Intravenous (IV) Therapy Skill Checklist
Student Name: ____________________________ Course: ___________Date: ____________
Instructor: ____________________________ Overall Validation Grade: S or U (circle one)
Student Signature: _____________________________________________________________
Directions: The checklist outlines actions that you will have to perform in order to
successfully pass the IV therapy skill validation. Critical points are highlighted in bold.
You will receive either a Satisfactory or Unsatisfactory for each section. If you receive an
Unsatisfactory for a section, you will have to remediate and revalidate the entire skill.
IV Validation Satisfactory Unsatisfactory Comments
S U
1. Checked physician’s order and
gathered equipment and
supplies. Introduced self,
explained what procedure was
to be done and why.
2. Performed hand hygiene,
following infection control
measures, and verified client’s
identity. Assessed for allergies
(Latex, Tape, Antiseptics)
3. Provided comfort and safety for
client and self, including raising
bed to appropriate height for
procedure
4. Prepared client: Assisted the
client to a comfortable position,
either sitting or lying. Exposed the
limb to be used but provided for
client privacy.
5. Selected venipuncture site:
A. Used client’s nondominant
arm. Identified possible
venipuncture sites by looking for
veins that are relatively straight.
B. Checked agency protocol about
shaving if site is very hairy.
C. Placed towel or bed protector
under extremity to protect linens.
6. Dilated the vein
A. Placed extremity in a dependent
position.
B. Applied tourniquet firmly 15 to
20 cm (6 to 8 in.) above
venipuncture site.
C. Explained that tourniquet may
feel tight.
D. For elders, placed arm in
dependent position and did not
use a tourniquet.
E. If vein did not sufficiently dilate,
massaged or stroked vein distal to
site and in direction of venous
flow toward heart. Encouraged
client to clench and unclench fist.
F. Lightly tapped vein with
fingertips.
G. If preceding steps failed to distend
vein, removed tourniquet and
wrapped the extremity in a warm,
moist towel for 10 to 15 minutes.
7. Minimized insertion pain as much as
possible using ice, transdermal
analgesic creams or intradermal
injection.
8. Applied clean gloves and cleaned
venipuncture site.
A. Cleaned skin at site of entry with a
topical antiseptic swab.
B. Used a back-and-forth motion for a
minimum of 30 seconds to scrub
the
insertion site and surrounding area
C. Permitted solution to dry on skin.
D. Prepare equipment aseptic
technique (set aside catheter,
tegaderm, flush the extension set
tubing)
9. Inserted the catheter, and initiated the
infusion.
A. Removed catheter assembly from
sterile packaging.
B. Used nondominant hand to pull
skin taut below entry site.
C. Held the over-the-needle catheter
at a 15- to 30-degree angle with
needle bevel up, inserted catheter
through skin and into vein.
D. Once blood appeared in the
lumen of the needle, lowered the
angle of the catheter until
almost parallel with the skin,
and advanced the needle and
catheter approximately 0.5 to 1
cm (about 1/4 in) further. Held
needle assembly steady,
advanced the catheter until the
hub was at the venipuncture
site.
E. If hematoma occurred, release
tourniquet, removed needle, and
applied pressure.
F. Released the tourniquet.
G. Put pressure on vein proximal
to catheter to eliminate or
reduce blood oozing out of
catheter. Stabilized hub with
thumb and index finger of
nondominant hand.
H. Carefully removed stylet,
engaged needle-safety device,
and connect distal end of
extension set tubing to the hub.
Flushed catheter with sterile
normal saline. Maintain
sterility. Placed stylet directly
into sharps container.
I. While maintaining sterility
connect distal end of the
extension set to the IV tubing.
Initiated infusion as prescribed.
11. Dressed and labeled venipuncture site
and tubing according to agency policy.
Applied Tegaderm dressing to secure
the site.
A. Labeled dressing with date and
time of insertion, type, gauge of
catheter used, and nurse’s initials.
B. Applied an IV site protector, if
available.
C. Looped any tubing and secured it
with tape.
D. Discarded tourniquet. Removed
and discarded gloves.
12. Discarded all used disposable items
in appropriate receptacles.
Cleansed any blood spills
according to agency policy.
13. Returned bed to lowest height.
Removed gloves and performed hand
hygiene.
14. Discontinuation of IV catheter
1. Stopped fluids infusion and disconnect
IV extension set from the IV tubing, if
fluids were infusing.
2. Pulled skin taut while removing
dressing
3. Removed IV catheter and inspected the
tip for integrity while applying pressure
at the site based on patient assessment.
4. Disposed catheter appropriately
15. Documented procedure, assessment
data, and client’s response.
1. Date and Time
2.Nurse
3.Site Location
4.Type/Size of catheter
5.Number of attempts
6.Dressing
7.Solution
8. Patient response
9.Teaching
