Safe IV Therapy Practice Guidelines

Medication Preparation and Administration

The Centers for Disease Control and Prevention recommends that all routine parenteral fluids must be admixed in a laminar-flow hood using aseptic technique 1
The Centers for Disease Control and Prevention suggests using single-dose vials for parenteral additives or medications whenever possible to minimize contamination risk 1
The Centers for Disease Control and Prevention advises against combining leftover contents of single-use vials for later use 1, 2
The Centers for Disease Control and Prevention recommends inspecting every container before use and discarding any parenteral fluid with visible turbidity, leaks, cracks, particulate matter, or expired manufacturer dates 1, 2
The Centers for Disease Control and Prevention suggests documenting who prepared each final solution and the exact time of preparation 1
The Centers for Disease Control and Prevention recommends completing lipid emulsions alone within 12 hours of hanging and lipid-containing solutions within 24 hours 1, 3, 4
The Centers for Disease Control and Prevention advises completing blood or blood products within 4 hours 4, 5

The Centers for Disease Control and Prevention recommends cleaning injection ports with 70% alcohol or iodophor before every access to the system 1, 5, 6
The Centers for Disease Control and Prevention suggests performing alcohol-based hand rub or antiseptic soap wash before and after every patient contact or IV system manipulation 1
The Centers for Disease Control and Prevention recommends applying 0.5-2% chlorhexidine with 60-70% alcohol solution for catheter insertion 1
The Centers for Disease Control and Prevention advises evaluating insertion sites daily by palpation through dressing to detect tenderness 4, 5, 8

The Centers for Disease Control and Prevention recommends avoiding steel needles for administering fluids and medications that might cause tissue necrosis if extravasation occurs 1, 4, 6
The Centers for Disease Control and Prevention suggests using midline catheter or PICC when IV therapy duration will likely exceed 6 days 1, 4, 6, 8
The Centers for Disease Control and Prevention recommends selecting catheters based on intended purpose, duration, known complications, and operator experience 1, 4, 6
The Centers for Disease Control and Prevention advises using upper extremity instead of lower extremity sites in adults 1, 4, 6

The Centers for Disease Control and Prevention recommends designating only trained personnel for insertion and maintenance of intravascular catheters 1, 5, 6
The Centers for Disease Control and Prevention suggests providing initial training on aseptic technique, hand hygiene protocols, and catheter insertion with site selection principles 1
The Centers for Disease Control and Prevention recommends verifying annual competency through skills review and demonstration 1

The Centers for Disease Control and Prevention advises against administering intranasal or systemic antimicrobial prophylaxis routinely before catheter insertion or during use 1, 5, 6
The Centers for Disease Control and Prevention recommends against applying prophylactic topical antimicrobial or antiseptic ointment to peripheral venous catheter insertion sites 5, 8
The Centers for Disease Control and Prevention suggests not using in-line filters routinely for infection-control purposes 1, 5, 6

The Centers for Disease Control and Prevention recommends storing emergency medications in clearly labeled containers with documented acceptable temperature ranges 1
The Centers for Disease Control and Prevention suggests monitoring refrigeration temperatures for medications requiring cold storage 1
The Centers for Disease Control and Prevention advises protecting photosensitive medications from light exposure 1
The Centers for Disease Control and Prevention recommends storing diluted epinephrine solutions up to 4 hours at room temperature or 24 hours refrigerated 1