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    Administration of Intravenous Medication to Adults and Children within the Community and Community Hospital. -Policy and Procedure

    Description: The document prescribes how clinicians will administer medication via the intravenous route using a

    peripheral cannula.

    Key Words: Intravenous peripheral cannula

    Version: Five

    Adopted by: Quality Assurance Committee

    Date adopted:

    Name of originator/author: Name of responsible committee: Date issued for publication:

    April 2012 David Leeson Clinical Effectiveness Group 2014

    Review date: January 2017

    Expiry date: April 2017

    Target audience: Clinical Staff

    Type of Policy (tick appropriate box)


    Non Clinical

    NHSLA Risk Management Standards if applicable: State Relevant CQC Standards:


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    Key individuals involved in developing the document

    Name Designation Karen Connor Original Policy Developer 2009 Jo Potts Original Policy Developer 2009 David Leeson Clinical Education Lead 2011 and 2014 update Julie Grant Clinical Education Lead 2011

    Circulated to the following individuals for consultation

    Name Designation Caroline Barclay Nurse Consultant Advanced Practice - CCHS Colin Bourne Clinical Trainer / Development Nurse MSOP Corinne Hutton Diana Nurse Bridge Park Plaza Debbie Leafe Clinical Education Lead CCHS Jane Bulman Team Leader Unscheduled Care Team West Locality CCHS Jo Bowley Unscheduled Care Team Sister - Loughborough Joan Carter Unscheduled Care Team Sister - Loughborough Joanne Charles Lead Pharmacist CCHS Julie Neville Clinical Trainer / Development Nurse Katie Willetts Senior Nurse Diana Service Lesley Tooley Clinical Education Lead CCHS Lindsay Bowles Ward Manager Wd 1 St Lukes Hospital Mary Marson Unscheduled Care Team Sister Melton Mel Hutchings Infection Prevention and Control Nurse Satheesh Kumar Medical Director - LPT Vyv Wilkins Equality and Diversity Officer Zoe Larosa Ward Manager Feilding Palmer Hospital

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    CONTENTS Section Contents Page

    - Title Page 1

    - Contribution and Circulation List 2

    - Contents 3

    - Version Control 4

    - Equality Statement, Due Regard, NHS Constitution 5

    - Links to CQC standards 6

    - Definitions 6

    1 Introduction 7

    2 Summary of Policy 7

    3 Scope of Policy 8

    4 Statutory Requirements 8

    5 Roles and Responsibilities 8 6 Training and Education 10 7 Audit and Monitoring 11 8 References 12


    1 Preparation of bolus dose of drug 13

    2 Administration of a peripheral intravenous bolus dose of 15


    3 Adding a drug to an infusion bag. 17

    4 Administration of a drug added to an intravenous infusion 18 Information regarding Electronic Infusion Devices Formula and calculation for infusion without an

    Electronic Infusion device

    5 Visual Infusion Phlebitis Score and Checklist 20

    6 Competency Assessment Criteria Generic LCAT tool 22 LCAT Competency Assessment sign off sheet

    7 Policy Training Requirements 24

    8 Due Regard Screening 25 9 Monitoring and Audit 26

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    Version Control and Summary of Changes

    Version number

    Date Comments (description change and amendments)

    1.0 October 2006

    2.0 December 2009

    Adopted for LCR PCT

    3.0 April 2012 Updated and adopted for LPT Procedure tables created for ease of reading. Updated list of other relevant policies. Added links to Medical Devices for Electronic Infusion Devices. Updated Reference list. Added Visual Phlebitis Score and Cannula Chart

    4.0 May 2014 Updated references, updated infection prevention and control measures, updated relevant reading.

    5.0 February 2015

    Removal of 10% rule and yellow labels on syringes for community hospitals. Updated VIPs scoring chart allows for clearer signatures and scoring. Updated to reflect Ulearn system. Updated references NMC code.

    All LPT Policies can be provided in large print or Braille formats, if requested, and an interpreting service is available to individuals of different nationalities who require them.

    Did you print this document yourself? Please be advised that the Trust discourages the retention of hard copies of policies and can only guarantee that the policy on the Trust website is the most up-to-date version.

    For further information contact:

    David Leeson Clinical Trainer / Practice Development Manager, Leicestershire Partnership NHS Trust Charnwood Mill, Sileby Rd, Barrow on Soar, Leics, LE12 8LR Tel: Mobile: 07500 097908 / Office: 01509 410265 Email:

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    Equality Statement Leicestershire Partnership NHS Trust (LPT) aims to design and implement policy documents that meet the diverse needs of our service, population and workforce, ensuring that none are placed at a disadvantage over others. It takes into account the provisions of the Equality Act 2010 and advances equal opportunities for all. This document has been assessed to ensure that no one receives less favourable treatment on the protected characteristics of their age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion or belief, sex (gender) or sexual orientation.

    In carrying out its functions, LPT must have due regard to the different needs of different protected equality groups in their area. This applies to all the activities for which LPT is responsible, including policy development, review and implementation.

    Due Regard

    The Trusts commitment to equality means that this policy has been screened in relation to paying due regard to the Public Sector Equality Duty as set out in the Equality Act 2010 to eliminate unlawful discrimination, harassment, victimisation; advance equality of opportunity and foster good relations.

    Please refer to Appendix 8 which provides a detailed overview of the due regard undertaken in support of this activity.

    NHS Constitution Core Principles

    The NHS will provide a universal service for all based on clinical need, not ability to pay.

    The NHS will provide a comprehensive range of services

    The following core principles apply to this policy.

    Shape its services around the needs and preferences of individual patients, their families and their carers

    Respond to different needs of different sectors of the population

    Work continuously to improve quality services and to minimise errors

    Support and value its staff

    Work together with others to ensure a seamless service for patients

    Help keep people healthy and work to reduce health inequalities

    Respect the confidentiality of individual patients and provide open access to information about services, treatment and performance

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    Links to CQC standards

    TARGET/STANDARDS KEY PERFORMANCE INDICATOR Use of individualised care plans that clearly show user

    1 involvement.

    Documented evidence of informed and ongoing consent to 2 treatment.

    Evidenced by thorough assessment of clinical need and

    4 multidisciplinary involvement in decision making. In addition this policy draws on the latest of guidance regarding intravenous medication. Evidenced by the use of involvement of infection prevention

    8 and control team in drawing up this policy.

    Evidenced through the use of personalised prescribing and 9 safe administration of medication utilising the latest


    Definitions that apply to this Policy Aseptic Technique Mechanisms employed to reduce potential contamination.

    Bolus Concentrated medication and / or solution given rapidly over

    a short period of time. Cannula Hollow tube made of silastic, rubber plastic or metal used for

    accessing the body. Extravasation Inadvertent infiltration of a vesicant solution or medication

    into the surrounding tissue. Infiltration Inadvertent administration of a non-vesicant solution or

    medication into the surrounding tissue. Non-Vesicant Intravenous medication that generally does not cause tissue

    damage or sloughing if injected outside of a vein. Phlebitis Inflammation of a vein; may be accompanied by pain,

    erythema, oedema, streak formation and / or palpable cord; rated by a standard scale Visual infusion phlebitis score.

    Thrombophlebitis Inflammation of the vein in conjunction with the formation of a blood clot (thrombus)

    Vesicant Agent capable of causing injury when it escapes from the intended vascular pathway into surrounding tissue.

    Inadvertent infiltration of a vesicant solution or medication into the surrounding tissue.

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    1. INTRODUCTION 1.1 The majority of medicines that are administered in the community setting are via the oral

    route. However, in certain clinical circumstances, administration of medicines via the intravenous route is preferred. Traditionally, this activity was carried out within acute hospitals as an in-patient or within the out-patient setting.

    1.2 Our health, Our care, Our Say a new direction for community services (DOH 2006)

    highlighted the need for more care to take place nearer to the patients home. This is reiterated in Care in Local Communities A New Vision and Model for District Nursing (DH 2013). As a result, there is more administration of intravenous medicines taking place in the community setting either within patients own homes or within community hospitals.

    1.3 Th


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