INTRAVENOUS THERAPY
            PROCEDURE MANUAL
                          - 1 -
                          LETTER OF ACCEPTANCE 
           __________________________________________ hereby approves 
                             (Facility) 
           the attached Reference Manual as of _____________________. 
                                              (Date) 
           The Intravenous Therapy Procedure Manual will be reviewed at least 
           annually or more often when deemed appropriate.  Revisions will be 
           reviewed as they occur. 
           Current copies of the Intravenous Therapy Procedure Manual shall be 
           maintained at each appropriate nursing station. 
           I have reviewed this manual and agree to its approval. 
           __________________________ 
                    (Administrator) 
           __________________________ 
                      (Director of Nursing) 
           __________________________ 
                      (Medical Director) 
                                    - 2 - 
                                                                TABLE OF CONTENTS 
                                                                TABLE OF CONTENTS 
                    INTRODUCTION 
                               A.  Purpose                                                                                                      1 
                               B.  Local Standard of Practice                                                                                   1 
                     RESPONSIBILITIES 
                               A. Responsibilities:  M Chest Pharmacy                                                                           1 
                               B. Responsibilities:  Administrator                                                                              1 
                               C. Responsibilities:  Director of Nursing Services (DON/DNS)                                                     1 
                               D. Skills Validation                                                                                             2 
                     AMENDMENTS 
                     GUIDELINES 
                               A.  Resident Candidacy for IV Therapy                                                                            1 
                               B.  Excluded IV Medications and Therapies                                                                        1 
                               C.  Processing the IV Order                                                                                      1 
                               D.  IV Solutions/Medications:  Storage                                                                           2 
                               E.  IV Solutions/Medications:  Handling                                                                          3 
                               F.  IV Solutions and Supplies:  Destroying and Returning                                                         4 
                               G.  IV Tubing                                                                                                    5 
                               H.  Peripheral IV Catheters and Needles                                                                          6 
                               I.   Central Venous Devices                                                                                      7 
                               J.  Documentation and Monitoring                                                                                 8 
                               K.  IV Medication Administration Times                                                                           9 
                               L.  Emergency IV Supplies                                                                                        10 
                                                                                       I 
                                                                TABLE OF CONTENTS 
                     PROTOCOLS 
                               A.  IV Antibiotic                                                                                                1 
                                    1. Purpose
                                    2. Guidelines
                                    3. Nursing Responsibilities
                               B.  IV Push                                                                                                      2 
                                    1. Purpose
                                    2. Guidelines
                               C.  Anaphylaxis Allergic Reaction                                                                                4 
                                    1. Purpose
                                    2. Guidelines
                                    3. Nursing Responsibilities and Interventions
                                    4. Signs and Symptoms of Anaphylaxis
                                    5. Drugs Used to Treat Anaphylaxis
                                    6. Physician Protocol
                     PRACTICE GUIDELINES 
                               A.  Purpose                                                                                                      1 
                               B.  Personnel                                                                                                    1 
                               C.  Competencies                                                                                                 1 
                               D.  Definitions                                                                                                  1 
                               E.  Resident Outcome                                                                                             2 
                               F.  Staff Outcome                                                                                                2 
                               G.  System Outcome                                                                                               2 
                               H.  Implementation Parameter                                                                                     3 
                               I.   Area of Intervention Responsibility                                                                         4 
                                    1. Assessment
                                    2. Planning
                                    3. Implementation
                                    4. Outcome Evaluation
                                    5. Documentation
                                                                                      II