Administering Medications by IV Piggyback to an Existing IV

Medical Equipments:

• Medication administration record (MAR)
• Prepared and labeled medication 50 ml solution bag from pharmacy
• Alcohol swab
• Secondary administration set
• Needle-less locking cannula

Nursing Procedures:

1. Gather all of prepared equipments
2. Wash your hand
3. Check patient identification or arm-band
4. Explain the procedures to the patient
5. Observe the puncture site for redness and puffiness then palpate for tenderness
6. Observe fluid infusing and check the patency of infusion site
7. Remove IV container from the pole and lower the container below the level of infusion site
8. Observe for backflow of blood into the hub of the venous access device and replace container on IV hole
9. Secure the medication bag and check the prescription and the MAR
10. Check patient's chart for allergies and drug compability
11. Hang the secondary bag on IV hole
12. Add the administration set to the secondary bag and prime the tubing
13. Affix a needle-less locking cannula to the end of tubing
14. Cleanse needle-less Y-site injection port of primary IV tubing closest to infusion site with an alcohol swab and allow to dry
15. Insert needle-less locking cannula of secondary bag set into Y-site injection port of primary set ans secure in place with tape
16. Affix the extension hook to the primary bag on the IV pole so that the primary bag hangs below the level of the secondary bag
17. Open clamp of secondary tubing and adjust drip rate to desired infusion rate
18. Observe patient for any signs or adverse reaction to the medication
19. When secondary bag and drip chamber are empty, close the clamp on secondary system, readjust drip of primary solution as indicated and remove the secondary system
20. Record medication infusion on the MAR and note any patient's responses