Intravenous Access
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Minutes
Evaluator
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Student
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Skill Steps
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Verbalizes/demonstrates appropriate infection control precautions
Gathers and prepares equipment
Connects administration set to IV bag
Prepares fill chamber and flushes IV tubing
Applies constricting band
Locates vein
Cleanses site
Performs venipuncture and notes flash
Disposes of needle in sharps container
Releases constricting band
Opens administration set, looks for infiltration and sets appropriate drip rate, or, attaches saline lock, looks for infiltration while flushing tubing
Secures catheter
Critical Criteria
Failure to establish a patent IV within 3 attempts
Contaminates equipment or site without appropriately correcting the situation
Failure to dispose/verbalize disposal of syringe and other material in proper container
Exhibits unacceptable affect with patient or other personnel
Uses or orders a dangerous or inappropriate intervention
Evaluator Comments
Success?
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Pass
Needs Remediation
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