CHS22 Perform intravenous cannulation

Overview

This standard relates specifically to the insertion of intravenous cannula to facilitate access to the blood system for treatment or diagnostic purposes.  Access may be required for serial sampling, or for administration of fluid or drug treatments.  This procedure may be performed with adults or children and will usually take place in hospital with individuals receiving health care.  It may also take place in a therapeutic, research or emergency situation. You will need a firm knowledge and understanding of this procedure based upon your employers protocols, guidelines and patient group directives, where used. Users of this standard will need to ensure that practice reflects up to date information and policies. Version No 1

Knowledge and Understanding

You will need to know and understand:

1. The current European and National legislation, national guidelines, organisational policies and protocols in accordance with Clinical/Corporate Governance which affect your work practice in relation to performing intravenous cannulation
2. Your responsibilities and accountability in relation to the current European and National legislation, national guidelines and local policies and protocols and Clinical/Corporate Governance
3. The duty to report any acts or omissions in care that could be detrimental to yourself, other individuals or your employer
4. The importance of applying standard precautions to performing intravenous cannulation and the potential consequences of poor practice
5. The importance of working within your own sphere of competence when and  seeking clinical advice when faced with situations outside your sphere of competence
6. The risks associated with the insertion of intravenous cannulae
7. Current evidence based practice related to the management of risks associated with the insertion of intravenous cannulae
8. The importance of protecting the comfort, safety and security of the individual and self throughout insertion of intravenous cannulae
9. The importance of maintaining strict asepsis when preparing, inserting and managing intravenous cannulae
10. The anatomy and physiology of the circulatory system in relation to the insertion and maintenance of intravenous cannulae
11. The importance of correct preparation and positioning of individuals for insertion of intravenous cannulae
12. The indications and reasons for intravenous cannulation
13. Potential sites for insertion of intravenous cannulae and how to identify the most suitable for the individual
14. The factors influencing:
    1. the choice of cannulae
    2. the site for intravenous cannulation
15. The importance of limb immobilisation prior to the insertion of intravenous cannulae
16. The importance of appropriate skin preparation, including the use of depilatory cream if required
17. The importance, and approved methods, of controlling and stopping blood flow prior to intravenous cannulation
18. The possible adverse reactions to the insertion of intravenous cannulae
19. The actions you will need to take in the event of adverse reactions to the insertion of intravenous cannulae
20. The importance of and the methods of cleaning and maintaining the cannula site following insertion of cannulae
21. The clinical indications of infection in the insertion site and the actions you would take if signs of infection are apparent
22. The implications of introducing fluids into the circulatory system when flushing cannula
23. The approved methods of checking the patency of inserted cannula
24. The procedures for preparing fluids for administration including drug additions
25. The potential complications associated with fluid administration
26. The different types of administration sets available and the  circumstances when each may be used
27. The uses and potential hazards associated with the use of infusion pumps
28. The types of cannulae and the range of sizes available
29. The types of infusion available and their characteristics, indications and contra-indications
30. The different types of infusion pumps available and the  circumstances when they may be used
31. The potential hazards associated with intravenous infusion administration sets
32. The importance of correctly recording your activities including type of cannula inserted and intravenous fluids administered
33. The importance of keeping accurate and up to date records
34. The importance of immediately reporting any issues which are outside your own sphere of competence without delay to the relevant member of staff

Performance Criteria

You must be able to do the following:

1. apply standard precautions for infection prevention and control and other relevant health and safety measures
2. determine the individual’s need or clinical request for cannulation against agreed protocol
3. check the individual’s identity and confirm the planned activity
4. give the individual relevant information, support and reassurance in a manner which is sensitive to their needs and concerns
5. gain valid consent to carry out the planned activity
6. assess risks relevant to performing procedure prior to commencement and take relevant action to eliminate risks to the individual – both pre and post cannulation
7. seek clinical advice and support from an appropriate member of the team when events or risks are beyond your level of competence
8. select an appropriate site for cannulation, taking account of individual's comfort and mobility, and prepare the selected site for aseptic insertion of the intravenous cannula following agreed protocol, administering the appropriate local anaesthetic if prescribed
9. correctly position and use a tourniquet to engorge the selected vein with blood
10. select the cannula of correct size and type for individual and purpose, ensuring it is fit for use
11. insert the cannula into the selected vein using the approved technique and confirm correct siting, positioning and patency of cannula for the intended purpose
12. apply an approved dressing to fix the cannula in position
13. where appropriate, flush the cannula when in situ according to local protocols and guidelines
14. attach and secure the correct giving set where infusion is required following approved procedures
15. immediately report any condition or behaviour which may signify adverse reactions to the procedure and take appropriate action
16. document the cannulation procedure in accordance with patient records procedures
17. maintain the cannulation site at regular intervals to avoid infection and maintain access

Additional Information

This National Occupational Standard was developed by Skills for Health. This standard links with the following dimension within the NHS Knowledge and Skills Framework (October 2004): Dimension: HWB7 Interventions and treatments This standard has replaced HCS_PH04