (E), remove dressing (C), and withdraw catheter with pressure (G).

Step-by-step solution

- Verification

Verify the procedure by checking the health care provider's order to ensure it is the right time and the patient no longer requires IV access.

- Patient Confirmation

Use two identifiers (name, date of birth, medical record number, etc.) to confirm the correct patient to ensure that the IV is discontinued for the right individual.

- Explanation of Procedure

Explain the details of the procedure to the patient to educate them on what to expect during the discontinuation of IV access and to gain their cooperation.

- Perform Hand Hygiene and Gloving

Perform hand hygiene to reduce the risk of infection and then apply gloves to protect both the healthcare provider and the patient.

- Stop Infusion and Clamp Tubing

Discontinue the IV fluid infusion by stopping the infusion and then clamp the tubing to prevent any additional fluid from flowing through the IV line.

- Remove Dressing and Tape

Gently remove the dressing and tape from the IV site to expose the catheter and prepare it for removal.

- Withdraw Catheter and Apply Pressure

Clean the IV site, carefully withdraw the catheter to remove the IV access, and then apply pressure to the site to control any bleeding and to prevent the formation of a hematoma.

Key concepts

IV Therapy Procedure

Intravenous (IV) therapy is a critical procedure in medical settings, utilized for administering medications, fluids, blood products, and nutritional supplements directly into a patient's vein. It's vital for healthcare professionals to master this procedure to ensure safe and effective patient care.

The process begins with verifying the doctor's order, which provides essential details such as the type of solution to be infused, the rate of administration, and the duration of the therapy. This is crucial for patient safety and to avoid medication errors. Next, confirming the patient's identity using at least two identifiers prevents any mix-up with other patients. Communicating clearly with the patient about what to expect forms the basis of a trusting healthcare relationship, reduces anxiety, and increases cooperation.

Performing hand hygiene and wearing gloves are standard infection control practices that minimize the risk of infection. Stopping the infusion and clamping the tubing prevents air from entering the bloodstream and controls the administration of IV fluids. The final steps involve the careful removal of the IV catheter and application of pressure to the site to prevent bleeding. Each of these steps is designed to maintain the integrity of the vein and protect the patient from harm.

Patient Safety in Nursing

Implementing Safety Checks

Patient safety in nursing is paramount and encompasses various practices aimed at preventing harm. Essential to this is the verification of the healthcare provider's order before any procedure, ensuring it's the appropriate time for discontinuation of IV therapy. Accurate patient identification plays a critical role in preventing medical errors.

Educating Patients

Educating patients about what to expect during the IV discontinuation process enables them to be informed participants in their care. It can also have the effect of allaying fears and ensuring compliance with necessary pre- and post-procedure instructions.

Post-Procedure Care

After the IV catheter is removed, proper care of the insertion site is crucial. Applying direct pressure prevents bleeding and hematoma formation, while ongoing monitoring for any signs of complications, such as infection or phlebitis, is vital for early detection and prompt treatment.

Infection Control Practices

Infection control is a critical component of healthcare that aims to prevent the spread of infections in healthcare facilities. Hand hygiene is the most effective measure and should be rigorously practiced before and after each patient contact. The use of personal protective equipment (PPE), like gloves, is essential when handling IV catheters to prevent cross-contamination.

Proper removal and disposal of dressings and IV catheters minimize the risk of exposure to bloodborne pathogens. Cleaning the IV site both before and after catheter removal, using appropriate antiseptic solutions, is vital. This practice not only helps in preventing local infections but also reduces the risk of systemic infections. Continuous education and adherence to these infection control practices are crucial for protecting both the healthcare provider and the patient from potential infections.