NASIONAL NURSING AUDIT SELANGOR

1. ADMINISTRATION OF
(I.V) INTRAVENOUS
INFUSION
KJ NURAFIDAH MOHAMAD RASIP
U32
NATIONAL NURSING AUDIT MINISTRY OF HEALTH MALAYSIA

2. ADMINISTRATION OF IV
INFUSION

3. DEFINITION OF
ADMINISTRATION OF
INTRAVENOUS INFUSION
• Intravenous (IV) therapy involves the
administration of a therapeutic solution
directly into a vein.
• It is one of the fastest methods available
to administer medicine or hydrate a
patient.
• There are several risks associated with
intravenous therapy, such as phlebitis
and embolism.

4. COMPLICATION OF IV THERAPY
(phlebitis).
clot
(infiltration or extravasations'),
circulatory overload
(air embolism).
Poor hydration

5. 2: WHAT IS STANDARD ?
•Patient receives safe
administration of intravenous
infusion and does not develop
infusion misadventures during
hospital stay.

6. 3: WHAT IS THE OBJECTIVES ?
•To ensure nurses administer all
intravenous infusions as prescribed.
•To ensure nurses exhibit the caring
component during the administration
of infusion therapy.
•To ensure accurate and correct

7. 4. CRITERIA
Structure :
1. Each patient has current legal written
prescription.
2. There is a Standard Operating Procedure
(SOP)/ manual procedure for administration o
intravenous infusion.
3. The nurse has knowledge on care and
maintenance of I.V. infusion.

8. PROCESS
1. Acknowledge / Greet patient.
2. Identify right patient – WRIST TAG &
ASKING NAME
3. Verify prescription – NOTES IN PC
4. Prepare schedule for I.V. Regime .
5. Prepare and check IV solution.
6. Inform and explain to patient.
7. Listen and responds promptly and politely to
patient’s questions.

9. PROCESS
8. Regulate flow rate as prescribed.
9. Check for patency of line.
10. Assess infusion site for signs of
Thrombophlebitis; (swelling, redness, warm,
pain) and dislodgement.
11. Monitor patient’s response and document.
12. Take appropriate measure if adverse reaction
identified.
13. Document fluid infused in intake-output chart.

10. OUTCOME
1. Patient receives safe administration of
intravenous infusion during hospital stay.
2. Patient is informed of his infusion regime.
3. Patient receives the IV regime as prescribed.
4. IV infusion misadventures are detected early
and appropriate measures taken timely.
5. Documentation is accurate and complete.

11. 5 . AUDIT GUIDE FOR
ADMINISTRATION OF
INTRAVENOUS INFUSION
5.1. INCLUSION CRITERIA
All patients on intravenous infusions including
those with infusion devices.
5.2 EXCLUSION CRITERIA
Patients
•receiving blood transfusion.
•on controlled analgesia (P.C.A.)
•with central venous lines (CVL)

12. 6. DEFINITION OF OPERATIONAL
TERMS
6.2 Written prescription – any legal orders of I.V. regime
must be endorsed in the patient’s case notes/ relevant
Hospital/ Unit policy on IV infusion.
6.3 Patient’s comfort - Nurse assist /attend to patient’s
activities of daily living.
6.1 Concurrent IV regime - a 24-hour plan that informs
the fluid type and time frame for prescribed infusion.

13. COMPONENT RELATED
THREE COMPONENT
1.SOFT SKILL COMPONENT
2.TECHNICAL COMPONENT
3.DOCUMENT COMPONENT

14. SOFT SKILL COMPONENT
S1.The nurse is responsive to the
need for patient’s comfort
-Ask patient
-Observe Nurse
Nurse assist/attend to patient’s activities of daily living

15. TECHNICAL COMPONENT

16. T2.2 Has indicator of time commence and complete
on IV bottle
Example:
Date: 16/7/2012
Time started: 8am
Time completed:4pm
Drop/min=21drop/
min
ML/H=42ml/h
-check label on IV bottle.
-The time is to be written on the label only

17. T2.3-Is valid(not expired)
-Check date on IV bottle
T2.4-Is clear
-no change in colour
-no sediments/particles
-Check solution
T2.5-Is infused as scheduled
-Check flow rate
-Titration of flow rate accordingly.
Right flow rate: +- 2 to 5 drops/min is acceptable (for adult only)

18. T2.6-Fluid balance in IV bottle correspond to
regime
-Check balance in IV bottle
-A difference of +_50mls remaining in the bottle is acceptable
(Air vent must be open)

19. T2.7-.Fluid level in IV bottle is above spike/
more than half in chamber
-Check fluid level in IV bottle
-If fluid level in IV bottle is below spike/less than half in chamber
- consider as dry infusion

21. T3.LINE IN-SITU AND PATENT-Inspect line and site of infusion
-Uninterrupted flow with no signs of tissue infiltration/
thrombophlebitis/air bubbles/Blood clot along line

22. D4. ACCURACY AND COMPLETENESS
OF DOCUMENTATION.
-check documents
-Current IV schedule available
-Accurate and complete recordings in the I/O chart
-Name and RN of patient on the I/O chart

23. TITRATE THE DROP

25.  Doctor ordered 1 pint of
intravenous fluid N/S in 24 hours.


 1 X 500ml X 20 = 7 drops / minute
 24h 60min


26. From drops to mls:
7 drops x 60mins = 21 mls / hr.
20
Mls to drops:
21mls x 20 = 7 drops / min
60mins

27. CALCULATING DRIP RATE:
1- calculate time for each pint
exp: 3pint over 24 hours = 24 /3 = ?
2- calculate drop/min (adult and paed)
exp: 3pint over 24 hours =?
3- Calculate ml/hour
exp: 3pint over 24 hours= ?

28. THANK YOU FOR
ATTENTION