Download Administering IV Medications by Piggyback S = Satisfactory U

Administering IV Medications by Piggyback
S = Satisfactory U = Unsatisfactory NP = Not Performed
S
1.
Ensured the drug was compatible with the
primary running IV solution and with anyother
medication the patient was receiving.
2.
Prepared medication for only one patient at a
time.
3.
Paused twice during preparation to compare
the medication label carefully with the MAR.
4.
Took medication to the patient at the correct
time, in accordance with agency’s policy.
Gave time-critical medications at the precise
time ordered.
5.
Introduced self to the patient and family.
6.
Performed hand hygiene and provided for the
patient’s privacy.
7.
Identified the patient using two identifiers.
Compared these identifiers with the MAR or
medical record. Asked the patient if he or she
has any known allergies.
8.
Checked the expiration date of the IV
medication. At the bedside, again compared
the MAR or computer printout with the
names of the medications on the medication
labels.
9.
Discussed the purpose of each medication,
its action, and possible adverse effects.
Explained that the medication would be given
through the patient’s existing IV line. Allowed
the patient to ask questions. Encouraged the
patient to report any symptoms of discomfort
at the IV site.
10. Administered the piggyback IV infusion:
a. Applied clean gloves. Assessed the IV
site for any signs of phlebitis or
infiltration.
b. Used an antiseptic swab to cleanse
the port of the Y site closest to the
patient. Allowed it to dry. Attached a
U
NP
Comments
Administering IV Medications by Piggyback
prefilled syringe with 0.9% sodium
chloride to the port, kinked off the
tubing above the Y site, pulled back
slightly on the plunger and assessed
for blood return. Slowly flushed the
line with 2 to 3 mL of NS according to
agency policy.Withdrew the syringe.
c. Removed the secondary infusion set
from the packaging.
d. Closed the roller clamp. Inserted the
spike end of the tubing into the
medication bag, kept it sterile. Hung
the piggyback.
e. Squeezed the drip chamber and filled
it halfway. Opened the roller clamp
and filled the tubing until all of the air
had been displaced by the solution.
Allowed the solution to drip into a
trash receptacle.
f. Capped the tubing and wiped the
infusion port above the IV pump with
an antisepticswab.
g. Connected the secondary set of
tubing to the port of the main IV line.
Twisted the Luer lock fitting to secure
the tubing.
h. Used a hook to lower the primary
infusion bag so that the bag of the
piggyback solution was above it.
11. Traced tubing or catheter from the patient to
point of origin (1) before connecting or
reconnecting any device or infusion, (2) at
any transition (e.g., new setting), and (3) as
part of the hand-off process.
12. Labeled the tubing at a site close to the
patient and at a site close to the source
when there are different access sites or
several bags.
13. Did not force connections and avoided
workarounds per the organization’s practice.
Administering IV Medications by Piggyback
14. Checked vital signs immediately after making
any connection per the organization’s
practice.
15. Regulated the flow of the piggyback
medication by setting the rate on the
infusionpump or adjusting the regulator
clamp on the primary tubing.
16. Infused the medication over the period of
time required by agency or recommended by
a reliable medication reference.
17. Removed and disposed of gloves. Performed
hand hygiene.
18. If needed, regulated the primary IV infusion
to the ordered rate.
19. Discarded the piggyback bag and tubing in a
puncture-proof, leak-proof container or left
them in place so the tubing can be reused
with the next piggyback infusion.
20. Stayed with the patient during the first
several minutes of the infusion to observe for
any signs of an allergic or other adverse
reaction to the piggyback medication.
21. Helped the patient into a comfortable
position, and placed toiletries and personal
items within reach.
22. Placed the call light within easy reach, and
made sure the patient knew how to use it to
summon assistance.
23. Raised the appropriate number of side rails,
and lowered the bed to the lowest position.
24. Disposed of used supplies and equipment.
Left the patient’s room tidy.
25. Documented and reported the patient’s
response and expected or unexpected
outcomes, including the IV fluid solution and
hourly volume rate.
Employee:____________________________Signature:____________________________
Evaluator:_________________________ Signature:____________________________
Date:____ / ____ / _________