NAME: _______________________________________________ DATE: ____________________

INSTRUCTOR/EVALUATOR: _______________________________ SECTION: __________________

NURSING PROCEDURE: PREPARING ON IV SOLUTION

DEFINITION: Priming refers to placing IV fluid in IV tubing to remove all air prior to attaching the IV tube to
the patient. Priming and connecting an IV line is the process undertaken to prepare sterile fluids for
infusion into the circulatory system in a closed, air-free, uncontaminated manner, through an
intravenous cannula as prescribed.

PURPOSE:

IV tubing is primed to prevent air from entering the circulatory system. ALL air must be removed from
the tubing to prevent an air embolism. 

PRINCIPLE/S:

- correct calculation of infusion rate apply and additional efforts to prevent infection 
- Application of aseptic non-touch technique (ANTT) in the preparation and administration of the fluid
infusions are required.
- Each bag of fluid be checked by two (2) staff and signed as per organisational policy.
- Always label your tubing with the time and date you initiated it and when it expires.

EQUIPMENT/SUPPLIES NEEDED:

IV solution, primary IV tubing, time label, change label, alcohol swab, and basin or sink.

STEP by STEP PROCEDURE

Rate:
Rating: 5 - Excellent 4 - Very satisfactory 3 - Satisfactory 2 - Needs improvement 1 - Poor

1. Perform hand hygiene.

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Rationale: To prevent transfer of microorganisms

2. Check order to verify solution, rate, and frequency.

Rationale: This ensures IV solution is correct and helps prevent medication error.

3. Gather supplies.

You will need IV solution, primary IV tubing, time label, change label, alcohol swab, and basin
or sink.

Rationale: To promote efficiency in doing the procedure

4. Remove IV solution from outer packaging and gently squeeze.

Rationale: Tear the perforated corner of the outer packaging; check colour, clarity, and expiration
date. You need to verify integrity of the solution.

Note the expiry date on IV bags are reported by month and year. The product is valid for the
entire month.

5. Remove primary IV tubing from outer packaging.

Rationale: Be careful and do not contaminate the spike.

6. Move the roller clamp about 3 cm below the drip chamber and close the clamp.

Rationale: Closing the clamp avoids the solution from flowing/rushing down the tube and to be
able to control the flow of the solution
7. Remove the protective cover on the IV solution port and keep sterile. Remove the protective cover
on the IV tubing spike.

Rationale: Be careful and do not contaminate the spike.

8. Without contaminating the solution port, carefully insert the IV tubing spike into the port, gently
pushing and twisting.

Rationale: Insert IV spike into sterile solution using sterile technique

9. Hang bag on IV pole.

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Rationale: The IV bag should be approximately one metre above the IV insertion site.

10. Fill the drip chamber one-third to one-half full by gently squeezing the chamber. Remove
protective cover on the end of the tubing and keep sterile.

Rationale: Filling the drip chamber prevents air from entering the IV tubing.

11. With the distal end of tubing over a basin or sink, slowly open the roller clamp to prime the IV
tubing. Invert back check valve and ports as the fluid passes through the tubing. Tap gently to remove
air and to fill with fluid.

Rationale: Inverting and tapping the access ports and back check valve helps displace and
remove air when priming the IV tubing
12. Close roller clamp. Cover end with a sterile dead-ender or sterile protective cover. Hang tubing on
IV pole to prevent from touching the ground.

Rationale: Keep the distal end sterile prior to connecting IV to patient.

13. Label tubing and IV bag with date, time, and initials.

Rationale: Label IV solution bag as per agency policy. Do not write directly on the IV bag.

14. Perform hand hygiene.

Rationale: For infection control. To prevent contamination

CHANGING AN IV SOLUTION BAG

Disclaimer: Always review and follow your hospital policy regarding this specific skill.

15. Verify and select the correct IV solution bag and compare it to the medication administration
record (MAR) or physician orders.

Rationale: IV solutions are considered a medication and must be checked using the SEVEN
RIGHTS x 3, as per agency policy.

16. Introduce yourself, identify patient, and explain procedure.

Rationale: Proper identification of a patient prevents medication errors. Explaining the

procedure provides an opportunity for the patient to ask questions.
17. Perform hand hygiene.

Rationale: For infection control. Prevents transmission of microorganism

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18. Remove outer plastic packaging and squeeze bag to test for leaks and expiration date. Assess for
precipitates or cloudiness. Hang a new IV solution on IV pole.

Rationale: This ensures the correct IV solution is used. Expiry dates on IV bags are reported by
month and year. The product is valid for the entire month.

19. Close the roller clamp on a gravity infusion set.

Rationale: Stops the infusion to prevent air bubbles from forming in IV tubing.

20. Remove protective plastic cover from the new IV solution tubing port.

Rationale: Keep all ports sterile.

21. Remove the old IV solution bag from the IV pole. Turn IV bag upside down, grasping the tubing
port. With a twisting motion, carefully remove the IV tubing spike from old IV solution bag.

Rationale: Removing old solution from IV pole and inverting it prevents spilling of solution.
Ensure IV tubing spike remains sterile during removal to avoid contaminating IV tubing.

22. Using a gentle twisting motion, firmly insert the spike into the new IV bag.

Rationale: This ensures that principles of asepsis are followed.

23. Fill the drip chamber by compressing it between your thumb and forefinger. Ensure the drip
chamber is one-third to one-half full. Check IV tubing for air bubbles.

Rationale: Fluid in the drip chamber helps prevent air from being introduced into IV tubing.

24. Open clamp and regulate IV infusion rate via gravity, or press start on the EID as per physician
orders.

Rationale: If using gravity, count the drops per minute in the drip chamber. If using an
EID follow the prompts on the screen to ensure the IV is running at the correct rate.

25. Label new IV solution bag as per agency policy. Time tape gravity IV solutions as per agency policy

Rationale: Labelling IV solutions provides easy viewing of infusing solutions, additives and when
the bag was hung.
26. Dispose of used supplies, perform hand hygiene, and document IV solution bag change according
to agency policy.

Rationale: To prevent contamination and prevent the spread of microorganisms. Proper

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 documentation provides accurate data and ensures safety of the patient. Document time,
date, type of solution, rate, and total volume.

TOTAL SCORE: /130

COMMENTS/SUGGESTIONS:
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