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. Drip stand
d. Giving set
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 vial and compare with patient’s treatment chart (manual or electronic) for the dosage
9. Reconstitute as per manufacturers instruction/prescribers order
10. Ensure quality of the medication (check for cloudiness, sediments and particles)
11. Place infusion stand at the side of the bed
12. Hang vial on the drip stand
13. Draw the medication into a syringe
14. Protect bed with a mackintosh and dressing towel
15. Remove the cap from the other end of the giving set
16. Connect giving set, fill the chamber half way and expel air
17. Perform hand hygiene
18. Wear sterile gloves
19. Clean the entry port of cannula with antimicrobial solution (methylated spirit)
20. Connect giving set to the cannula via entry port
21. Regulate the flow rate as ordered with a timer
22. Reposition patient appropriately in bed
23. Observe patient for adverse reaction
24. Encourage patient to report any adverse reaction
25. Remove mackintosh and dressing towel
26. Record time of setting up medication, name of medication and amount on the intake and output chart and Treatment Chart (Manual or Electronic)
27. Document procedure on nurses’ notes and chart on the treatment chart (manual or electronic)
28. Dispose off used items and decontaminate trolley
29. Perform hand hygiene
30. Check on patient after thirty (30) minutes for therapeutic effect
31. Remove giving set from cannula after administration of medication and cover the entry port cannula
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