Goal: The medication is delivered via the intravenous route using sterile technique.
1. Gather equipment. Check each medication order against the original order in the medical record according to facility policy. Clarify any inconsistencies. Check the patient’s chart for allergies.
2. Know the actions, special nursing considerations, safe dose ranges, purpose of administration, and adverse effects of the medications to be administered. Consider the appropriateness of the medication for this patient.
3. Perform hand hygiene.
4. Move the medication cart to the outside of the patient’s room or prepare for administration in the medication area.
5. Unlock the medication cart or drawer. Enter pass code and scan employee identification, if required.
6. Prepare medications for one patient at a time.
7. Read the CMAR/MAR and select the proper medication from the patient’s medication drawer or unit stock.
8. Compare the label with the CMAR/MAR. Check expiration dates. Confirm the prescribed or appropriate infusion rate. Scan the bar code on the package, if required.
9. When all medications for one patient have been prepared, recheck the label with the MAR before taking them to the patient.
10. Lock the medication cart before leaving it.
11. Transport medications to the patient’s bedside carefully, and keep the medications in sight at all times.
12. Ensure that the patient receives the medications at the correct time.
13. Perform hand hygiene and put on PPE, if indicated. Identify the patient. Usually, the patient should be identified using two methods. Compare information with the MAR/CMAR.
a. Check the name and identification number on the patient’s identification band.
b. Ask the patient to state his or her name and birth date, based on facility policy.
c. If the patient cannot identify him- or herself, verify the patient’s identification with a staff member who knows the patient for the second source.
15. Close the door to the room or pull the bedside curtain.
16. Complete necessary assessments before administering medications. Check the patient’s allergy bracelet or ask the patient about allergies. Explain the purpose and action of the medication to the patient.
17. Scan the patient’s bar code on the identification band, if required.
18. Assess the IV site for the presence of inflammation or infiltration.
19. Using aseptic technique, remove the cap on the tubing and the cap on the syringe, taking care not to contaminate either end.
20. Attach infusion tubing to the syringe, taking care not to contaminate either end.
21. Place label on tubing with appropriate date.
22. Fill tubing with medication by applying gentle pressure to syringe plunger. Place needleless connector on the end of the tubing, using sterile technique, if required.
23. Insert syringe into mini-infusion pump according to manufacturer’s directions.
24. Use antimicrobial swab to clean the access port or stopcock below the roller clamp on the primary IV infusion tubing, usually the port closest to the IV insertion site.
25. Connect the secondary infusion to the primary infusion at the cleansed port.
26. Program pump to the appropriate rate and begin infusion. Set alarm if recommended by manufacturer.
27. Clamp tubing on secondary set when solution is infused. Remove secondary tubing from access port and cap, or replace connector with a new, capped one, if reusing. Follow facility policy regarding disposal of equipment.
28. Check rate of primary infusion.
29. Remove PPE, if used. Perform hand hygiene.
30. Document the administration of the medication immediately after administration.
31. Evaluate the patient’s response to medication within appropriate time frame. Monitor IV site at periodic intervals.
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