Probable Questions on Infection Control During JCIA SurveyApril 9, 2017
Discharge PlanningApril 9, 2017
INTRODUCTION ABOUT IVP MEDICATION
When a doctor has prescribed a medicine that will be administered via an intravenous (IV) line in your arm. An IV Push is so named because the medicine is “pushed” into the bloodstream using a syringe during this procedure. Additionally, IV line will need to be flushed.
Flushing is the process of filling the IV tubing with a solution in order to prevent it from becoming clogged (clotting).
Check the medication labels and patient identification
Prepare all your needs beforehand
2 Saline syringes
Heparin syringe, if needed
Alcohol disinfectant swab
Remove the syringe cap
Gently tap the syringe
Push the plunger to remove air and extra solution.
Replace the syringe cap
- Indications for IV push medications
- Emergency administration during cardiopulmonary resuscitation.
- When quicker response to the medication is required (e.g. Furosemide).
- Some drugs are metabolized quickly and must be administered quickly to achieve the desired effects, like Adenosine.
- Administration of a “loading” dose of a medication to rapidly achieve a desired drug level.
- To avoid incompatibility problems when multiple medications are being administered.
- IVP of Chemotherapeutic drugs should be given by chemotherapy qualified nurses.
- A clear written order must be obtained by a licensed physician before administration of an IV push medication, except during a Code Blue.
- A Registered Nurses will be certified to administer IV push medications in accordance with the guidelines of the institutions, the nursing units and with the IV Medication Reference Manual.
- The nurse must be knowledgeable regarding:
- Compatibility of medication and IV solution
- Maximum dosage and rate of administration
- Desired therapeutic effects
- Possible adverse effects
- Appropriate preparation and dilution
- Required monitoring parameters
- The nurse must ensure the following:
- Right patient
- Right drug
- Right dosage
- Right route
- Right time
- Right dilution/fluid compatibility
- Right flow rate
- Right monitoring
- Right documentation
- To avoid speed shock, don’t administer a drug in less than 1 minute, unless the order is direct you to do so or if patient is in cardiac or respiratory arrest.
- To decrease drug tolerance, slower injection times or grater drug dilution may be required if the patient has:
- Systemic edema
- Pulmonary congestion
- Decreased cardiac output
- Reduced urine output, renal flow, or glomerular filtration rate.
- For quickly metabolized drugs.
- Indications for IV push medications
- To define the professionals authorized to administer medications by direct IVP.
- To safely administer approved medications intravenously by push/direct route.
– IVP is defined as the administration of any medication, diagnostic agent or intravenous fluid infused over less than 5 minutes without the use of an infusion device.
– IVP can be administered by two ways; directly into a vein or through an existing infusion line.
- Advantages & Disadvantages of IVP
- ( When injecting into vein (no infusion line):
(When nonversicant drug with low risk of immediate ADR required for a patient with no other IV
- Elimination the risk of complications from an indwelling venipuncture device.
- Eliminate the inconvenience of an indwelling venipuncture device.
- Can only be given by a doctor or especially certified nurse.
- Required venipuncture, which can cause patient anxiety.
- Required two syringes-one to administer the medication and one to flush the vein after administration.
- Risk of infiltration from steel needle
- Drug can’t be diluted and delivery can’t be interrupted if irritation occurs.
- Carries risk of clotting with administration of drug over
a long period and with a small volume.
2. Through existing infusion line:
– If the drug is incompatible with the IV.
– If patient needs immediate high blood levels.
– In emergencies.
- Doesn’t required time or authorization to perform venipuncture because the vein is already accessed.
- Doesn’t require a needle puncture, which can cause patient anxiety.
- Allows the use of IV soln. To test the patency of venipuncture device before drug administration.
- Allows continued venous access in case of ADR.
- Carries the same inconveniences and risk of
complication associated with indwelling venipuncture
device (such as infection, infiltration, and pain).