Application
This unit describes the skills and knowledge required to perform peripheral intravenous cannulation on clients.
This unit applies to registered enrolled nurses, registered Aboriginal and/or Torres Strait Islander health practitioners and emergency workers for whom peripheral intravenous cannulation is part of the job role. They may be working in hospitals, primary health care in rural remote locations, pathology services, out-of-hospital settings or in other allied health care environments.
The extent of the practitioner’s role for peripheral intravenous cannulation may be subject to state/territory legislation and organisation policy, and competency should be demonstrated within the context of applicable legislation and organisation practice.
The skills in this unit must be applied in accordance with Commonwealth and State/Territory legislation, Australian/New Zealand standards and industry codes of practice.
Elements and Performance Criteria
ELEMENT Elements define the essential outcomes | PERFORMANCE CRITERIA Performance criteria describe the performance needed to demonstrate achievement of the element |
1. Prepare for peripheral intravenous cannulation | 1.1 Correctly identify client and authorised request/s for peripheral intravenous cannulation 1.2 Explain procedure to client and obtain consent and check for allergies 1.3 Identify any additional specific requests/tests relevant to the procedure before proceeding 1.4 Ensure client is correctly and comfortably positioned to access the veins 1.5 Work with multidisciplinary team to coordinate activities to ensure they do not impact on peripheral vascular cannulation 1.6 Discuss with parent/carer/staff member appropriate holding and/or distraction technique for a client during cannulation 1.7 Assemble and prepare peripheral intravenous cannulation equipment using standard precautions 1.8 Apply tourniquet/blood pressure cuff to limb, palpate for identification of suitable vein and then release tourniquet/blood pressure cuff 1.9 Prepare and clean insertion site for cannulation |
2. Perform peripheral intravenous cannulation | 2.1 Identify own work health and safety (WHS) risks associated with poor posture during procedure and adjust client’s position 2.2 Use aseptic technique to insert peripheral intravenous cannula in accordance with manufacturer’s instructions and organisation policies and procedures 2.3 Respond to complications in accordance with organisation policy and procedures and refer client to supervisor |
2.4 Dress the site with visibility of cannula entry and secure cannula to limb. 2.5 Date the cannula in-situ dressing site, ensure client is left comfortable and is provided with relevant information and instructions 2.6 Dispose of wastes, taking into account opportunities to address waste minimisation, environmental responsibility and sustainable practice issues 2.7 Document in client’s health information the site of peripheral intravenous cannulation and number of attempts | |
3. Monitor peripheral intravenous cannula in-situ | 3.1 Assess site and cannula patency regularly in accordance with organisation procedures 3.2 Refer to supervisor or authorised personnel observed indications for cannula removal 3.3 Upon authorised request, remove intravenous cannula, cover insertion site and check bleeding has stopped |
Evidence of Performance
The candidate must show evidence of the ability to complete tasks outlined in elements and performance criteria of this unit, manage tasks and manage contingencies in the context of the job role. There must be evidence that the candidate has:
prepared equipment and performed peripheral intravenous cannulation for 3 different clients according to manufacturer’s instructions and organisation procedures
monitored 1 in-situ peripheral intravenous cannula, documenting assessment of the patency of the cannula and condition of the site
safely removed 1 peripheral intravenous cannula from a client in accordance with organisation procedures
Evidence of Knowledge
The candidate must be able to demonstrate essential knowledge required to effectively complete tasks outlined in elements and performance criteria of this unit, manage tasks and manage contingencies in the context of the work role. This includes knowledge of:
basic anatomy and physiology of the circulatory system and first aid relevant to bleeding from peripheral vascular system
factors necessitating a client to need a peripheral intravenous cannula to be in-situ:
venous blood samples
intravenous fluids
medication
identification of suitable veins in the upper and lower limbs for peripheral intravenous cannulation including:
size and condition of clients vein
use of non-dominant limb if possible
avoid the cephalic vein in clients with chronic renal failure
expected duration of the in-situ intravenous cannula
identification of veins to avoid using for peripheral intravenous cannulation:
areas of flexion e.g. antecubital fossa or bony prominences
vein just below the previous cannulation site
bruised or phlebitis areas
areas of poor venous return
limb with arteriovenous fistulae or shunt
infected limb e.g. cellulitis
arm on the same side as a previous lymph node dissection, mastectomy or affected by a cerebrovascular accident
limb with an implanted venous access device
if surgical procedure is required on limb
basic medical terminology used in peripheral vascular cannulation and pathology laboratory requests
factors which may affect the chemical analysis of blood collected from an in-situ peripheral intravenous cannula:
appropriate times to collect
impact of drugs
timing of last dose
required fasting times
protecting the integrity of the specimen
how to position client for comfort and adjust chair or bed to reduce practitioners WHS risk factors associated with poor posture during repetitive tasks
clinical applications for sizes (gauge) of cannula required, selection should take into account:
previous cannulation sites
age of patient e.g. neonates, children and the older person
purpose of peripheral intravenous cannula:
rapid transfusion
intravenous fluids
long term medication
care and maintenance of peripheral intravenous cannula in- situ
complications associated with peripheral intravenous cannulation:
occlusion
infection
phlebitis
rupture
migration
extravasation
unsuccessful cannulation attempt, client discomfort or distress
how to safely use equipment associated with peripheral intravenous cannulation:
tourniquet and/or blood pressure cuff
chlorhexidine and alcohol swabs
peripheral intravenous cannula
local anaesthetic cream and dressings
extension set and/or three-way tap device & bung associated with intravenous therapy
flushing in-situ cannula with syringe
pre-collection criteria when peripheral intravenous cannulation is for the purpose of collecting blood including:
fasting and/or dietary restrictions
drug therapies administered to client
physical health status of client
referral of client to an appropriate health professional if pre-criteria is not met prior to cannulation
Assessment Conditions
Skills must have been demonstrated in the workplace with the addition of simulations and scenarios where the full range of contexts and situations has not been provided in the workplace. The following aspects of the performance evidence must have been demonstrated using simulation prior to demonstration in the workplace or with members of the general public and where state/territory legislation prevents this occurring:
prepared equipment and performed peripheral intravenous cannulation for 3 different clients according to manufacturer’s instructions and organisation procedures
monitored 1 in-situ peripheral intravenous cannula, documenting assessment of the patency of the cannula and condition of the site
safely removed 1 peripheral intravenous cannula from a client in accordance with organisation procedures
The following conditions must be met for this unit:
use of suitable facilities, equipment and resources, including:
simulation learning equipment e.g. simulation limb suitable for peripheral intravenous cannulation
dressing pack for aseptic technique
solution for cleaning cannulation site
tape for securing cannula
suitable dressing to cover and allow visibility of entry site of cannula
peripheral intravenous cannulation equipment
personal protective equipment
clinical waste disposal equipment
tourniquet/blood pressure cuff
organisation procedure used in the planning of the procedure
Assessors must satisfy the Standards for Registered Training Organisations (RTOs) 2015/AQTF mandatory competency requirements for assessors.
Foundation Skills
The Foundation Skills describe those required skills (such as, language, literacy, numeracy and employment skills) that are essential to performance
Foundation skills essential to performance are explicit in the performance criteria of this unit of competency.