The document discusses the nurse's role in IV therapy. It covers several topics: 1) Ensuring IV fluids and accessories are sterile and free of microbes to prevent contamination that can cause infections. 2) Proper use and disinfection of infusion equipment like luer locks, needleless connectors, filters, flow control devices, and tourniquets. 3) Best practices for site care and maintenance like set change frequency and flushing/locking IV lines to minimize infection risk.

1. IV THERAPY: NURSE’S ROLE
Nutcharee Jungvanichar RN, MBA

2. ความปลอดภัยในการบริหารสารน้ า
 particulate contamination and
Free from
micro-organisms including pyrogens.
 Thefluids and the accessories must be
sterile and free of micro-organisms.
 Microbial contamination can cause serious
impact (local infection, septic thrombophlebitis or primary
bloodstream infection).

3. Infusion Equipment

4. Infusion Equipment
Add-on devices
 Luer-locked design
 Disinfect the port (using friction)
 The use of stop cock is not recommended
Needleless connector
 Nurse should be knowledgeable about the function
 Nurse should be aware that the catheter hub is a know
source of infection

5. Infusion Equipment
Filters

6. Infusion Equipment
Flow - control device
 Electronic infusion device with administration based ,
anti free flow mechanisms shall be used
 Dose –error reduction system shall be considered in
selection and use of electronic infusion devices
 The nurse should be involved in the evaluation and
selection of flow –control devices

7. Infusion Equipment
Tourniquets
 The tourniquet should be single-patient use
 Latex allergy should be assesses

8. Hand Hygiene

9. Site Care And Maintenance

10. Site Care And Maintenance
Set change:
 IV: No more frequency than 96 hrs.
 Parenteral Nutrition : should be routine change every
24 hrs
 Blood and blood product: should be replace every 4
hrs

11. Site Care And Maintenance
Flushing and Locking
 Single use system include single-dose vial and prefilled
syringe are the preferred choice of flushing

12. Infusion Therapy

13. Pharmacist
Nurse, infusion nurse
Nurse, infusion nurse
Nurse, infusion nurse

14. Types of IV Fluid Containers
There are generally three types of IV fluid
containers in use globally.
 Rigid containers which are made of glass,
High Density Polyethylene (HDPE) or
Polypropylene (PP)
 Semi-rigid containers which are made of
Polyethylene (PE) or Polypropylene (PP)
 Flexible bags which are made of polyvinyl
chloride (PVC), or Polyolefin laminate

15. Open Infusion System
Open Infusion Container – Open Infusion Container –
Glass container with air filter. Semi-rigid container with air filter.

16. Open Infusion System
 The chance of contamination in an open
system is 10 times more than the closed
system.
 Any device which has tubes with one end
inside the body and one outside can
cause contamination. These include
urinary catheters, IV fluid bags,
endotracheal tube, etc. These should be
closed systems so as to prevent
contamination.

17. Closed Infusion System
Closed Infusion Container-
Fully collapsible plastic container without air filter

18. Acceptance of closed Infusion System
 In North America, Europe and Australia,
a closed IV system is the minimum
acceptable standard.
 It is dependent on the understanding of
the inherent risks associated with open
IV systems and the risks can be
avoided by using a closed IV system.

19. Acceptance of closed Infusion System
 The main reasons for acceptance of the closed IV
system are:
a) Patient safety and reduce infection risk.
b) Reduce costs of treatment as a result of patients
not prolonging their stay in hospitals.
c) Improved quality care delivery in hospitals.
d) Meeting regulatory authorities to ensure best
practices.

21. Should we use closed or open infusion containers
for prevention of bloodstream infections?
Results
 CLABSI was significantly decreased
(81%) in the closed container

22. Should we use closed or open infusion containers
for prevention of bloodstream infections?

23. Central line Bundle
 Hand Hygiene
 Maximal Barrier Precautions
 Chlorhexidine Skin Antisepsis
 Optimal Catheter Site Selection
 Assessment of Central Line Necessity

24. 2012 Highlight
• Scrub the hub 15 seconds prior accessing the line
• Daily assessment

26. Scrub the hub
Scrub with friction 15 sec.

27. …We can not predict the
future but we can create it…
from INS 2012

28. Thank You for Your Attention