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MANUAL
Covenant Health
Rural Pediatrics
POLICY
Initiated by:
Nursery
Approved by: Site Administrator
Date First Issued:
August 2015
Category: Pediatrics
Ref Policy #:
PROCEDURE
Topic: RESPONSIBILITIES OF PEDIATRIC RNS AND LPNS FOR
INTRAVENOUS INFUSIONS/SITE CARE
1.0
PROCEDURE
1.1
Continuous peripheral intravenous infusions, with or without medications, will be
assessed at a minimum hourly for site condition and line integrity. Documentation will
reflect that the IV has been checked hourly.
1.2
When intermittent medications or blood products are infusing, the intravenous
infusion site will be assessed hourly as well as:
1.2.1
At the time the medication/blood product is administered
1.2.2
At the time the “flush volume” is infused
1.3
Buretrols must be used on all pediatric patients. The level in the buretrol must be
checked and documented at least Q1H. When adding solution to the buretrol, a
maximum of 2 hours’ worth of solution only may be added to the buretrol clamp
between the IV bag and the buretrol must be clamped during the infusion. No
medication will be added to the buretrol unless there is an adequate volume in the
buretrol for the proper dilution of that medication.
1.4
LPNs may monitor ongoing infusions, including those with medications. LPNs may not
hang the bag, prime the line, or fill the buretrol for those IV solutions containing
medication unless the solution is a premixed (manufacturer or RN prepared) bag of KCl
20 meq/L.
1.5
LPNs may add the “flush” to a buretrol once a medication added to the buretrol by the
RN has infused, providing that the infusion is controlled by a pump, the “flush” solution
does not contain medication, and the rate for the “flush” does not need to change. If the
IV solution does contain KCl it must be run at a rate no faster than the prescribed
maintenance rate.
1.6
Upon completion of the flush, RNs or LPNs may add a maximum of 2 hours’ worth of
IV solution and adjust the flow rate as per Doctor’s orders, providing the IV solution does
not contain medications. If the IV solution does contain KCl it must be run at a rate faster
than the prescribed maintenance rate.
1.7
IV solutions that are attached to a patient will be infused using an IV pump. A line not in
use must be disconnected and capped.
1.8
To ease visibility in assessment for peripheral infusions, intravenous infusion
catheters should be secured with transparent tape and the site covered with transparent
dressing. Intravenous sites should not be wrapped with gauze or kling. The site may be
protected by a clear hard plastic cover.
1.9
Transparent dressing should be changed every 7 days and PRN when loose.
St. Mary’s Hospital
Camrose, Alberta
Page 2 of 2
1.10
Peripheral intravenous infusion sites are to be changed when complications arise.
1.11
Site specific IV monitoring flowsheets will be used for documentation as described above
and are to be used for all pediatric patients with intravenous infusions. One flowsheet
will be used for each pump.
1.12
In the event that a peripheral intravenous site becomes infiltrated, the nurse will;
discontinue the IV, elevate the limb, assess and document the site and notify the
physician. Warm/moist compresses are not to be applied for most situations; however
exceptions to this rule are listed in the Regional Cytotoxic Administration and Handling
Manual.