1. Venous Cannulation Learning Resource
Aim and Learning Outcomes
Overview – what do you need to do
NDHB Learning Handout
BD Interactive Learning Module
Resource Articles
Self Test
Competency Assessment Tool
Version 1 – February 2009

2. Aim: To provide registered nurses with the knowledge
and skills to safely perform venous cannulation
Learning Outcomes
On completion of the readings and practice session the
nurse will be able to:
Describe rationale for selection of cannulation device
Discuss criteria for vein selection
Demonstrate selection of veins
Discuss potential complication, causes and nursing actions
Demonstrate safe cannulation technique
Version 1 – February 2009

3. Overview What do you need to do?
Discuss with your manager and educator
– is this right for you right now?
Read through the training handout
Work through the “Interactive learning module – produced by
BD Medical - Medical Surgical Systems
Read the resource articles
Complete the Self Test
Book in for a practise and training session with your Venous
Cannulation Link nurse
Develop expertise by performing cannulation supported by
your Link nurse or a credentialed peer
Be signed off as competent, using the competency assessment
Tool
CHECKLIST – PRINT AND TAKE TO YOUR TRAINING SESSION
Version 1 – February 2009

4. BD Interactive Learning Module Click here
Scroll down
Double click on “Interactive
Inservice Module
Click “next” at bottom to go
to next slide
Note: video may take a
minute to load – be patient
Version 1 – February 2009

5. Resource Articles Hadaway, L.C., & Millam, D.A. (2003).On the road to
successful I.V. starts. Nursing2003, 33 (1), 1-14.
Ingram, P., & Lavery, I. (2007).Peripheral intravenous
cannulation: safe insertion and removal technique. Nursing
Standard, 22 (1),
Lavery, I., & Ingram, P. (2005). Venepuncture:best practice.
Nursing Standard. 19, (49)
Lavery, I., & Ingram, P. (2006). Prevention of infrection in
peripheral intravenous devices. Nursing Standard. 20, (49)
49-56.
Scales, K. (2005). Vascular access: a guide to peripheral
venous cannulation. Nursing Standard, 19 (49),
Version 1 – February 2009

6. Self Test
When determining the type and size of cannulation device to use, you need to consider the expected use over:
The next 6 hours
The next 24 hours
The next 48 hours
The next 72 hours a b. c. d.
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7. No, when determining size, consider the fluid type expected to be used over the next 72 hours.  This may prevent an additional venepuncture.  Always use the smallest needle/cannula that you can to reduce the risk of phlebitis
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8. Yes!
When determining size, consider the fluid type expected to be used over the next 72 hours.  This may prevent an additional venepuncture.  Always use the smallest needle/cannula that you can to reduce the risk of phlebitis
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9. 2 For an adult patient going to surgery, who may require blood, your best choice of cannula size would be:
22 g
24 g
20 g
18 g a. b. c. d.
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10. No, an 18g is recommended for surgical patients and for blood administration (Although blood can be given through smaller catheters, it flows better through a larger lumen).
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11. Yes!
An 18g is recommended for surgical patients and for blood administration (Although blood can be given through smaller catheters, it flows better through a larger lumen).
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12. Veins below a previous IV insertion site should be avoided for:
12 hours
24 hours
48 hours
72 hours a. b. c. d.
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13. No, veins below a previous IV insertion sites should be avoided for 72 hours
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14. Yes!
Veins below a previous IV insertion site should be avoided for 72 hours
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15. three times the diameter as large as possible
A vein should be at least ______of the diameter of the cannula to be used.
the same diameter
twice the diameter
three times the diameter
as large as possible a. b. c. d.
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16. No, the vein should be twice the diameter of the cannula to be used.
First determine the size of cannula required, and then choose the vein.
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17. The vein should be twice the diameter of the cannula to be used.
Yes!
The vein should be twice the diameter of the cannula to be used.
First determine the size of cannula required, and then choose the vein.
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18. When choosing a vein to cannulate, avoid:
Joints, straight veins, areas of skin inflammation
Joints, distal veins, arms with an artreriovenous shunt
Joints, areas of skin inflammation, veins below previous IV insertion sites, arms with an artreriovenous shunt
Distal veins, straight veins, hand veins a. b. c. d.
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19. No, straight, distal veins are recommended
No, straight, distal veins are recommended. Hand veins, being distal, can be used if they are large enough to accommodate the cannula required.
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20. Yes! AVOID Veins below a previous IV site (for 72 hours).
Veins below a phlebotic area.
Areas of skin inflammation, bruising.
Joints.
Arms affected by mastectomy, arteriovenous shunt.
Anterior aspect of forearm.
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21. Tourniquets should be placed _________above the intended insertion site.
2 cm
as close as possible
5 cm
10-15 cm a. b. c. d.
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22. No, apply the tourniquet 10 - 15 cm above intended insertion site
No, apply the tourniquet cm above intended insertion site.  Apply snugly to trap venous blood, without occluding the pulse.
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23. Yes!
Apply the tourniquet cm above intended insertion site.  Apply snugly to trap venous blood, without occluding the pulse.
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24. The BD cannula should be inserted through the skin at an angle of_______.
5-10º
15-30º
45º
90º a. b. c. d.
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25. No, insert over the needle cannula at 15-30° angle with bevel up
No, insert over the needle cannula at 15-30° angle with bevel up.  As soon as flash back of blood observed, lower the angle to skin level.        
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26. Yes!
Insert over the needle cannula at 15-30° angle with bevel up.  As soon as flash back of blood observed, lower the angle to skin level.        
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27. Potential causes of phlebitis include:
1. tourniquet applied incorrectly
2. puncturing the back of vein
3. site not changed regularly (72-96hr)
4. vein too small for cannula
1 and 2
2 and 3
1 and 3
3 and 4 a. b. c. d.
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28. No, Phlebitis Potential Causes Needle/cannula size inappropriate
Site not changed regularly
Nursing Action
Use large cannula/needle for caustic medication. Choose vein twice the diameter of cannula/needle.
Peripheral IV sites should be changed every hours.  DO NOT wait for redness to appear, by then it is too late.
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29. Yes! Phlebitis Potential Causes Needle/cannula size inappropriate
Site not changed regularly
Nursing Action
Use large cannula/needle for caustic medication. Choose vein twice the diameter of cannula/needle.
Peripheral IV sites should be changed every hours.  DO NOT wait for redness to appear, by then it is too late.
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30. Stablising the cannula well NOT placing over a joint
9 Nursing actions that can reduce the potential for extravasation (tissuing) include:
Stablising the cannula well
NOT placing over a joint
Entering the vein at 15-30º
All of the above a. b. c. d.
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31. Yes Potential Causes Needle/Cannula dislodged from vein
Vein doesn’t seal around cannula/needle
Nursing Action
Don’t place over a joint.
Stabilise cannula well.
Observe regularly for oedema, coolness, tenderness.
Enter vein at 15-30° angle to reduce cutting of vein wall fibres.
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32. Peripheral IV site and dressing should be changed every:
24 – 48 hours
72 – 96 hours
5 – 7 days
only when redness appears a. b. c. d.
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33. No, Change IV site and dressing Q 72 - 96 hours
No, Change IV site and dressing Q hours.  Observe site 8 hourly, change dressing as needed.  Change IV site at first sign of redness, inflammation even if less than 72 hours.
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34. Yes!
Change IV site and dressing Q hours.  Observe site 8 hourly, change dressing as needed.  Change IV site at first sign of redness, inflammation even if less than 72 hours.
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35. The end Have you read the resource articles?
Have you read through the BD interactive learning module?
Have you booked into a practice session?
Print off check list
Fill in
Take with you to your practice session
Version 1 - February 2009