Renal: IV Antibiotic administration during Haemodialysis Treatment Doc#
Guideline and
Procedure
IVI Antibiotic administration during Haemodialysis Treatment
Document Number:
Sites where Guideline and Procedure
applies:
All HNE facilities where a patient undergoes
haemodialysis
Target audience:
Nephrology clinical staff, who provide care to
haemodialysis patients.
This document comprises part of the clinical information
package for care of Haemodialysis patients
Antibiotic, Haemodialysis
Description:
Keywords:
Replaces Existing Guideline and
Procedure:
Yes
Registration Number(s) and/or name and
of Superseded Documents:
JHH Nephrology SWP N.1.4
Relevant or related Documents, Australian Standards, Guidelines etc:
 NSW Health Policy Directive 2007_079 Correct patient, Correct procedure, correct site
http://www.health.nsw.gov.au/policies/pd/2007/pdf/PD2007_079.pdf
 NSW Health Policy PD 2005_406 Consent to Medical Treatment
http://www.health.nsw.gov.au/policies/PD/2005/pdf/PD2005_406.pdf
 NSW Health Policy Directive PD 2007_036 Infection Control Policy
http://www.health.nsw.gov.au/policies/pd/2007/pdf/PD2007_036.pdf
 NSW Health Circ, 2001/64 – Policy on Handling of Medication in NSW Public Hospitals
 NSW Health Circ, 2005/343 – Policy on Medication Administration by EEN’s
 Product Information Leaflet
 JHH Policy No 3.2.3A Medication Incident reporting
 AMGEN Dialysis medication guide 2010
Prerequisites (if required):
Registered or Endorsed Enrolled Nurses who have been deemed
competent in the performance of haemodialysis
Procedure Summary:
This Guideline and Procedure sets out the steps to be followed when
administering IV Antibiotics to a Renal Patient during the haemodialysis
Procedure. The procedural components of the document such as,
Preparation of patient, Preparation of equipment, Technique, Cleaning up
and Documentation are considered mandatory.
Guideline Note :
This document reflects what is currently regarded as safe and appropriate
practice. However in any clinical situation there may be many factors that
cannot be covered by a single document and therefore does not replace
the need for the application of clinical judgment in respect to each
individual patient.
Date authorised:
Authorised by:
Contact Person:
HNEAHS Renal Clinical Stream Leadership Group
Contact Details:
Review due date:
TRIM Number:
Version No. 1
December 2010
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Renal: IV Antibiotic administration during Haemodialysis Treatment Doc#
OUTCOMES
1
Reduce the risk of incorrect antibiotic dose and administration and drug reactions
2
Safe and effective administration of Antibiotics during Haemodialysis by ensuring correct
dosage and correct equipment is utilized e.g. dialyzer selection when administering antibiotics
3
Maintenance of infection control policies, and safe disposal of contaminated waste.
4
Risk of blood exposure or needle stick injury significantly reduced
ABBREVIATIONS & GLOSSARY
IV
Intravenous
RMO
Resident Medical Officer
GUIDELINE
Prior to IV antibiotic administration during Haemodialysis refer to “The Renal Drug Reference
Guide” to check that the antibiotic is not dialysed out during the dialysis procedure.
If a patient is dialysed on a high flux dialyser for their standard dialysis procedure, they must be
changed to a low flux dialyser for the administration of antibiotics unless otherwise documented by
a Nephrologist or Nurse Practitioner.
Caution should be used when administering an antibiotic in the community stand alone units (eg.
Wansey & Nita Reed) if the patient has not had the drug in the past due to risk of allergic reactions.
Ideally first ever dose of a particular antibiotic should occur in a dialysis unit co-located on a
hospital campus.
PROCEDURE
The procedure requires mandatory compliance.
Patient Preparation
It is mandatory to ensure that the patient has received appropriate information to provide informed
consent and, that patient identification, correct procedure and correct site process is completed
prior to any procedure.
Patient advised to inform staff if they notice any unusual symptoms during the administration of the
antibiotics.
Check if the patient has had the drug before and if they have any allergies to medications,
specifically antibiotics.
Staff Preparation
It is mandatory for staff to follow relevant: “Five moments of hand hygiene”, infection control,
moving safely/safe manual handling, and documentation practices.
Ensure potential administration side effects are explained to the patient prior installation.
Version No. 1
December 2010
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Renal: IV Antibiotic administration during Haemodialysis Treatment Doc#
Equipment Requirements
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Alcohol hand gel
Personal Protective Equipment
Antibiotic vial
1x19g needle
100ml bag Normal Saline (if required)
1x20ml syringe
3 x Alco wipes
Infusion pump (if required)
IV giving set (if required)
Orange Additive Label
IV Antibiotic Handbook
Procedure Steps
1. Check drug order with Registered Nurse, Endorsed Enrolled Nurse.
2. Check expiry date of antibiotic
3. Check ID of patient and check for allergies
4. Explain procedure to patient
5. Don personal protective equipment
6. Wash Hands
7. Reconstitute antibiotic according to drug manufacturer’s literature i.e. Dilution/rate
8. Give antibiotic as ordered by RMO.
a)
If to be given via bolus, connect syringe to venous bubble trap via a safe-site
valve, label the syringe with the drug additive label.
Or
b)
If antibiotic is to be infused over 1 hour
i.
Label the Normal saline bag with the drug additive label.
ii. Connect the giving set to normal Saline bag and prime giving set.
iii. Wash hands, don gloves, safety eyewear and apron.
iv. Connect IV giving set line to the venous bubble trap port on the
haemodialysis bloodlines ensuring the port is clamped prior to connection.
v. Infusion rate of the antibiotic should be calculated according to the drug
manufacturer’s literature.
vi. Infusion rate should be monitored via an electric IV pump
vii. When infusion is complete, clamp the bubble trap line and the giving set line
and disconnect the IVI line.
9. Discard needles into the sharps bin and document procedure in patient record
Version No. 1
December 2010
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Renal: IV Antibiotic administration during Haemodialysis Treatment Doc#
APPENDICES
Five Moments for Hand Hygiene
REFERENCES
Hand Hygiene Australia 2008: Five Moments for Hand Hygiene
NSW Health Circ. 2001/64 –Policy on the Handling of Medication in NSW Public Hospitals
NSW Health Circ. 2005/343 – Policy on Medication Administration by EEN’s
Product Information Leaflet
Mathew J Cervelli (edited by), February 2007, The Renal Drug Reference Guide, Australia, Kidney
Health Australia
Version No. 1
December 2010
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Renal: IV Antibiotic administration during Haemodialysis Treatment Doc#
Appendix 1
Adopted from the World Health Organization and Hand Hygiene Australia.
Version No. 1
December 2010
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