IV Therapy Module A.

1 “Legal and Infection Control” Script

Slide One

Welcome to IV Therapy. In this course you will be gaining the knowledge and
skills you are required to have to administer IV’s in the clinical environment. Being an IV
technician, or any level of healthcare provider who is certified to administer and IV, is a
prestigious feet. An IV can be lifesaving in emergency medical events, and are extremely
useful in medical intervention to treat many different patients.

Slide Two

In this unit we will be discussing the history of IV therapy, as well as some of the
uses of an IV. We will also learn about patient consent, and communication with the
patient. And finally cover documentation and OSHA guidelines for IV therapy.

Slide Three

Be sure to have your worksheet and any homework assignments ready for class
or while you meet your objectives online. You will be expected to know several key
terms and medical terminology for the IV course. Take time to fill out the definitions and
any examples to help you remember the meaning and application of these words. You
will be quizzed over each module throughout the course.

Slide Four

The early days of IV therapy were strictly practiced using animals and
experimenting with fluid replacement and medical therapy. After attempting IV therapy
with animals, the first animal to human blood transfusion was attempted using a lamb. It
was unsuccessful.
In the 1800s the first human to human blood transfusion was accomplished and
IV solutions were created with saline. In the early 1900s blood types were discovered,
and blood transfusions became much more successful.

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 IV Therapy Module A.1 “Legal and Infection Control” Script

In the 1940s, during the world war efforts, IV’s had become prevalent in combat
medicine as well as long term care for patients. And in 1973, the INS or, Intravenous
Nurses Society was formed. This society set out the guidelines to research and develop
better methods to administering IV’s

Slide Five

Scope of practice is vital in regards to IV therapy. Currently the rules are

subjective because the CCMA is under the scope of the license of the medical provider.
Other medical persons holding state licensure in IV therapy such has LPN’s, RN’s or
EMT’s have specific regulations about when, where, and how they can administer IV
therapy. Let’s define Omission and Commission. Omission is a Failure to provide a
specific act or treatment when required. Commission is going beyond ones scope of
practice

Slide Six

Each type of consent is used for different patients. The ideal type of consent is
informed consent. The patient has been informed of both the risks and rewards for the
procedure. They have signed a document allowing the procedure to be performed. Next,
we have expressed consent where the patient consents either verbally or nonverbally to
the procedure. This can be left up to interpretation a bit more in the court of law.
Implied Consent is the premise is that the patient would give consent if he/she were
able to do so. Used for children (under 18) and patients with altered levels of
consciousness.

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Slide Seven

If the medical practitioner does not obtain consent, then charges of assault and
battery can be brought against the practitioner. The patient who is alert and oriented as
well as over the age of 18 may refuse any medical procedure. However, if the patient’s
status changes, need for intervention may be revisited and another type of consent may
be used. It is important to understand the difference in assault and battery, and to be
able to reassess our patient’s mental status for any changes that will determine if
consent is necessary.

Slide Eight

Negligence is when a patient is injured due to action the provider took. This is
also called malpractice. All four of the components of negligence must be present in
order for the charge to be viable in a court of law. The provider must have had a duty to
act, they must have breached this duty in some way and this break of duty must be
directly linked to the causality of the damage. Without all four components satisfied,
there is no case for negligence.

Slide Nine

Other legal issues you may encounter are abandonment and invasion of privacy.
At no time should you abandon your patient or discontinue care unless personal safety is
in question, or your patient refuses further treatment. Remember, your patient must be
alert and oriented before they are able to decide if they want care or wish to refuse.

Slide Ten

The Nurse Practice Act is a document stating the acceptable legal means to be
taken in providing care to a patient. This act, found in the link provided, focusses on the
board of nursing IV practices and the Tennessee specific information.

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 IV Therapy Module A.1 “Legal and Infection Control” Script

Slide Eleven

According to the Infusion Nursing Practice Standard 22 “It is the nurse’s

responsibility prior to initiating a particular treatment modality to explain the procedure
in sufficient detail for the patient and/or caregiver to understand”.
Always be honest with your patient. Many people have a phobia of needles, and
this is where your patient communication skills will be useful. It is ok to let them know
the procedure can be painful, but that if they remain calm and still, it will be over quickly
and easily. Also explain the functions of the equipment if the patient has any questions.

Slide Twelve

Take a look at the CDC’s basic infection control guidelines. After you have read the
material, review your worksheet and homework to answer any questions pertaining to
infection control.

Slide Thirteen

This is the correct hand washing procedure as listed by the CDC. Visit CDC.gov for
more information about hand washing and infection control. It is required that before
and after lab procedures that you correctly wash your hands to maintain as clean of a
patient environment as possible.

Slide Fourteen

There are also various sites to administer an IV. We will discuss these during lab
sessions. The two main routes to administer an IV are either via a central line, which is
located at the truck or neck area, and the peripheral line, which are located at the
extremities. The larger the needle gauge, and larger the vein, the higher the chance for
infection.

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Slide Fifteen

Understanding why we prep the site we are going to use for Venous access is just
as important as the skill of inserting the needle to obtain the patent IV. A strict aseptic
technique must be used with every single attempt for an IV. Site prep is commonly
accomplished by cleansing with 70% isopropyl alcohol and 10% proidone-iodine or 2%
chlorhexidine solution.

Slide Sixteen

Here we will discuss Catheter sizes. The manufacturer or style of catheter you will
use in this course and lab sessions may vary from what you see in the clinical
environment. Even though the body or length may change, the gauge, or size, of the
needle will remain the same. The number system is the best to follow as the color of the
catheter may change based on manufacturer. The smaller the number, the larger the
diameter of the needle. The smallest size used with most adult patients is the 24gauge,
and the largest size is the 14gauge.

Slide Seventeen

Carefully inspect all equipment before use. The Fluids must be in date and
changed every 24 hours. Check for solution type, expiration date, and clarity of the
solution. Any medications being administered must be by order of the physician and
given only after the 5 R’s are met. Tubing must be checked for cracks or leaks.

Slide Eighteen

All IV equipment must be packaged in a sterile container. All materials must be in

date and everything connected to the IV much be changed every 72 hours.

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Slide Nineteen

The standard is to rotate the site every 72 hours. However, recent research has
discovered that IVs left in place for 72 hours have a greater likelihood of phlebitis. So the
recommendation has been reduced to every 48 hours. We will discuss the signs of site
care later in the course.

Slide Twenty

Not only do we need to assess the site for introducing the needle and catheter,
but also the dressing we use to hold the line in place. Transparent dressings, like the one
in the picture above, are only required to be changed with site rotation. A gauze or
taped site must be changed every time it is removed to assess the site itself.

Slide Twenty One

Always keep in mind the risks for infection. The easiest way to reduce the
likelihood of infection is by proper hand washing. Also insure aseptic technique and
appropriate cleansing of the site is performed. NEVER reuse a needle, and check that
your needle, tubing, and solution are in date and correct for the procedure. Cover the IV
site with a sterile dressing.

Slide Twenty Two

Credits slide only. There is no audio for this slide.