Pre‐procedure

ActionRationale

1. 1.Show
   Introduce yourself to the patient, explain and discuss the procedure with them, and gain their consent to proceed.
   To ensure that the patient feels at ease, understands the procedure and gives their valid consent (NMC [356], C).
2. 2.Show
   Wash hands with soap and water, or an alcohol‐based handrub, and dry.
   To reduce the risk of contamination (DH [117], C; Fraise and Bradley [156], E).

Procedure

1. 3.Show
   Open sterile pack and arrange equipment.
   To gain access to equipment. E
2. 4.Show
   Clean the needle‐free connector using 2% chlorhexidine in 70% alcohol. Apply with friction, rubbing the cap in a clockwise and anticlockwise manner at least five times. Allow to air dry.
   To minimize the risk of contamination at the connections (DH [117], C; Loveday et al. [278], C; NICE [351], C).
3. 5.Show
   Attach the syringe to the needle‐free connector.
   To establish a connection between the cap and syringe. E
4. 6.Show
   Using a push–pause method, inject the contents of the syringe (inject 1 mL at a time).
   To create turbulence in order to flush the catheter thoroughly (Goodwin and Carlson [175], E; Guiffant et al. [188], E).
5. 7.Show
   Maintain pressure on the plunger as the syringe is disconnected from the connector, then clamp the device tubing if necessary.
   To maintain positive pressure, thus preventing backflow of blood into the catheter and possible clot formation (Berreth [29], E; Dougherty [123], E; Gorski et al. [181], C).

Post‐procedure

1. 8.Show
   Dispose of equipment safely.
   To prevent contamination of others (DH [117], C).
2. 9.Show
   Record the procedure in the relevant care plan within the patient's records.
   To maintain accurate records (NMC [356], C).