Administration of Intravenous Medication (Infusion)
Parenteral route of medication administration entails the introduction of medications directly through the skin for gradual distribution into systemic circulation and body tissues. The various routes of parenteral medicine administration are: a. Intravenous – through the vein b. Intramuscular – through the muscle c. Subcutaneous – under the skin d. Intradermal – through the dermis e. Intrathecal – through the spinal canal These medications are delivered in the form of sterile ampoule, vial or volumes of fluid(s). During the procedure, the nurse is required to generally observe the patient and also observe strict aseptic technique to minimize the introduction of micro-organisms into the body.
Aims
· Therapeutic effect
· Investigation and examination
· Prophylactic effect
Requirements
A trolley containing the following:
a. Top Shelf
· A sterile field with two sterile gallipot with a lid
b. Bottom Shelf
· Cannula (Different sizes)
· Tourniquet
· Medication (Infusion bag/bottle, ampoule or vial)
· Syringe and needle
· Sterile glove
· Sterile cotton in a pack
· Antimicrobial solution (Methylated spirit)
· Sterile water
· Receiver for used items
· Sharps container
· Adhesive strips/tape
· Mackintosh and dressing towel
· Timer
c. Giving set
d. Drip stand
Steps
1. Check for the right patient, right medication, right time, right dose against doctor’s order and treatment chart (manual or electronic) as well as the expiry date
2. Establish rapport (Refer to steps)
3. Explain procedure to patient and ensure patient’s right to know/consent and to refuse
4. Perform hand hygiene
5. Ensure quality of the infusion (check for cloudiness, sediments and other particles)
6. Prepare and send trolley and other equipment to the patient’s bedside
7. Read the label on the infusion and compare with patient’s treatment chart (manual or electronic)
8. Encourage patient to use the washroom or serve a bedpan/urinal
9. Check vital signs and records
10. Select and inspect sites for administration
11. Place infusion stand at the side of the bed and prepare adhesive strips/tape
12. Insert the piercing needle of giving set into the rubber seal of the infusion bag/bottle
13. Hang the infusion bag/bottle on the drip stand
14. Remove the cap from the other end of the giving set and attach needle to it
15. Assist patient to assume a desirable position
16. Protect the bed with a mackintosh and dressing towel
17. Fill the chamber half way and expel air from the giving set
18. Perform hand hygiene using alcohol rub
19. Wears sterile gloves
20. Clean the site with antimicrobial solution (methylated spirit) with cotton swab
21. Ask assistant to apply tourniquet to locate the vein
22. Introduce the cannula into the vein
23. Remove the metallic stylet and put it in the sharps container
24. Release the tourniquet and connect the giving set
25. Secure cannula into position and check for infiltration or haematoma
26. Remove glove and perform hand hygiene
27. Regulate the flow rate as ordered with the aid of a timer
28. Reposition patient appropriately in bed
29. Observe patient for any adverse reaction
30. Encourage patient to report any adverse reaction
31. Check infusion rate accuracy after ten (10) minutes and continue to observe the site of insertion for swelling
32. Record time of setting up, type and amount of fluid on the treatment, intake and output chart
33. Document procedure on nurses’ notes (manually or electronically)
34. Dispose off used items and decontaminate trolley
35. Perform hand hygiene
36. Check on patient after thirty (30) minutes for therapeutic effect
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