Intravenous: Intermittent Infusion (IV Piggyback): Pump Infusion

Critical Elements

• Prepare medication for one patient at a time.
• Assess the IV site for the presence of inflammation or infiltration.
• Calculate, accurately, the rate of administration, confirming safe dose range.
• Verbalize potential adverse effects and any monitoring requirements.
• Perform 3 checks for safe medication administration.
• Utilize 2 patient identifiers.
• Evaluate patient allergies.

Procedure

Prior to Treatment: (Critical Thinking)

• Assess patients need for treatment.
• Confirm order.
• Gather equipment: IV medication, medication administration reacord (MAR), labels for tubing, alcohol wipes, IV pump, extension hook. If necessary: clean gloves.

Patient Interaction: (Safety)

• Patient identifiers.
• Provide for privacy.
• Explain procedure.
• Confirm allergies.
• Wash hands.

Steps of the Procedure: (Safety)

1. Confirm medication compatibility if appropriate.
2. Assess IV site.
3. Inspect tubing dates.
4. Lower empty secondary bag and open roller clamp allowing air to purge backwards into the empty bag.  Close roller clamp with drip chamber on secondary tubing is about 1/3 full.
5. Remove secondary bag and spike new medication bag.
6. Lower main bag on extension devise.
7. Program IV pump to proper rate of administration.
8. Return to room when infusion if complete and confirm proper rate of primary solution.

After Procedure (Patient Centered Care)

• Straighten room making patient comfortable, replace call light.
• Wash hands before leaving room.

Documentation (Informatics, Communication)

• Assessment of insertion site.
• MAR should reflect: right patient, medication, dose, frequency, and route.
• Intake of fluid, if appropriate.
• Patient’s response to procedure.

Resources

• Infusion Nurses Society
• The Joint Commission