Component Task: Administration of Intrathecal Medication

Administration of Intrathecal Medication

This is the administration of medication into the spinal canal or the subarachnoid space which gradually reaches the cerebro-spinal fluid. This route of medication administration is mostly performed by a physician or an anaesthetist. The nurse therefore has the responsibility to prepare trolley, assist and observe the patient throughout the procedure.

Aims

·         Administer pain medications

·         Take samples for investigative purpose

·         Administer anaesthetic agents

Requirements

A trolley containing the following:

a.      Top Shelf: A sterile field with two sterile gallipots

b.      Bottom Shelf

·         Sterile and epidural pack (if available)

·         Local anaesthetic agent

·         Antimicrobial solution

·         Sterile gloves

·         Sterile cotton wool swab

·         Spinal cannula different sizes

·         Medication

·         Adhesive tape/strip

·         Receiver for used items

·         Syringes and needles

c.      Vital signs tray

d.      Sharps container

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 the procedure to the patient

4.      Obtain verbal or formal consent from patient and relatives

5.      Reassure him/her to gain co-operation

6.      Provide privacy

7.       Instruct patient to void before the procedure

8.      Perform hand hygiene

9.      Prepare sterile trolley and send to the bedside

10.    Check patient’s vital signs

11.      Provide adequate lightening at the puncture site

12.    Assist patient into a required position i.e. lying or sitting and supports him/her

13.    Open the equipment tray taking care not to contaminate

14.    Continue to support, observe and reassure patient throughout the procedure

15.    Wear sterile gloves and applies sterile dressing when needle is withdrawn

16.    Secure punctured site firmly with a sterile dry swab and an adhesive tape

17.    Allow patient to lie flat on the back and make him/her comfortable

18.    Document procedure on nurses’ notes and chart on the treatment chart (manual or electronic)

19.    Dispose off used items and decontaminate trolley

20.  Perform hand hygiene

21.    Observe patient continuously for therapeutic and adverse effects