Objectives

At the end of the presentation the audience will be

able to:
 Learn about the nursing responsibilities in the
administration of IV Fluids and Drugs.
 Administrate the blood and blood products
according to the local policy.
There are three principles to be follow during the IV,
drugs and blood administration process:
1. Patient Identification
2. Documentation
3. Communication
* Signed written consent for transfusion at present is
not legally required in the Sultanate*
Patient Identification
 Patient Must ask to State his/her full name :

* Blood sampling
*Collect of blood from the storage and delivery to the
clinical area
*Administration to the patient
Documentation

 Full and complete documentation is required:

*Pre- transfusion blood Sampling
*Request the blood
*Prescribe the blood
*Collect the blood
*Administer the blood components
(All steps in transfusion process must be document)
Communication
 Clear communication between all the staff (Physician,
nurses, laboratory staff and any other support staff).
 Communication can be:
*Written
*Verbal
*Electronic (Blood transfusion Chart).
***Often the transfusion errors results from poor
communication***
IV Fluids and Drugs administration
 Medication is defined as any substance, solid, liquid
or vapour which may be administered to the body
through various routes to:
 To prevent disease
 To cure disease

Medication Rights??????
Advantages of Using An IV Route
1-An immediate therapeutic effect is achieved due to a
rapid delivery of the drug/fluid to target sites

2-Pain and irritation caused by some substances when

given intra muscularly or subcutaneously

3-Some patient cannot tolerate drug by oral route.

Indications of I.V Therapy
 Establish or maintain a fluid or electrolytes balance.
 Administer continuous or intermittent medication
 Administer blood or blood component
 Administer intravenous anesthetics/pain
management.
 Maintain or correct patient’s nutritional status
Principles to be applied throughout the
preparation and administration of I.V
therapy and Drugs

1- Asepsis
2- Safety
3- Comfort1- Asepsis
Asepsis
It can be defined as “ a set of specific practices and
procedures performed under carefully controlled conditions
with the goal of minimizing contamination by pathogens”
Principles of Aseptic Technique:
Only sterile items are used within sterile field.

Sterile objects become unsterile when touched by

unsterile objects.

Sterile items that are out of vision or below the waist

level of the nurse are considered unsterile.
Principles of Aseptic Technique:
Fluids flow in the direction of gravity.

Sterile objects can become unsterile by prolong

exposure to airborne microorganisms.

Moisture that passes through a sterile object draws

microorganism from unsterile surfaces above or below
to the surface by capillary reaction.
How to maintain aseptic technique?
1- Hand washing
2- Non touch technique:
a-Changing bags or bottles
Safety can be maintained by
- Two nurses checking:
a- 5 rights of the patients
b- Drug:
- Compatibility of the drug with the diluent or infusion
fluid and the related factors
such as : pH, concentration, temperature
Comfort:
Physical:
a-Comfortable environment
b-Privacy

Psychological:
a-Explaining to the patient
b-Consent
C-Assurance
Possible Mechanical Problems which may
Occur:
1- Infusion Slows or Stops:
Possible Causes:
2- Change in position of:
a-Patient
b-Limb
c-Administration Set
Nursing responsibilities in administration
of IV Fluids and Drugs
1. Check physician's order…………..
2. Identify the patient ( Check Identification against the
physician's order)…………….
3.Explain the procedure to the patient or parent and
allowing him to ask questions……
4. Wash and dry hands…………
5. Collect and prepare the equipment
6.Ensure patient privacy…………….
Nursing responsibilities in
administration of IV Fluids and
Drugs
7. Position the patient in a comfortable position……..
8. Identify and select the drug to be administered on
the patient’s drug prescription treatment record…….
9. Ensure that the patient has no history of drug
allergy…….
10. Check that the drug has not already been
administered……..
Nursing responsibilities in
administration of IV Fluids and
Drugs
11. Check the name of the drug, dose, and expiry date
against drug prescription and drug label……..
12. Calculate the required prescribed dose……
13. Wash and dry hand if required…..
14. Obtain the prescribed dosage from the container
15. Re-identify the patient by checking the patient’s ID
band number and verbal verification is required……..
Nursing responsibilities in administration
of IV Fluids and Drugs
16. Administer the drug by the route as prescribed (
Observed the patient throughout the procedure)………..
17. Ensure that the patient is left comfortable………..
18. Dispose the equipment appropriately…
19. Wash and Dry hand ……
20. Record the procedure in the appropriate
documents………
21. Monitor the patient and report any abnormal
findings immediately………..
Pre- transfusion process
 The nurse should check the physician's order and the
clinical indication for blood transfusion.
 The prescription must contain:
 Patient ID
 The component to be transfused
 Date of transfusion
 The volume
 The unit number
 The rate of transfusion
 Any special instructions
Pre- transfusion process
 Pre-transfusion blood sampling (blood grouping and
Cross match)…. Wrong in Patient’s ID results in fatal
ABO- incompatible transfusions.
 The nurse must check that there is appropriate and
patent IV access
 Vitals signs are measured and documented
 If the patient required more than one unit to be
transfused … the nurse must collect one unit at a
time.
Pre- transfusion process
 The Blood unit must be checked with the request in
the laboratory with the Lab staff
 Two nurses must check that the correct blood has
been delivered:
 Patient ID
 Blood request
 Blood unit number
 Blood group
 Donor number
 Date/ Expiry
*** Not to Keep the blood longer than 30 mints out of
the refrigerator***
Administration of Blood
 Re-assure patient’s condition, comfort and privacy.
 Vital signs should be checked
 Start transfusion
 The nurse must be with the patent the first 15 mints of
the transfusion process (observe vitals)
***Many blood reaction appear within the first 30 mints of
the procedure***
*** Rashes, Shivering, Flushing, Pain, Tachypnea and
Tachycardia are serious transfusion reaction ***
**Documentation.
Post Transfusion Care
 Re-assure patient’s condition, comfort and privacy.
 Vital signs should be checked
 Document the time of completed transfusion
***Transfusion must be completed within 4 hours***
 The empty blood bag should be discard according to
hospital policy
 If other unit required the same process must be
follow.
Post Transfusion Care
 If no need other unit the blood transfusion set should
be discard immediately after finishing the transfusing.
 No need to Flush the line, If done it should be flushed
with Normal Saline (Should follow the hospital Policy)
 Observe patient condition
 Documentation
 Post transfusion blood investigation