Goal: The medication is delivered via the intravenous route using sterile technique.
1. Gather equipment. Check the medication order against the original order in the medical record according to facility policy. Clarify any inconsistencies. Check the patient’s chart for allergies. Verify the compatibility of the medication and IV fluid.
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 medication 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 and perform calculations, if necessary. Confirm the prescribed or appropriate infusion rate. Calculate the drip rate if using gravity system. Scan the bar code on the package, if required. Check the infusion rate.
9. If necessary, withdraw medication from an ampule or vial as described in Skills 5-3 and 5-4. Attach needleless connector or blunt needle to end of syringe, if necessary.
10. When all medications for one patient have been prepared, recheck the label with the CMAR/MAR before taking
them to the patient.
11. Prepare medication label including name of medication, dose, total volume, including diluent, and time of administration.
12. Lock the medication cart before leaving it.
13. Transport medications and equipment to the patient’s bedside carefully, and keep the medications in sight at all times.
14. Ensure that the patient receives the medications at the correct time.
15. Perform hand hygiene and put on PPE, if indicated.
16. Identify the patient. Usually, the patient should be identified using two methods. Compare information with the CMAR/MAR.
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.
17. Close the door to the room or pull the bedside curtain.
18. 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.
19. Scan the patient’s bar code on the identification band, if required.
20. Assess IV site for presence of inflammation or infiltration.
21. Fill the volume-control administration set with the prescribed amount of IV fluid by opening the clamp between IV solution and the volume-control administration set. Follow manufacturer’s instructions and fill with prescribed amount of IV solution. Close clamp.
22. Check to make sure the air vent on the volume-control administration set chamber is open.
23. Use antimicrobial swab to clean access port on volumecontrol administration set chamber.
24. Attach the syringe with a twisting motion into the access port while holding the syringe steady. Alternately, insert the needleless device or blunt needle into the port. Inject the medication into the chamber. Gently rotate the chamber.
25. Attach the medication label to the volume-control device.
26. Use an 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.
27. Connect the secondary infusion to the primary infusion at the cleansed port.
28. The volume-control administration set may be placed on an infusion pump with the appropriate dose programmed into the pump. Alternately, use the roller clamp on the volume-control administration set tubing to adjust the infusion to the prescribed rate.
29. Discard the syringe in the appropriate receptacle.
30. 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.
31. Check rate of primary infusion.
32. Remove PPE, if used. Perform hand hygiene.
33. Document the administration of the medication immediately after administration.
34. Evaluate the patient’s response to medication within appropriate time frame. Monitor IV site at periodic intervals.
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