A Brief Guide To Best Practices in IV Push Administration
Administering IV push medication is one of the most performed activities by nurses. Yet it’s also a practice in which many professionals feel unsure. Even though education and training have never been as accessible as they are now, there are still a large number of professionals in hospitals, clinics, and skilled nursing facilities performing these procedures using outdated techniques.
This situation represents a danger not only to nurses’ careers, but mainly to patients’ health.
There are many risks involved when intravenous insertion is performed incorrectly. One of the main dangers is the unnecessary dilution of medications, which easily alters recommended dosage. Even slight alterations can be harmful, especially with high-alert drugs such as injectable potassium chloride concentrate or intravenous anticoagulants.
Although some of the most commonly used IV push medications are anti-inflammatories and loop diuretics, the therapeutic range for medications is still very narrow. There is also a high risk of contamination when nurses dilute drugs in non-sanitized places such as bedside tables.
That said, the most important initial guiding steps for best practices in IV push administration include:
- Washing hands
- Verifying accuracy of the physician’s order
- Explaining procedure to both the patient and/or a significant other
- Assembling equipment and supplies using aseptic technique
- Donning gloves
- Cleaning needleless access device with alcohol swab and allowing to dry
Patients must be monitored closely during the administration of the IV bolus or push medication.
If any problems or adverse reactions occur, the drug administration must be terminated immediately.
IV push medications must be performed by a licensed nurse according to state laws and facility policies. Skilled nurses are also expected to follow infection control and safety compliance procedures.
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