1 · Preparation

• Verify the provider's order and review for allergies (adhesives, antiseptics, latex)
• Perform hand hygiene and gather supplies: catheter (appropriate gauge), extension set/saline lock, prefilled saline flush, tourniquet, antiseptic swab, transparent dressing, tape, gloves, sharps container within reach
• Identify the patient using two identifiers
• Explain the procedure and obtain verbal consent
• Position the patient comfortably with the arm supported below heart level

2 · Site Selection

• Apply the tourniquet 4–6 inches (10–15 cm) above the intended site
• Palpate for a straight, spongy, resilient vein (prefer forearm; avoid areas of flexion, bruising, or previous infiltration)
• Use warmth, gravity, or fist clenching to dilate the vein if needed
• Release the tourniquet if selection takes more than 1–2 minutes

3 · Insertion

• Perform hand hygiene and don gloves
• Cleanse the site with antiseptic using friction; allow to dry completely, do not re-palpate the cleansed site
• Reapply the tourniquet; apply firm skin traction below the site with the non-dominant thumb
• Insert bevel-up at 10–30° depending on vein depth
• Observe flashback, lower the angle, advance slightly, then thread the catheter off the stylet, never reinsert the stylet
• Release the tourniquet; apply pressure above the catheter tip while retracting the stylet directly into the sharps container
• Attach the primed extension set or saline lock

4 · Confirm, Secure & Document

• Flush with saline; confirm easy flow with no pain, resistance, or swelling
• Apply the transparent dressing without covering the connection; label with date, time, gauge, and initials
• Dispose of sharps and waste; remove gloves; perform hand hygiene
• Document: date/time, site, gauge, number of attempts, patient response, and how the patient tolerated the procedure
• Know the limit: after 2 unsuccessful attempts, escalate to a colleague

Evaluator Comments

Result: ☐ Competent    ☐ Needs additional practice    Evaluator signature: ____________________