Adding Medication to an IV Infusion

Adding Medication to an IV Infusion

Equipment
■ Prescribed IV solution.
■ Syringe for medication.
■ Needleless access device or safety needle (if a VAD is not available).
■ Alcohol or CHG-alcohol prep pad.
■ Label with medication, dose, date, time, and your initials.

Assessment
■ Assess the patency and appearance of the IV site.
■ Be Safe! Check the medication insert or drug formulary for appropriate time or rate for infusion and for preparation. Post-Procedure Reassessment
■ Check the IV line at least once every hour to ensure that the ordered or calculated rate is maintained.
■ Assess the patient for complaints of pain at the infusion site.

Key Points
■ Check the compatibility of the IV solution and medication.
■ Refer to agency policy regarding maximum number of medications that can be added to one IV solution.
■ Remove any protective covers, and inspect the bag or bottle for leaks, tears, or cracks. Inspect the fluid for clarity, color, and presence of particulate matter.
■ Scrub all surfaces of the IV additive port with an alcohol or CHG-alcohol combination product.
■ Check the expiration date.
■ Assess the patency of the IV site.
■ Maintain the sterility of IV fluids and medication admixture.
■ Mix the IV solution and medication by gently turning the bag from end to end.
■ Be Smart! Affix the medication label to the bag; include the medication name, dose, route, and your name. Be sure the label does not cover the solution label or volume marks.

Documentation
■ If you added medication to an existing IV setup, document related patient assessment findings, such as appearance of IV site and complaints of pain or discomfort during administration.
■ Findings are usually documented on an IV flow record rather than in the nursing notes.
■ Added medications are sometimes charted on the MAR.
■ Chart a nursing note only if there is something outside of the expected findings (e.g., if the IV has infiltrated).

Inserting the needleless access device into the injection port