Peripheral IV Cannula Audit Tool
(Reference: CDHB Vol 10 and 12)
Methodology:
Real time observational audit of staff engaged in managing the cannula of a patient who has had the cannula in for over 8hrs plus
documentation audit
Location of Audit:
Month finished:
Auditors Name/Designation:
Use Y (Yes), N (No) or NA (not applicable) below
Section 1
Q 1 Hand hygiene performed prior to accessing cannula
Q 2 Asepsis maintained throughout procedure
Q 3 Cannula dressed and secured as per policy
Q 4 Completed Green ID label placed on dressing
Q 5 Completed Green ID label placed in clinical notes
Q 6 Extension set attached
Q 7 Phlebitis score documented at least 8hrly
Q 8 Cannula flushed at least 8hrly
Q 9 The cannula is within its date of expiry (i.e. not
expired)
1
2
3
4
5
6
7
8
9
10
TOTALS
Yes
No
NA
Comments for all audit questions
Entered in database by:
Date entered: