Weight for weight based drugs

Here’s a conversation I’ve had with an RN preparing to give a weight based medication via a peripheral IV:  I don’t weigh the patient each time they come in for an infusion. I only weigh them at the beginning of their treatment to get a baseline weight. Why should I weigh them again, they can…

Q&A: Treatment Orders for Infusion Therapy

Q: I am a registered nurse working in a physician owned infusion center. We work very closely with the physician and if the patient needs IV therapy, the doctor tells me what IV and meds to give, then I start the infusion, He writes what he wants given in his progress notes. Is there a…

Infusions in Physician Offices

Nearly 53 million outpatient procedures are performed annually in the United States. While most of these procedures occur in hospital outpatient departments, a growing number are being done in nonhospital-based facilities such as ambulatory surgery centers and physician offices. One of these procedures include infusion therapy, the administration of fluids and medications via the venous…

Why do nurses use the same alcohol swab over and over?

I know, this may come as a surprise to all of you, but the truth is, I have seen many nurses (even those highly trained and specialized) both in hospitals and outpatient settings, use the same alcohol swab over and over. Imagine this scenario where a nurse is ready to withdraw medication from several vials.…

ICYMI: Check out these ASHP Guidelines

1. The ASHP Guidelines on Home Infusion Pharmacy Services – defines the role of the pharmacist in providing home infusion care to patients and to outline minimum requirements (indicated by use of the word “shall”) and best practices for the operation  and management of services provided by pharmacies in the home or alternate-site setting.  Home…

Large Volume IV Solution Shortages

It just doesn’t seem right that the national crisis with “drug shortages” would include  large volume (1000mL) IV solutions we commonly administer to our patients: 0.9% Sodium Chloride Injection 0.45% Sodium Chloride Injection Lactated Ringer’s Injection 5% Dextrose Injection   But the reality is there is a shortage, IV saline solution, in particular is on…

Vesicants and Extravasation

These two terms defined by the Infusion Nurses Society means: Vesicant – an agent capable of causing blistering, tissue sloughing or necrosis when it escapes from the intended vascular pathway into surrounding tissue. Extravasation – the inadvertent infiltration of vesicant solution or medication into surrounding tissue. There are several chemotherapeutic agents with vesicant properties, and…

Think Safety, Insert Safely

In June of 2013, I was honored to chair a national task force for the Infusion Nurses Society’s (INS) project on Short Peripheral Catheter Safety (SPC).  Along with five other colleagues, we embarked on a task  to identify the safety and practice issues and  look at ways to promote safety in the insertion and management…