HOSPITAL NAME
INSTITUTIONAL POLICY AND PROCEDURE (IPP)
Department:
Manual:
TITLE/DESCRIPTION
Section:
POLICY NUMBER
INTRAVENOUS (IV) PUSH MEDICATIONS
EFFECTIVE DATE
APPROVED BY
REVIEW DUE
REPLACES NUMBER
NO. OF PAGES
APPLIES TO
PURPOSE
This document delineates the policy and procedure for injecting solutions by IV push through an existing IV line
or by direct venipuncture.
RESPONSIBILITY
CROSS REFERENCES
POLICY
The following delineates the policy for administering medication by IV push through an existing IV line or by
direct venipuncture:
1. Before administering a medication by IV push, the Registered Nurse will identify the proper rate,
maximum amount recommended, concentration, special precautions and patient monitoring that is
recommended.
2. Push Medications are defined as:
a. Rapid IV a specific amount of medication (diluted or undiluted) given directly into the vein over
thirty to sixty (30 – 60) seconds.
b. Slow IV push: A specific amount of medication given into the vein over three to five (3 – 5)
minutes. Any medication administered for greater than five (5) minutes must be given through an
existing IV line.
c. Drugs administered by IV push on the pediatric unit in non-code will be limited as follows:
i. Routine IV push: 0.9% sodium chloride flush, Heparin Lock flush solution.
ii. Terminal patients requiring pain control IV push:
1. Morphine, Meperidine.
2. Non-code emergency (i.e., seizure, hypertensive crisis, anaphylactic
shypoglycemic crisis): Diazepam, Dextrose, Phenytoin, Insulin, Nalo
Diphenhydramine, Epinephrine, Furosemide, Phenobarbital, Hydralazine.
JCI
Standards
CBAHI
Page 1 of 3
PROCEDURE
Use the following procedure to administer an IV push:
Step
Action
One
Identify patient
Two
Verify that the medication is appropriate to be given by IV push and
verify rate of administration.
Three
Read the label on the package/container of medication to ascertain the
patient's name, drug and dosage, and compare with the Patient's Medical
Record.
Four
Check the expiration date of the medication. Do not give drugs that are
outdated, or have changed color or consistency.
Five
Wash Hands
Six
Cleanse the medication stopper with an alcohol swab and allow drying.
Draw up the amount of medication ordered.
Seven
Injection of medication:
A. Through an existing IV line.
1. Prior to administration, verify the compatibility of the drug
with the IV solution. KEY POINT: if at any point in the
administration of the medication, signs of precipitation occur
in the tubing/solution, stop injection of medication (do not
continue the infusion), clamp the IV tubing, and call the
physician immediately.
2. Check patency of the IV line.
3. Cleanse injection port nearest catheter insertion site with
the alcohol swabs. Allow 30 seconds drying time.
4. Close flow of primary IV fluid.
5. Insert needle into port and inject medication as prescribed
by the physician.
6. Withdraw syringe and needle/bare cannula, and dispose of
them appropriately.
7. Open primary IV and return to ordered flow rate.
B. By direct venipuncture
1. Select suitable vein.
2. Apply tourniquet
3. Cleanse the injection site.
4. Insert needle. On blood return, remove tourniquet.
5. Inject medication at the ordered rate.
6. Place sterile gauze pad over injection site and remove
needle.
7. Apply pressure over site with the sterile gauze.
8. Discard the syringe and needle in the appropriate
container.
9. Observe patient for adverse drug reactions and side effects.
JCI
Standards
CBAHI
Page 2 of 3
Notify the physician if a reaction is observed. Document the
occurrence of adverse drug reactions in the Patient's Medical
Record.
10. If an adverse drug reaction occurs, complete the adverse
Reaction Form or call the Pharmacist.
LABEL OF IV
Patient Name:……………..................
MRN……………Room No…………
Drug Name…………………………..
Concentrate………….Diluents……...
Volume……………Infusion ………..
Rate…… Date…… ….…Time ……..
Prepared by…… Checked by………..
FORMS
EQUIPMENT
SYRING
NEEDLES
LABLE
LIST OF MEDICINE GIVEN AS IV PUSH.
REFERENCES
APPROVAL:
Name
Signature
Date
Prepared by
Reviewed by
Approved By
Approved By
Latest Revision Approved By
JCI
Standards
CBAHI
Page 3 of 3