Policy Manual sample

MDT Home Health Care Agency, Inc. HOME IV THERAPY POLICY AND PROCEDURE Purpose To ensure that all standards of care are met. Policy This home health agency will implement a written system for nurses performing home I.V. therapy. An R.N. will be the responsible nurse to initiate intravenous therapy and medication administration. LPNs are now and have historically been a necessary part of the healthcare workforce in U.S. hospitals, and Home Health Care Agencies. As the technical complexity of patient care has increased, the demand for more extensive education for both LPNs and RNs has increased. Additionally, both practitioners can opt to expand their scopes of practice with additional training. An L.P.N. in our Agency, as permitted in our state, may administer, monitor and discontinue I.V., therapy as ordered (1). Procedure 1. Check physician order and the need for classification of home intravenous therapy. 2. Explain procedure to patient/family. 3. Provide privacy. 4. Wash hands thoroughly or use antiseptic gel. 5. Assemble equipment on a clean surface and prime injection plug extension tube. 6. Apply tourniquet to arm and select venipuncture site. Note: Care must be taken to apply tourniquet with enough Pressure to impede venous flow and allow arterial flow to be maintained. Start I.V. therapy in distal (furthest) point of upper extremities. 7. Once a site has been located, remove tourniquet. 8. Cleanse site with alcohol swab working from center to outward using circular motion allow 1-2 minutes to dry. 9. Reapply tourniquet. 10. Put on gloves. USE UNIVERSAL PRECAUTIONS. 11. Inspect intravenous catheter for any manufacturer defects. 12. Place thumb below indented venipuncture site and gently draw skin toward you to secure vein. For winged-tip needle: 1. Hold needle by the wings with bevel up at 25-35 degree angle to skin surface. 2. Penetrate skin surface. Decrease angle and penetrate vein. (This should be in one smooth motion to prevent vessel damage.) 3. Observe for back flow of blood from needle into attached tubing. (Back flow of blood indicates the needle is in the vein, although sometimes there is no back flow in the elderly.) 4. Remove tourniquet and secure wings with tape. For Plastic Catheter: 1. Insert catheter through skin and into vein at 30-45 degree angle with bevel up. Decrease angle and advance about 1/4' into vein. 2. Hold the flash chamber of stylet steady and advance Plastic catheter over stylet into vein, up to catheter hub. (Never reinsert stylet after removal from catheter). 3. Remove tourniquet. 4. Remove stylet from catheter and attach heparin lock extension tube. Home Health Agency Nursing Manual J-31