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Venous Cannulation Learning Resource Aim and Learning Outcomes Overview – what do you need to do NDHB Learning Handout BD Interactive Learning Module Resource.

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Presentation on theme: "Venous Cannulation Learning Resource Aim and Learning Outcomes Overview – what do you need to do NDHB Learning Handout BD Interactive Learning Module Resource."— Presentation transcript:

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), 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) Scales, K. (2005). Vascular access: a guide to peripheral venous cannulation. Nursing Standard, 19 (49), Version 1 – February 2009

6 Version 1 - February 2009 Self Test 1When 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.

7 Version 1 - February 2009 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

8 Version 1 - February 2009 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

9 Version 1 - February 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 b. c. d. a.

10 Version 1 - February 2009 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).

11 Version 1 - February 2009 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).

12 Version 1 - February Veins below a previous IV insertion site should be avoided for: 12 hours 24 hours 48 hours 72 hours a. b. c. d.

13 Version 1 - February 2009 No, veins below a previous IV insertion sites should be avoided for 72 hours

14 Version 1 - February 2009 Yes! Veins below a previous IV insertion site should be avoided for 72 hours

15 Version 1 - February 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.

16 Version 1 - February 2009 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.

17 Version 1 - February 2009 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.

18 Version 1 - February 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.

19 Version 1 - February 2009 No, straight, distal veins are recommended. Hand veins, being distal, can be used if they are large enough to accommodate the cannula required.

20 Version 1 - February 2009 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.

21 Version 1 - February Tourniquets should be placed _________above the intended insertion site. 2 cm as close as possible 5 cm cm a. b. d. c.

22 Version 1 - February 2009 No, apply the tourniquet cm above intended insertion site. Apply snugly to trap venous blood, without occluding the pulse.

23 Version 1 - February 2009 Yes! Apply the tourniquet cm above intended insertion site. Apply snugly to trap venous blood, without occluding the pulse.

24 Version 1 - February The BD cannula should be inserted through the skin at an angle of_______. 5-10º 15-30º 45º 90º a. b. c. d.

25 Version 1 - February 2009 No, insert over the needle cannula at ° angle with bevel up. As soon as flash back of blood observed, lower the angle to skin level.

26 Version 1 - February 2009 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.

27 Version 1 - February 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.

28 Version 1 - February 2009 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.

29 Version 1 - February 2009 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.

30 Version 1 - February 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.

31 Version 1 - February 2009 Yes Potential Causes Needle/Cannula dislodged from vein Vein doesnt seal around cannula/needle Nursing Action Dont 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.

32 Version 1 - February 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.

33 Version 1 - February 2009 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.

34 Version 1 - February 2009 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.

35 Version 1 - February 2009 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


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