Intravenous: Push: Capped Line

Intravenous: Push: Capped Line

Prerequisite Skills

Safe medication administration; aseptic aechnique

Critical Element Criteria

Students must meet criteria of Critical Elements to safely perform the skill based on evidence-based practice.  Score can be pass/fail, letter grade, or point assignment.  Only acceptable score for Critical Elements is 100%

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 record (MAR), labels for syringe, alcohol wipes, diluent, saline flush and clean gloves.

Patient Interaction: (Safety)

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

Steps of the Procedure: (Safety)

1. Assess IV site for the presence of infiltration or inflammation.
2. Check medication label with MAR and/or health care provider’s order and verify name, dose, frequency and route.  Check expiration dates and perform calculations. (First check).
3. Check medication label with MAR and/or order (Second check).
4. Draw up ordered amount of medication, properly diluting with saline, if necessary.
5. Label syringe with medication name and dose.
6. Check medication label against MAR at the bedside, prior to delivery.  (Third check)
7. Swab and flush IV capped line with normal saline per agency policy.
8. Swab the IV capped line and administer medication at the prescribed rate of administration.
9. Swab the IV capped line and administer the 2nd normal saline flush. The first 1-2 mL should be administered at the same rate as the medication.
10. Dispose of or remove equipment and supplies.

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.
• Patient’s response to procedure.