Definition
Discontinuing an intravenous infusion (IV) is a routine yet critical nursing procedure that must be done with precision to prevent complications like bleeding, infection, or catheter embolism.
Indications
- Patient is discharged from hospital.
- Advent of an allergic reaction.
- Impaired skin/tissue integrity.
- Completion of the treatment regimen.
Purposes
- Patient discharge or transition: The patient is being discharged from the facility or transitioning to oral medications or enteral feeding, making IV access redundant.
- Restoration of fluid balance: The patient has returned to a stable fluid and electrolyte status (euvolemia) and can maintain hydration and nutrition orally.
- Prevention of complications: To reduce the risk of infection, phlebitis, infiltration, or catheter-related bloodstream infections—especially if the IV site shows signs of inflammation or malfunction.
- Device-related issues: The IV catheter has become dislodged, occluded, or is no longer patent, requiring removal or replacement.
- Allergic or adverse reactions: If the patient develops a reaction to the IV medication or fluid, discontinuation is necessary to prevent further harm.
Articles
- Clean gloves.
- Dry antiseptic swab.
- Small sterile gauze piece.
- Adhesive strip.
- Kidney tray.
Procedure
| Nursing Actions | Rationale | |
| 1. | Before procedure Explain procedure to patient. | Reduces anxiety and helps in obtaining cooperation. |
| 2. | During procedure Wash hands and assemble equipment. | Reduces risk of transmission of microorganisms. Assembling equipment save time and energy. |
| 3. | Clamp infusion tubing. | Clamping prevents fluid from flowing out of the needle onto the patient or bed while removing. |
| 4. | Loosen tape at the venipuncture site while holding the cannula firmly and applying counter traction to skin. | Movement of the cannula can injure the vein and cause discomfort to the patient. Counter traction prevents pulling of skin and causing discomfort. |
| 5. | Don clean gloves and hold sterile gauze over venipuncture site. | |
| 6. | Withdraw IV cannula/catheter from vein by pulling it along the line of vein. | Pulling along the line of vein will avoid vein injury. |
| 7. | Apply firm pressure for 2-3 minutes. Hold extremity above the level of heart if bleeding persists. | Prevents bleeding and hematoma formation. Raising limb reduces blood flow to the area. |
| 8. | Examine the catheter removed from patient to see if it is intact. If broken or any part is missing, report it at once to the nurse in charge and physician. If broken piece can be palpated inside the vein, apply a tourniquet above the level of the palpated piece. | If a piece of tubing remains in vein it can travel centrally to heart or lung Application of tourniquet reduces possibility of the broken piece moving to the heart till physician comes. |
| 9. | Apply sterile gauze piece over venipuncture site with an adhesive tape over it. | Dressing continues to apply pressure over the site. |
| 10. | After procedure Discard all disposable articles. | |
| 11. | Wash hands and remove gloves. | Reduces risk of transmission of microorganisms. |
| 12. | Document all relevant information, i.e. time of discontinuing solution, amount of solution left in the old container if any. |
Special Considerations
- Never pull the cannula out forcefully or at an angle this can damage the vein.
- Monitor for signs of phlebitis, infiltration, or infection post-removal.
- Ensure the call bell is within reach, bed is low and locked, and patient is comfortable before leaving.
REFERENCES
- Annamma Jacob, Rekha, Jhadav Sonali Tarachand: Clinical Nursing Procedures: The Art of Nursing Practice, 5th Edition, March 2023, Jaypee Publishers, ISBN-13: 978-9356961845 ISBN-10: 9356961840
- Omayalachi CON, Manual of Nursing Procedures and Practice, Vol 1, 3 Edition 2023, Published by Wolters Kluwer’s, ISBN: 978-9393553294
- Sandra Nettina, Lippincott Manual of Nursing Practice, 11th Edition, January 2019, Published by Wolters Kluwer’s, ISBN-13:978-9388313285
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