Students’s Name:___________________ Evaluator: __________________

Section/Group #:____________________ Date:_______________________

Preparing medication from ampule

Incorporating medication to a volumetric chamber(soluset)

Performance criteria PC PI NP Remarks

1. Check accuracy and completeness of the MAR with prescriber’s
written medication order. Check the patient’s name, medication
name, and dosage, route of administration, and time of
administration.
Rationale: The order sheet is the most reliable source and legal
record of patient’s medications. This also ensures that patient
receives the correct medication.
2. Introduce self and verify client’s identity.
Rationale: Complies with The Joint Commission requirements and
improves medication safety.
3. Explain procedure to client and discuss how results will be used.

4. Gather appropriate equipment.

• Medication
• Filter needle or aspirating needle
• 3 cc syringe
• Cotton balls with alcohol/alcohol swab
• Sterile gauze

5. Perform hand hygiene and observe other appropriate infection

prevention procedures

6. Prepare medication from ampule or vial for drug withdrawal. (Make

sure to check expiration and right drug)
• Change needle with a filter or aspirating needle
• Aspirate accurate amount of medication from desired dose as
calculated
• Remove air in the syringe.
• Replace the filter or aspirating needle with the original needle
7. Prepare the ampule
• Tap the top of the ampule lightly and quickly.
• Place a small gauze pad or unopened alcohol swab around the
neck of the ampule
• Quickly and firmly snapped the neck of the ampule.
8. Draw up the medication
• Aspirate the medication into the syringe.
• Keep the needle tip under the surface of the liquid. Tip the
ampule to bring all of the fluid within reach of the needle.
* To expel excess air bubbles, remove the needle from the ampule. Tapped
the side of the syringe. Draw the plunger back slightly, and push the plunger
upward to eject the air.
• Cover the needle through by sliding it through the needle cap,
with one-hand technique.
* If medication was drawn up away from the patient’s bedside, label the
syringe with the name of the medication and the amount of medication it
contains.

9. Dispose of soiled supplies. Place the broken ampule and used filter
needle/straw in a puncture-proof and leak-proof container. Clean work
area, and perform hand hygiene.

10. Check present IV fluid label, level and incorporated medicine in

the Volumetric Chamber or IV bottle if with incorporated medicine,
check for the drug-drug incompatibility and if the on-going IV fluid in
the Volumetric Chamber is to be consumed in 6-8 hours, request a
prescription and keep the whole set sterile for succeeding doses.

11. Add desired IVF diluents into volumetric chamber by opening the
sliding clamp from the bottle then close the clamp

12. Disinfect rubber injection port of the volumetric chamber and

incorporate the drug. Mix gently

13. Open the clamp of the airway at the volumetric chamber and
incorporate the drug. Mix it again gently

14. Regulate the flow rate of IV infusion accordingly.

15. Place IVF label on volumetric chamber indicating drug

incorporated and flow rate.
16. Reassure/monitor patient when incorporated medicine is
consumed; clamp airway of volumetric chamber, add IVF and regulate
flow rate of main IVF as prescribed.

17. Discard the syringe in the sharp container and other waste/supplies
in its proper disposal according to waste management
18. Document in the MAR and in the patient’s chart (if needed)

Legend: 2 pts. Performed Correctly without supervision (P.C)

1 pt. Performed Incorrectly and/or need supervision (P.I)
0 pt. Not Performed (N.P)