Essential IV Skills Every Nurse Should Know.

  • By Alice Fields

Published: January 29, 2024

Intravenous (IV) therapy is a fundamental aspect of modern nursing practice, crucial for administering medications, fluids, and blood products directly into the patient's bloodstream.

 

 For nurses at any stage of their careers, mastering IV insertion can significantly enhances patient outcomes, reduce complications, and ease patient discomfort. This article provides a thorough walkthrough of IV insertion, tips, and troubleshooting advice.

 

Let’s face it—sometimes your brain feels like it has as many veins to navigate as the patient’s arm. For a quick refresher on crucial IV details that actually stick, the Nursing School Success Handbook by Nursing Gems might just be the mental IV your brain needs!

 

So, how do you actually master the art of IVs? Let’s dive in...

Understanding IV Insertion

IV insertion is the process of placing an IV catheter into a vein to deliver substances directly into the vascular system. This skill demands a combination of:

  • Anatomical knowledge
  • Dexterity
  • Patient-centered approach

Pre-Insertion Preparation

Before officially starting the insertion, it is essential to:

 

Gather Supplies 

  • IV catheter (size depends on patient needs)
    • Example: A patient undergoing surgery must be placed with a G18 or G16 IV catheter to accommodate large or bolus infusions during the procedure.

Patient Communication 

  • Explain the procedure to the patient step by step to reduce anxiety and gain informed consent.

Vein Selection

  • Choose veins in the hands or forearms that are visible, palpable, and straight. 
  • Avoid sites with previous venipuncture, hematomas, or signs of phlebitis.
  • Use the tourniquet to engorge the veins, but remove it after one minute or if the patient experiences discomfort.

 Step-by-Step IV Insertion Guide

Follow this structured approach for optimal technique:

 

Hand Hygiene

  • Use soap and water or an alcohol-based sanitizer to prevent infection.

Site Preparation

  • Clean the chosen site with an antiseptic, moving in a circular motion from the center outwards. 
  • Allow it to dry fully.

Vein Stabilization

  • Use your non-dominant hand to stretch the skin below the insertion site, anchoring the vein to prevent it from rolling.

Catheter Insertion

  • Hold the catheter bevel-up and insert at a 15–30° angle.
  • Swiftly but gently insert the needle into the vein until you see a backflow of blood in the catheter's flashback chamber.
  • Lower the needle angle, advancing the catheter slightly further into the vein.
  • Carefully slide the catheter off the needle into the vein.

Securing the IV

  • Connect the IV tubing.
  • Secure the catheter with a transparent dressing.
  • Create a loop in the tubing to give extra room for movement without dislodging the IV.

Flushing and Verification: 

  • Flush with saline to confirm patency.
  • Watch for signs of infiltration, extravasation, resistance, or swelling.

Tips and Tricks for Successful IV Insertion

Use of Heat

  • Apply a warm compress to help dilate veins, especially in patients with challenging venous access.

Avoid Excessive Probing

  • If you miss the vein, retract slightly and attempt at a new angle or site. 
  • Probing can cause tissue damage and discomfort.

Pediatric Considerations: 

  • Use toys or conversation to distract young patients. 
  • Whenever possible, insert the IV into the non-dominant hand for comfort.

Troubleshooting: 

  • A minor leak at the site may be resolved by advancing the catheter further, but always reassess for safety before proceeding.

Conclusion

Proficiency in IV insertion is a continual process of skill development and knowledge enrichment. This article mainly aims to advance nurses’ techniques and reduce occurrences of patient discomfort. 

 

Every successful IV insertion enhances patient care, builds clinical confidence, and contributes to stronger healthcare outcomes. 

 

Just as a successful IV line provides vital access to the patient's system, the Nursing School Success Handbook provides a crucial path to comprehensive IV therapy knowledge, ensuring confident and effective practice. Click below to find out more...

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