Clinical Policy
Definition:
Owner Group:
Policy
Operations
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Diversity Statement 3
Subject 4
Rationale 4
Manager Responsibility 4
Staff Responsibility 4
Knowledge of Policy
Principles 4
Rationale for Administration of Intravenous Fluids
Exclusions 5
Training 5
Audit 5
Guidelines/Procedures 5
Prior to Administration of the Infusion
Prescribing 6
Administration 7
After Care 7
References 9
This policy endeavours to deliver care in such a way as to treat patients fairly and
respectfully regardless of age, gender, race, ethnicity, religion/belief, sexual
orientation and/or disability.
The care and treatment provided will respect the individuality of each patient.
BEN PCT is caring, committed and competent in its core values and these will be
developed to ensure equality and fairness becomes the working culture.
In line with the PCT’s strategy and plans for race and equality all clinical policies
and protocols are reviewed against the values, standards and targets contained
within the strategy for fairness and equality.
2.0 RATIONALE
Provide Training.
To ensure Staff attend Trust Training which is competency based, and ensure
Staff are given opportunities to maintain competencies
Knowledge of Policy
To Practice within Policy guidelines
To ensure updated knowledge by attending Training and maintaining
competency
6.0 PRINCIPLES
6.3 Patient’s privacy and dignity will be maintained at all times during the
consultation and administration process.
7.0 EXCLUSIONS
Not having gained patient’s informed consent – refer to BEN PCT Consent
Policy
8.0 TRAINING
8.1 Any nurse administering intravenous drugs must be competent in all clinical
aspects of intravenous therapy and have validated competency. The nurse
must practice in accordance with the NMC Code of Conduct.
9.0 AUDIT
9.1 Audit of clinical activity will be via the BENPCT Incident Reporting procedure
and any adverse events should be reported by the nurse, via the yellow card
system.
10.3 The nurse administering medications and solutions should have knowledge of
indications for therapy, side effects and potential adverse reaction, and
appropriate interventions, particularly related to the management of
anaphylaxis. Refer to the Anaphylaxis Policy 2005
10.5 inspection of fluids, drugs, equipment and their packaging must be undertaken
to detect any points where contamination may have occurred during
manufacture and/or transport. This intrinsic contamination may be detected as
cloudiness, discolouration or the presence of particles.
10.6 The date of insertion and date of removal of the device will be documented, in
the clinical record as a matter of routine.
10.7 The number of lines, lumens and stopcocks will be kept to the absolute
minimum consistent with clinical need.
11.0 PRESCRIBING
All details of the infusion and any drug additions should be prescribed, by the
prescriber at John Taylor Hospice, on the Drug Administration sheet IV Drugs
section, and in the patient’s records.
11.1 All drug additions to intravenous infusions are made by the Doctor or
prescriber attending John Taylor Hospice.
11.2 When adding drugs to a continuous infusion, only one addition should be
made to each bag or bottle of fluid after the compatibility has been
ascertained.
11.3 The additive and fluid must be mixed well, by means of inverting the container
several times, to prevent a layering effect and a bolus injection of the drug
being delivered.
12.1 The number of lines, lumens and stopcocks will be kept to the absolute
minimum consistent with clinical needs.
Winnings Ways 2003
12.1 The Nurse is accountable for evaluating and monitoring the effectiveness of
the prescribed therapy; documenting patient response, adverse events, and
interventions; and achieving effective delivery of the prescribed therapy.
12.3 The insertion site should be inspected at least once a day for complications
such as infiltration, phlebitis or any indication of infection, e.g. redness at the
insertion site of the device or pyrexia. These problems will necessitate the
removal of the cannula and further investigations e.g. wound swab in the
presence of exudate.
12.5 Replace solution administration sets and stopcocks used for continuous
infusions every 72 hours. Research has indicated that routine changing of
administration sets every 48-72 hours instead of every 24 hours is not
associated with an increase in infection and could result in considerable
savings for hospitals.
12.6 Infusion bags should not be left hanging for longer than 24 hours. After being
added to an infusion bag, a medication or solution should be infused within 24
hours or discarded, via the Clinical Waste disposal system.
Nice Guidelines 2003
13.1 On completion of the prescribed regime, tubing and the infusion bag will be
disposed of in the appropriate Clinical Waste disposal system.
13.2 The nurse will remove the cannula from the patient following an aseptic
procedure.
13.4 Fluid charts and prescription charts will be filed in patient’s records on
completion of treatments. The episode of care and treatment should be
documented in the patients records according to the Trust Record Keeping
Policy.
The Royal Marsden Hospital Manual of Clinical Nursing Procedures (6th Edition) The
Royal Marsden NHS Foundation Trust 2004
The NMC Code of Professional Conduct: Standards for conduct, performance and
ethics. November 2004
Policy adopted from Sandwell and West Heath Birmingham Hospitals NHS Trust
Incorporating Local Procedures for John Taylor Hospice for the safe administration
of Blood Transfusion 2004