Policy Manual sample

MDT Home Health Care Agency, Inc. INITIATION, MEDICATION, ADMINISTRATION, MONITORING AND DISCONTINUATION OF IV THERAPY PURPOSE: To ensure that all standards of care are met POLICY: This home health agency will implement a written system for nurses performing home IV therapy. An RN will be the responsible nurse to initiate intravenous therapy and medication administration. An LPN may monitor and discontinue IV therapy as ordered (1). Procedure 1. Check physician order and the need for clarification 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 IV therapy in distal (furthest) point to 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 glove, USE UNIVERSAL PRECAUTIONS. 11. Inspect intravenous catheter for any manufacturer defects. 12. Place thumb below indented venipuncture site and gently draw skin toward your 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. 3. Observe for back flow of blood from needle into attached tubing. (Back flow of blood indicated 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.) (1) The Nursing Board recognizes that through appropriate education and training, a Licensed Practical Nurse is capable of performing intravenous therapy via central lines under the direction of a registered professional nurse. Appropriate education and training requires a minimum of four (4) hours of instruction. The requisite four ( 4) hours of instruction may be included as part of the thirty (30) hours required for intravenous therapy education. (4) Educational Alternatives. The cognitive training shall include one or more of the following: Post-graduate Level Course, in recognition that the curriculum requirements, for practical nursing programs are extensive and that every licensed practical nurse will not administer IV Therapy, the course necessary to qualify a licensed practical nurse or graduate practical nurse to administer IV therapy shall be not less than a thirty (30) hour post-graduate level course teaching aspects of IV therapy containing the required components. Home Health Agency Nursing Manual J-35