Reflective accounts

IV cannula site management

A CPD article enhanced John Paul Martin Esquillo’s knowledge of how to manage intravenous cannula sites safely and effectively.
Intravenous cannula

A CPD article enhanced John Paul Martin Esquillos knowledge of how to manage intravenous cannula sites safely and effectively

What was the nature of the CPD activity, practice-related feedback and/or event and/or experience in your practice?

The article discussed management of intravenous (IV) cannula sites, including cannula insertion, care of the device and potential complications related to cannula use.

What did you learn from the CPD activity, feedback and/or event and/or experience in your practice?

The article outlined common reasons for inserting an IV cannula, which include: maintaining adequate hydration, administering IV medications, transfusing blood or blood products, and monitoring deteriorating patients.

It stated that common complications of IV cannulation are phlebitis, which is inflammation of the vein, infection, infiltration and extravasation. I learned that early signs of phlebitis include redness, pain and swelling at the IV cannulation

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A CPD article enhanced John Paul Martin Esquillo’s knowledge of how to manage intravenous cannula sites safely and effectively


Picture: Alamy

What was the nature of the CPD activity, practice-related feedback and/or event and/or experience in your practice?

The article discussed management of intravenous (IV) cannula sites, including cannula insertion, care of the device and potential complications related to cannula use.

What did you learn from the CPD activity, feedback and/or event and/or experience in your practice?

The article outlined common reasons for inserting an IV cannula, which include: maintaining adequate hydration, administering IV medications, transfusing blood or blood products, and monitoring deteriorating patients.

It stated that common complications of IV cannulation are phlebitis, which is inflammation of the vein, infection, infiltration and extravasation. I learned that early signs of phlebitis include redness, pain and swelling at the IV cannulation site. These signs may indicate IV cannula resiting is necessary.

Later signs of phlebitis include pain along the path of the cannula, erythema, induration and a palpable venous cord. If such signs are present, the cannula should be resited and the patient might require further treatment. I am now aware of the importance of appropriate vein and cannula device selection in the prevention of phlebitis.

Early identification of the signs and symptoms of phlebitis may prevent the condition from increasing in severity. The article discussed the use of a phlebitis scoring system to monitor patients and to reduce incidence of IV cannula-associated infections. The patient’s score is based on their clinical signs, and indicates whether the cannula needs to be resited and additional treatment is necessary.

How did you change or improve your practice?

I am a paediatric nurse in an intensive care unit (ICU), in which IV cannulation is a vital part of clinical practice. I care for children who are vulnerable and in a critical condition. These children often receive IV medications that are associated with a risk of extravasation and infiltration, and can increase morbidity. Therefore, it is important that I monitor each IV cannulation site regularly.

I intend to use the phlebitis scoring system, which will enable me to identify the early signs of phlebitis and intervene immediately, thus avoiding severe complications.
I will ensure I document my observations and details of the IV cannulation procedure, including the size and type of cannula used. I will also make sure I follow the ICU protocol and guidelines for IV cannulation.

How is this relevant to the Code? Select one or more themes: Prioritise people, Practise effectively, Preserve safety, Promote professionalism and trust

The Code states nurses must keep clear and accurate records relevant to their practice, as part of the theme of practising effectively. The article emphasised the importance of effective record keeping, stating that failure to document interventions may have legal and professional consequences.

I have learned that for IV cannulation, documentation should include: the patient’s information; the date, time and location of the cannula insertion; the gauge and type of cannula used; the type of dressing used; and any problems with the procedure.

Nurses must also assess signs of deteriorating physical health in patients, to preserve safety. The article discussed the importance of recognising complications associated with IV cannulation early to provide effective care, for example by using the phlebitis scoring system.

John Paul Martin Esquillo is a staff nurse at Great Ormond Street Hospital, London


This reflective account is based on NS858 Brooks N (2016) Intravenous cannula site management. Nursing Standard. 30, 52, 53-62

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