ChippewaValleyTechnicalCollege Nursing Skills Course 543-102
IV Piggyback Administration via existing IV line or saline lock
Directions: In this check-off, you will demonstrate the skill of administering a piggyback medication. You will read the critical indicators, gather your equipment and practice with a peer colleague.
Scoring Guide / CriteriaRatings- Verify medical orders
- Gather supplies/equipment
- Wash your hands before preparing medication
- Prepare IV piggyback bag utilizing the five rights of medication administration including allergies and expiration date
- Assess bag for color, leaking, precipitates, and compatibility with primary IV
- Calculate IV rate accurately
- Knock, enter room and provide privacy
- Identify self with name and title of student nurse
- Wash hands before approaching the client and put on clean gloves
- Use two methods to identify the client
- Explain procedure and answer questions
- Assess IV site.Cleanse port according to agency policy and flush port with 2-3 ml of sterile normal saline assessing patency of IV site
- Assess suitability of the form of the medication, and verify allergies
Infusing Piggyback via Saline Lock
14. Open piggyback tubing, adjust and close roller clamp / satisfactory / unsatisfactory
15. Spike piggyback and prime tubing / satisfactory / unsatisfactory
16. Cleanse port again if needed and insert tubing into IV hub and open
roller clamp / satisfactory / unsatisfactory
17. Establish drip rate, recheck IV site, apply new dressing to IV site if
needed, and apply tubing labels and IV bag timing strip / satisfactory / unsatisfactory
18. When infusion complete, disconnect tubing / satisfactory / unsatisfactory
19. Cleanse saline lock port with alcohol swab and flush again with 2-3
ml of sterile normal saline / satisfactory / unsatisfactory
If Infusing Piggyback with a Primary IV Line Already Infusing
- Close clamp on tubing of secondary infusion set, spike medication bag with secondary infusion tubing maintaining sterility, open clamp, allow tubing to fill with solution or backflush after connecting to primary tubing (see below)
- Hang piggyback medication bag above level of primary IV bag (or lower primary bag so it is below piggyback)
- Connect piggyback tubing to primary tubing at Y-port
- Backflush secondary tubing, if tubing is not primed
- Check the prescribed length of time for infusion, regulate the flow rate of the piggyback, observe that primary infusion has stopped during drug administration and that the piggyback is running
- Recheck IV site
- Remove gloves and wash hands
- Assess patient for adverse reactions
- Provide for patient comfort and safety
- Recognize and report significant deviations from norms
- Explain how you would modify technique to reflect variations across lifespan/culture
- Document on the MAR and nursing notes/flowsheet using correct terminology
- Satisfactory peer check-off
COMMENTS: / PASS / FAIL
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