Administration of Intravenous Medication (Ampoule/Vial Reconstitution)
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
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. Check medication label and method of reconstitution as per manufacturer’s instructions
3. Establish rapport (Refer to steps)
4. Explain procedure to patient and ensure patient’s right to know/consent and to refuse
5. Perform hand hygiene
6. Prepare and sent trolley to the bed side
7. Ensure a cannula is in situ
8. Read the label on the ampoule/vial and compare with patient’s treatment chart (manual or electronic) for the dosage
9. Reconstitute as per manufacturers instruction where necessary/prescribers order
10. Examine reconstituted medication for cloudiness and sediments
11. Draw medication with syringe, expel air from the barrel and place the syringe into a receiver
12. Protect bed linen with a mackintosh and dressing towel
13. Put patient in a desirable position
14. Perform hand hygiene
15. Wear sterile glove
16. Clean entry port of cannula with antimicrobial solution and cotton wool swab
17. Fix syringe with the medication into the entry port of cannula
18. Pull gently on the plunger to check for blood return
19. Push medication slowly using the push-stop-push-stop technique till administration is completed
20. Observe patient throughout the administration for any reaction and swelling
21. Continue observing patient five (5) to ten (10) minutes later after injecting medication
22. Reposition patient appropriately in bed
23. Encourage patient to report any adverse reaction
24. Remove mackintosh and dressing towel
25. Document procedure on nurses’ notes and chart on the treatment chart (manual or electronic)
26. Dispose off used items and decontaminate trolley
27. Perform hand hygiene
28. Check on patient after thirty (30) minutes for therapeutic effect
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