The Royal Marsden Hospital Manual of Clinical Nursing Procedures - Lisa Dougherty [583]
26 For gravity infusion, restart the infusion and adjust the rate of flow as prescribed. If via an infusion pump, start the pump and set rate. To ensure that the infusion will be delivered at the correct rate over the correct period of time (NPSA 2007d, C).
27 If the addition is made into a burette, the infusion can be restarted immediately following mixing and recording and the infusion rate adjusted accordingly. To ensure that the infusion will be delivered correctly (NPSA 2007d, C).
28 Ask the patient whether any abnormal sensations, and so on, are experienced. To ascertain whether there are any problems that may require nursing care and refer to medical staff where appropriate. E.
Postprocedure
29 Discard waste, making sure that it is placed in the correct containers, for example sharps into a designated receptacle. To ensure safe disposal and avoid injury to staff. To prevent reuse of equipment (DH 2005, C; MHRA 2004, C).
30 Complete the patient’s recording chart and other hospital and/or legally required documents. To maintain accurate records. To provide a point of reference in the event of any queries. To prevent any duplication of treatment (NMC 2009, C).
Procedure guideline 13.21 Medication: intermittent infusion of intravenous drugs
Essential equipment
Patient’s prescription chart
Recording chart or book as required by law or hospital policy
Protective clothing as required by hospital policy for specific drugs
Container of appropropriate intravenous infusion fluid
Drug additive label
Intravenous administration set
Intravenous infusion stand
Clean dressing trolley
Clinically clean receiver or tray containing the prepared drug to be administered
Sterile needles and syringes
10 mL for injection of a compatible flush solution, for example 0.9% sodium chloride or 5% dextrose
Flushing solution to maintain patency plus sterile injection cap
2% chlorhexidine swab
Gloves
Alcohol-based hand wash solution or rub
Sterile dressing pack
Hypoallergenic tape
Sharps bin
Preprocedure
Action Rationale
1 Explain and discuss the procedure with the patient. To ensure that the patient understands the procedure and gives their valid consent (Griffith and Jordan 2003, E; NMC 2006c, C; NMC 2008b, C).
2 Before administering any prescribed drug, check that it is due and has not been given already. Check that the information contained in the prescription chart is complete, correct and legible. To protect the patient from harm (NMC 2008a, C; NPSA 2007d, C).
3 Before administering any prescribed drug, consult the patient’s prescription chart and ascertain the following:
Drug
Dose
Date and time of administration
Route and method of administration
Diluent as appropriate
Validity of prescription
Signature of prescriber.
To ensure that the patient is given the correct drug in the prescribed dose using the appropriate diluent and by the correct route. To protect the patient from harm. To comply with NMC (2008a) Standards for Medicines Management (NMC 2008a, C; NPSA 2007d, C).
4 Wash hands with bactericidal soap and water or bactericidal alcohol handrub. To prevent contamination of medication and equipment (DH 2007, C).
5 Prepare the intravenous infusion and additive as described in Procedure guidelines 13.12–13.15 To ensure the drug is prepared correctly (NPSA 2007d, C).
6 Prime the intravenous administration set with infusion fluid mixture and hang it on the infusion stand. To ensure removal of air from set and check that tubing is patent. To prepare for administration (NPSA 2007d, C).
7 Draw up 10 mL of compatible flush solution for injection using an aseptic technique. To ensure sufficient flushing solution is available. E
8 Draw up solution (as per hospital policy) to be used for maintaining patency, for example 0.9% sodium chloride. To prepare for administration. E
9 Place the syringes in a clinically clean