Changing IV Solution Container and Tubing
Goal: The patient experiences minimal to no trauma when solution and tubing are
changed.
1. Identify the patient. Ask the patient if allergic to any medication, iodine, or tape, as appropriate.
2. Gather all equipment and bring to bedside. Check IV solution and medication additives against physician’s order. Label IV if medication is added. Include the date, time, and your name or initials.
3. Explain procedure and reason for change to patient.
4. Perform hand hygiene.
To Change IV Solution Container
5. Carefully remove protective cover from new IV solution container and expose bag entry site.
6. Close clamp on IV tubing. If using an electronic device, turn device to “hold” position.
7 Lift container off IV pole and invert it. Quickly remove the spike from the old IV container, being careful not to contaminate it.
8. Steady new container and insert spike. Hang on IV pole.
9. Reopen clamp, check the drip chamber of the administration set on tubing, and adjust flow. Readjust electronic device by turning the device “ON” and verify the programmed flow rate. Inspect for air bubbles in the tubing. If using an electronic device, check that the device is operating correctly.
10 Label container according to agency policy. Record on intake and output record and document on chart according to agency policy. Discard used equipment properly. Perform hand hygiene.
To Change IV Solution Container and Tubing
11. Prepare IV solution and tubing, checking IV order with the physician’s order, and labeling the IV with date, time, and name or initials.
a. Maintain strict aseptic technique when opening sterile packages and IV solution.
b. Clamp IV tubing, uncap spike on administration set , and insert into entry site on IV bag or bottle as manufacturer directs.
c. Squeeze drip chamber and allow it to fill at least halfway.
d. Remove cap at end of the IV tubing and while maintaining its sterility, open the IV tubing clamp, and allow fluid to move through tubing. Allow fluid to flow until all air bubbles have disappeared and the entire length of the tubing is primed (filled) with IV solution. Close clamp and recap end of tubing, maintaining sterility of the setup.
e. If an electronic device is to be used, follow manufacturer’s instructions for inserting tubing and setting infusion rate.
f. Label tubing with date and time that tubing was hung.
g. Place time-tape on container and hang IV on pole.
12. Close the clamp on the existing IV tubing. Also, close the clamp on the short extension tubing connected to the IV catheter in the patient’s arm.
13. Remove the current infusion tubing from the resealable cap on the short extension IV tubing. Using an antimicrobial wipe, swab the resealable cap and insert the new IV tubing into the cap.
14. Open the clamp on the IV tubing and on the short extension tubing. Check the IV flow. Readjust electronic device as needed.
15. Regulate IV flow according to physician’s order.
16. Label IV tubing with date, time, and your initials. Label IV solution container and record procedure according to agency policy. Discard used equipment properly and perform hand hygiene.
17. Record patient’s response to IV infusion.