SRI MANAKULA VINAYAGAR NURSING COLLEGE

DEMONSTRATION

ON

INTRAVENOUS INJECTION

SUBMITTED TO: SUBMITTED BY;

PROF.DR. R. DANUSU, P.DEEPA.

PRINCIPAL, M.SC., NURSING I st YEAR

SMVNC. SMVNC.

SUBMITTED ON:
 STUDENT PROFILE
NAME OF THE STUDENT : P.DEEPA

NAME OF SUBJECT : NURSING EDUCATION

TOPIC : INTRAVENUS INJECTION

GROUP OF STUDENTS : ALLIED HEALTH SCIENCES

NO.OF STUDENT :

PLACE : SRI MANAKULA VINAYAGAR MEDICAL COLLEGE AND HOSPITAL

DATE :

TIME AND DURATION : 45 MINUTES

METHOD OF TEACHING : DEMONSTRATION

AV AIDS : PAMPLET, LEAFLET, FLIP CHART,FLASH CARD , ROLLER BOARD, OHP, PPT,

NAME OF THE EVALUATOR : Prof. DR.R.DANASU, PRINCIPAL, SMVNC

GENERAL OBJECTIVES:

 At the end of the class the students gain a in depth knowledge regarding “Intravenous injection ” and to develop desirable skill in
performing nursing care for patients in clinical settings.

SPECIFIC OBJECTIVES:

 The students will able to:

 define intravenous injection
 enlist the purpose of the intravenous injection
 elaborate the principles of intravenous injection
 mention the indication and contraindication of intravenous injection
 enumerate the IV fluid calculation
 list out the articles needed for the intravenous injection
 demonstrate the procedure on intravenous injection
 enlist the complication of intravenous injection
 explain the nursing responsibilities of intravenous injection
 S.N SPECIFIC TIME CONTENT TEACHER AND AV EVALUATION
O OBJECTIVES LEARNING AIDS
AVTIVITY
1. Introduction 2 mins INTRODUCTION: Introduction Black Explain the
about the about the topic board intravenous
 Some medication must be given by an intravenous injection or
procedure injection
infusion.
 This mean they are sent directly into vein using a needle or tube.
 IV therapy are used to administer a fluids, drug and nutrients
when patient cannot take orally fluids.

2. Define 2 mins DEFINITION: Teacher is Roller What is mean by

intravenous explaining and board intravenous
 The process of puncturing a vein with needle aseptic technique .
injection students are injection
listening

3. Enlist the 2 mins PURPOSES OF INTRAVENOUS INJECTION: Teacher is Chart List out the
purposes of the explaining and purposes of
 To administer fluids intravenously
intravenous students are intravenous
 To administer bolus medicine for investigation or treatment
injection listening and injection
 To draw blood specimens
taking notes.
 To administer total parenteral nutrition
 To administer a blood products
 S.N SPECIFIC TIME CONTENT TEACHER AND AV EVALUATION
O OBJECTIVES LEARNING AIDS
AVTIVITY
3. Elaborate the 3 mins PRINCIPLES OF INTRAVENOUS INJECTION: Teacher is Leaflet Explain the
principles of explaining and principles of
 The knowledge of the anatomy and physiology of the body is
intravenous students are intravenous
essential for the safe administration of the injection
injection listening. injection
 If carelessly given injections into the
 Drugs that change the chemical composition the life of the patient
if not used cautiously
 Any family situation produces anxiety
 Once a drug is injected it is irretrievable
 Organization and planning results in the economy of time
material effort.

4. Mention the 3 mins INDICATION AND CONTRAINDICATION OF INTRAVENOUS Teacher is Pamphl List the
contraindication INJECTION: explaining and -et indication and
of intravenous students are contraindication
INDICATION OF INTRAVENOUS INJECTION:
injection observing of intravenous
 To administer a medication and fluids as well as blood collection injection

CONTRAINDICATION OF INTRAVENOUS INJECTION:

 An arteriovenous fistula in the extremity

 S.N SPECIFIC TIME CONTENT TEACHER AND AV EVALUATION
O OBJECTIVES LEARNING AIDS
AVTIVITY

 Mastectomy on the same side of the arm a surgically compromised

extremity.
 Presence of phlebitis , infiltration or sclerosis

5. enumerate the 5 mins IV FLUID CALCULATION: Teacher is PPT What is the

IV fluid explaining and Present formula for IV
DRIP RATES:
calculation students are -ation fluid calculation
 Drip rates is when the infusion volume is calculated into drops. listening and
 Formula for the drip rate: taking notes.
Volume (ml)
Drip rate =
Time (h)

CALCULATION OF DRIPS RATES PER MINUTE (DPM):

 There are two standard giving sets of drip rates:

1. .Macro drop factor : Drop size is normally 20 drops in 1 ml
2. sMicro drop factor : Drop size is normally 60 drops in 1 ml
 The formula to calculate drip rates in drops per minute(dpm):

S.N SPECIFIC TIME CONTENT TEACHER AND AV EVALUATION

 O OBJECTIVES LEARNING
AVTIVITY AIDS
FLOW RATES:
Total volume of fluid in ml ×drop factor (drops / ml)
= Total time of infusion

6. list out the 3 mins ARTICLES: Teacher is Display What is the use
articles needed explaining and -ed in of tourniquet
ARTICLES PURPOSE
for the students are tray.
intravenous 1. Sterile cotton swabs in a To prevent infection observing. Article
injection bowl with antiseptic , are displayed in
alcohol pads the tray.
2. Tourniquet To visible vein
3. Tapes for fixing catheter ,
For safety measures
needle
4. Syringe of required size for To drawn a blood sample

blood drawn
To collect specimen
5. Specimen bottle
Injecting medicine
6. Syringe/ infusion made
ready for administration

S.N SPECIFIC TIME CONTENT TEACHER AND AV EVALUATION

O OBJECTIVES LEARNING AIDS
 AVTIVITY
ARTICLES PURPOSE

7. Towel / mackintosh Protecting linen

8. IV pole
to receive a waste products
9. Kidney tray or paper bag

7. demonstrate the 20 mins PROCEDURE: Teacher is Demon List the common

procedure on demonstrating the stration sites of
S.NO STEPS RATIONALE
intravenous procedure and intravenous
injection 1. Check the physician order Ensures the right procedure is students are injection
and nursing care plan being done for right observing.

2. Identify the client

3. Explain the procedure to Reduces the anxiety and

patient that there will be ensures client cooperation
slight discomfort initially. If
required , demonstrate
procedure on doll for children

S.N SPECIFIC TIME CONTENT TEACHER AND AV EVALUATION

O OBJECTIVES LEARNING AIDS
AVTIVITY
 S.NO STEPS RATIONALE

4. Make sure that clothing can Prevents dislodgment of needle.

be removed over IV tubing
if needed .
Provide client with a gown
if necessary
5. Wash hands Prevents dislodgment of needle

6. Select venipuncture site. It is difficult to initiate and

Unless contraindicated maintain IV access if using
select the non dominant arm sclerotic veins.
of the client. Joint flexion increases risk of
Look for veins that are irritation of vein walls by the
relatively straight. catheter.
Consider catheter length so
that the wrist / elbow will
be away from the catheter
tip

S.N SPECIFIC TIME CONTENT TEACHER AND AV EVALUATION

O OBJECTIVES LEARNING AIDS
AVTIVITY
S.NO STEPS RATIONALE
 COMMON SITES USED FOR VEINPUNCTURE

S.N SPECIFIC TIME CONTENT TEACHER AND AV EVALUATION

O OBJECTIVES LEARNING AIDS
AVTIVITY
S.NO STEPS RATIONALE
 7. Dilate the vein
a. Place extremity in Gravity slows venous
dependent position (lower return and distends the
than heart). vein
b. Apply a tourniquet firmly Obstructing arterial flow
about 15 to 20 cm ( 6 to 8 inhibits venous filling .
inches) above the vein If a radial pulse is felt ,
puncture site , explain the arterial flow is not
tourniquet will feel tight. obstructed.
The tourniquet must be
tight enough to obstruct
arterial supply .
This action helps in filling
c. If the vein is not
the vein
sufficiently dilated ,
massage / stroke the vein
distal to the site in the
direction of venous flow

S.N SPECIFIC TIME CONTENT TEACHER AND AV EVALUATION

O OBJECTIVES LEARNING AIDS
AVTIVITY
S.NO STEPS RATIONALE
 towards heart
d. Encourage a client to Contracting the muscles
clench and unclench the compresses the distal
fist veins, forcing blood along
the veins and distending
them
e. Lightly tap the vein Tapping the vein may
distend it .
f. If all the above steps fail, Heat dilates superficial
remove the tourniquet and blood vessels causing them
apply heat to the entire to fill
extremity for 10 to 15
minutes.
8. Don clean gloves Prevents nurses from
exposure to blood

S.N SPECIFIC TIME CONTENT TEACHER AND AV EVALUATION

O OBJECTIVES LEARNING AIDS
AVTIVITY
S.NO STEPS RATIONALE

9. Clean vein puncture site

a. Clean with antiseptic swab This movement carries
 from center out – ward in micro organisms away
circular motion for several from site of entry.
inches
b. Permit solution to dry on Povidone iodine should be
the skin. in contact with skin for at
least one minute to be
effective
10. Insert the needle/catheter
a. Use a non dominant hand This stabilizes the vein and
to pull the skin taut below makes taut for needle entry
the entry site.
b. Hold catheter / needle at Holding the needle at 15 to

15 to 30 degree angle with 30 degree reduces the risk

bevel up, insert catheter of counter puncture

through the skin and into

S.N SPECIFIC TIME CONTENT TEACHER AND AV EVALUATION
O OBJECTIVES LEARNING AIDS
AVTIVITY
S.NO STEPS RATIONALE

Vein in one thrust. A sudden lack

of resistance is felt as needle enters
the vein.
c. Once blood is seen in the
 lumen or when a lack of Reducing the angle of
resistance is felt , reduce the catheter lower the risk of
angle of catheter till it is counter puncture
almost parallel to the skin
and advance the needle and
catheter approximately 0.5
to 2 cm.
d. Remove needle from inside
the angio cath completely
and attached syringe with
medication / syringe for
blood draws / IV infusion
tube as required .

S.N SPECIFIC TIME CONTENT TEACHER AND AV EVALUATION

O OBJECTIVES LEARNING AIDS
AVTIVITY
S.NO STEPS RATIONALE

11. Tape the catheter using 3 strips of Prevents dislodgement of

adhesive tapes needle
a. Place one strip with sticky
side up under the catheter
hub.
 b. Fold over each side so that
sticky sides are against the
skin.
c. Place second strip sticky
side down over catheter
hub.
d. Place 3rd strip sticky side
down over catheter hub /
infusion tubing.

S.N SPECIFIC TIME CONTENT TEACHER AND AV EVALUATION

O OBJECTIVES LEARNING AIDS
AVTIVITY
S.NO STEPS RATIONALE

12. Dress and label the venipuncture Reduces risk of infection

site as per agency policy.
a. Place a sterile gauze piece
with povidone – iodine over
the veni puncture site.
Apply pad over the site .
Apply occlusive dressing
 over site.
b. Label the dressing with
date, time of insertion , size
of needle used , catheter
used and initials.

13. Remove gloves and wash hands

14. Discard all soiled equipment

appropriately

S.N SPECIFIC TIME CONTENT TEACHER AND AV EVALUATION

O OBJECTIVES LEARNING AIDS
AVTIVITY
S.NO STEPS RATIONALE

15. Document all relevant data and

report any observation

8. enlist the 3 mins COMPLICATION OF INTRAVENOUS INJECTION: Teacher is Bulletin List the
complication of explaining and board complications of
 Hematoma
intravenous students are intravenous
 Thrombosis
injection listening and injection
 Phlebitis
taking notes.
 Extravasation
  Allergic reaction
 Infiltration
 Embolism
 Systemic infection
 Circulatory overload.

9. explain the 2 mins NURSING RESPONSIBILITIES OF INTRAVENOUS INJECTION: Teacher is Hand Explain the
nursing explaining and out nurses role of
 Nurse should identifying and verifying the doctors order
responsibilities students are intravenous
 Nurse should follow the five rights of drug administration
of intravenous listening and injection
 Nurse should monitors the patient for adverse reactions
injection taking notes.

S.N SPECIFIC TIME CONTENT TEACHER AND AV EVALUATION

O OBJECTIVES LEARNING AIDS
AVTIVITY
 Nurse should ensures that the tubing, bandages and needle stay in
place.
 Nurse should monitor the patient's fluid and electrolyte status to
evaluate the effectiveness of the infusion to avoid potential
complications of fluid overload and electrolyte imbalance.
 Nurse should maintaining the records
SUMMARY:

 In this demonstration, we had discussed about the definition, purposes, indication, articles, contraindications, complications, nursing
management and demonstrated the procedure of intravenous injection

CONCLUSION:

 I hope you all understand the procedure of intravenous injection and you can apply this knowledge and skill while doing this procedure in
your future and taking care to the patient for providing intravenous injection in clinical setting.

EVALUATION:

 Write an assignment on recent advancement of intravenous injection.

BIBLIOGRAPHY:
1. Annamma Jacob , A text book of Clinical Nursing procedure : The art of nursing Practice , published by Jaypee brothers , Edition:
Page no:175-180
2. LSKHWINDER KAUR AND MANINDER KAUR, 2015 A textbook of NURSING FOUNDATIONS and published By S.VIKAS and
COMPANY , Edition : Page no:

NET REFERENCES:

 www.healthcare.com
 www.pubmed.com
 www.healthlibrary.com
 www.nursingtimes.net.com
JOURNAL REFERENCES:

TOPIC:

 Incidence and prevalence of intravenous medication errors in the UK: a systematic review
AUTHOR:

 Adam Sutherland .et.al

PUBLISHED ON:

 January 2020
PUBLISHED BY:

 European journal of Hospital pharmacy.

ABSTRACT:
OBJECTIVES :

 Medication error is the most common type of medical error, and intravenous medicines are at a higher risk as they are complex to prepare
and administer.
 The WHO advocates a 50% reduction of harmful medication errors by 2022, but there is a lack of data in the UK that accurately
estimates the true rate of intravenous medication errors.
 This study aimed to estimate the number of intravenous medication errors per 1000 administrations in the UK National Health Service
and their associated economic costs.
 The rate of errors in prescribing, preparation and administration, and rate of different types of errors were also extracted.

METHODS:

 MEDLINE, Embase, Cochrane central register of clinical trials, Database of Abstracts of Reviews of Effectiveness, National Health
Service Economic Evaluation Database and the Health Technology Appraisals Database were searched from inception to July 2017.
 Epidemiological studies to determine the incidence of intravenous medication errors set wholly or in part in the UK were included. 228
studies were identified, and after screening, eight papers were included, presenting 2576 infusions.
 Data were reviewed and extracted by a team of five reviewers with discrepancies in data extraction agreed by consensus.
RESULTS :

 Five of eight studies used a comparable denominator, and these data were pooled to determine a weighted mean incidence of 101
intravenous medication errors per 1000 administrations (95% CI 84 to 121).
  Three studies presented prevalence data but these were based on spontaneous reports only; therefore it did not support a true estimate.
32.1% (95% CI 30.6% to 33.7%) of intravenous medication errors were administration errors and ‘wrong rate’ errors accounted for
57.9% (95% CI 54.7% to 61.1%) of these.
CONCLUSION:

 Intravenous medication errors in the UK are common, with half these of errors related to medication administration.
 National strategies are aimed at mitigating errors in prescribing and preparation. It is now time to focus on reducing administration error,
particularly wrong rate errors