GUIDANCE FOR ASSESSORS - Intravenous Drug Administration.
COMPETENCIES
Generic
1. Demonstrates knowledge of policy,
guidelines for practice, legal aspects and
professional accountability.
2. Demonstrates knowledge of drugs
relevant to clinical area. Can identify
sources of information on drugs and IV
therapy. Has completed period of
supervised practice in reconstitution of
IV drugs and assessment for safe
handling of Trust infusion pumps.
.Peripheral Line
1.Inspects cannula site and cannula to
ensure patency, observes for signs of
pain, swelling or redness
2. Observes site whilst administering
drug for pain or swelling.
3. Checks dressing before and after
administration and is aware of when
dressing should be renewed.
Peripheral Administration
4. Interprets prescription correctly.
Verifies drug, checks dosage and route
for individual patient.
5. Prepares drug/ solvent according to
practice guidelines.
6. Calculates amount of drug required
correctly.
7. Checks all aspects with a competent
second nurse/ doctor prior to
administration.
8.Checks identity of patient prior to the
procedure.
Clinical Skills June 2006
GUIDANCE
To be able to state what the main points
of the IV policy are, what IV drugs
he/she is covered to give according to
Trust “How to give I V Drugs”
guidelines. To have knowledge of NMC
Guidelines for administration of
medicines and Code of conduct.
Able to state indications for IV drugs
commonly used on ward, contraindications, side effects and normal
dosage. Candidate knows how to obtain
further information. Provides evidence of
infusion pump assessment.
Able to identify signs of inflammation
and recognise signs of extravasation.
Able to refer to visual infusion phlebitis
scoring system and be aware of when
cannula needs to be renewed. Able to
discuss safe documentation of cannula
Able to recognise complications which
may occur whilst administering
medication such as extravasation and
recognises need to stop procedure.
Able to discuss infection control issues
with regard to dressing. Can discuss types
of dressing available and pros and cons of
each type.
Assessor witnesses.
Assessor witnesses.
Assessor witnesses.
Assessor witnesses that the nurse checks
the prescription and dosage.
Assessor witnesses the nurse checking
the patient details on prescription chart
with patient ID band or asks patient to
9. Checks site prior to administration.
10. Administers drug according to
practice guidelines – How to give IV
drugs.
11. Monitors flow of drug for duration of
infusion.
confirm details.
Assessor witnesses nurse checking site
and is able to describe what she is
looking for and why.
Assessor witnesses the procedure.
Assessor questions the candidate as to
why the drug is given over a specific time
period.
12. Monitors condition of patient during
Candidate is able to state how an adverse
administration.
reaction would manifest itself and what
action would be appropriate
13. Accurately records administration in
Assessor witnesses that the
all relevant documentation.
administration of the drug is accurately
recorded on the relevant documents.
14. Disposes of all equipment safely.
Assessor witnesses disposal of
equipment. Candidate can indicate the
dangers of incorrect disposal.
15. Able to discuss possible side effects.
Candidate can state side effects of
common drugs used on the ward and can
obtain information regarding drugs not
commonly used on the ward.
16. Can indicate action to be taken if drug Candidate is able to state how an adverse
reaction occurs.
reaction would manifest itself and what
action would be appropriate.
Central triple/double lumen non valved
lines.
1. Able to identify and care for central
1. Able to identify and care for central
triple/double lumen non valved line,
triple/double lumen non valved line,
describe rationale for site of insertion and describe rationale for site of insertion and
indications for their use.
indications for their use.
2.Competent to administer drugs via
Assessor witnesses procedure.
central venous catheter according to Trust
policy.
3. Checks dressing and site before and
Assessor witnesses, candidate able to
after administration of drugs and is
identify what they are looking for when
proficient to change dressing aseptically
checking dressing and site. Candidate
adhering to Trust protocol.
able to discuss type of dressing used and
when this would be changed/and
witnesses aseptic technique.
4. Able to correctly draw blood samples Assessor witnesses if appropriate
from lines.
5. Able to safely remove central
Assessor witnesses procedure. Candidate
triple/double lumen non valved venous
able to describe signs of potential
catheters. Can discuss potential
complications and actions which would
complications of central line removal.
then be taken.
Clinical Skills June 2006
COMPETENCIES
Central single and double lumen
valved PICC lines
1. Able to identify and care for central
single/double lumen valved PICC line,
describe rationale for site of insertion and
indications for their use.
2.Competent to administer drugs via
central venous catheter according to
Trust policy.
3. Checks dressing and site before and
after administration of drugs and is
proficient to change dressing aseptically
adhering to Trust protocol.
4. Able to correctly draw blood samples
from lines.
5. Able to safely remove central
single/double lumen valved PICC venous
catheters. Can discuss potential
complications of central line removal.
Hickman lines
1. Able to identify hickman line rationale
for site of insertion and indications for
their use.
2.Competent to administer drugs via
central venous catheter according to
Trust policy.
3. Checks dressing and site before and
after administration of drugs and is
proficient to change dressing aseptically
adhering to Trust protocol.
4. Able to correctly draw blood samples
from lines.
GUIDANCE
1. Able to identify and care for central
single/double lumen valved PICC line,
describe rationale for site of insertion and
indications for their use.
Assessor witnesses procedure.
Assessor witnesses, candidate able to
identify what they are looking for when
checking dressing and site. Candidate
able to discuss type of dressing used and
when this would be changed/and
witnesses aseptic technique.
Assessor witnesses if appropriate
Assessor witnesses procedure. Candidate
able to describe signs of potential
complications and actions which would
then be taken.
1. Able to identify and care for hickman
line, describe rationale for site of
insertion and indications for their use.
Assessor witnesses procedure.
Assessor witnesses, candidate able to
identify what they are looking for when
checking dressing and site. Candidate
able to discuss type of dressing used and
when this would be changed/and
witnesses aseptic technique.
Assessor witnesses if appropriate
Guidance for central, Hickman and PICC line administration numbers 6 –18
are as peripheral administration numbers 4 – 16.
Clinical Skills June 2006
Blood Transfusion.
1. Obtains consent from patient prior to
commencing transfusion.
2. Performs the identity check of the
patient at the bedside.
3. Checks all patient details are the same
on; Identification band, prescription
chart, blood transfusion compatibility
report and compatibility label on blood
unit.
4. Checks the blood group, unit number
and expiry date are the same on:
Transfusion centre blood label, blood
transfusion compatibility report and
compatibility label on blood unit.
5. Accurately records all details of
transfusion on prescription chart and
blood compatibility report.
6. Able to discuss the potential
complications of a transfusion and
actions to be taken if they occur.
Clinical Skills June 2006
Assessor witnesses the nurse explaining
risks and benefits of the transfusion.
Gives a patient information leaflet.
Assessor witnesses the nurse asking the
patient to state full name and date of
birth. Checks this information with
identification band
Assessor witnesses procedure
Assessor witnesses procedure
Assessor witnesses the nurse clearly and
accurately documenting all details
Assessor asks the nurse to identify the
signs and symptoms of an acute
transfusion reaction and what actions
would be taken.