Guidance for Assessors- Intravenous Drug Administration

GUIDANCE FOR ASSESSORS - Intravenous Drug Administration.

COMPETENCIES

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GUIDANCE

Generic

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1. Demonstrates knowledge of policy, guidelines for practice, legal aspects and professional accountability. / 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.
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. / Able to state indications for IV drugs commonly used on ward, contra-indications, side effects and normal dosage. Candidate knows how to obtain further information. Provides evidence of infusion pump assessment.
.Peripheral Line
1.Inspects cannula site and cannula to ensure patency, observes for signs of pain, swelling or redness / 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
2. Observes site whilst administering drug for pain or swelling. / Able to recognise complications which may occur whilst administering medication such as extravasation and recognises need to stop procedure.
3. Checks dressing before and after administration and is aware of when dressing should be renewed. / Able to discuss infection control issues with regard to dressing. Can discuss types of dressing available and pros and cons of each type.

Peripheral Administration

4. Interprets prescription correctly. Verifies drug, checks dosage and route for individual patient. / Assessor witnesses.
5. Prepares drug/ solvent according to practice guidelines. / Assessor witnesses.
6. Calculates amount of drug required correctly. / Assessor witnesses.
7. Checks all aspects with a competent second nurse/ doctor prior to administration. / Assessor witnesses that the nurse checks the prescription and dosage.
8.Checks identity of patient prior to the procedure. / Assessor witnesses the nurse checking the patient details on prescription chart with patient ID band or asks patient to confirm details.
9. Checks site prior to administration. / Assessor witnesses nurse checking site and is able to describe what she is looking for and why.
10. Administers drug according to practice guidelines – How to give IV drugs. / Assessor witnesses the procedure.
11. Monitors flow of drug for duration of infusion. / Assessor questions the candidate as to why the drug is given over a specific time period.
12. Monitors condition of patient during administration. / Candidate is able to state how an adverse reaction would manifest itself and what action would be appropriate
13. Accurately records administration in all relevant documentation. / Assessor witnesses that the 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 reaction occurs. / Candidate is able to state how an adverse 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 triple/double lumen non valved line, describe rationale for site of insertion and indications for their use. / 1. Able to identify and care for central triple/double lumen non valved 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. / Assessor witnesses procedure.
3. Checks dressing and site before and after administration of drugs and is proficient to change dressing aseptically adhering to Trust protocol. / 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.
4. Able to correctly draw blood samples from lines. / Assessor witnesses if appropriate
5. Able to safely remove central triple/double lumen non valved venous catheters. Can discuss potential complications of central line removal. / Assessor witnesses procedure. Candidate able to describe signs of potential complications and actions which would then be taken.
COMPETENCIES / GUIDANCE
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. / 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. / Assessor witnesses procedure.
3. Checks dressing and site before and after administration of drugs and is proficient to change dressing aseptically adhering to Trust protocol. / 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.
4. Able to correctly draw blood samples from lines. / Assessor witnesses if appropriate
5. Able to safely remove central single/double lumen valved PICC venous catheters. Can discuss potential complications of central line removal. / Assessor witnesses procedure. Candidate able to describe signs of potential complications and actions which would then be taken.
Hickman lines
1. Able to identify hickman line rationale for site of insertion and indications for their use. / 1. Able to identify and care for hickman 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. / Assessor witnesses procedure.
3. Checks dressing and site before and after administration of drugs and is proficient to change dressing aseptically adhering to Trust protocol. / 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.
4. Able to correctly draw blood samples from lines. / Assessor witnesses if appropriate

Guidance for central, Hickman and PICC line administration numbers 6 –18 are as peripheral administration numbers 4 – 16.

Blood Transfusion.
1. Obtains consent from patient prior to commencing transfusion. / Assessor witnesses the nurse explaining risks and benefits of the transfusion. Gives a patient information leaflet.
2. Performs the identity check of the patient at the bedside. / Assessor witnesses the nurse asking the patient to state full name and date of birth. Checks this information with identification band
3. Checks all patient details are the same on; Identification band, prescription chart, blood transfusion compatibility report and compatibility label on blood unit. / Assessor witnesses procedure
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. / Assessor witnesses procedure
5. Accurately records all details of transfusion on prescription chart and blood compatibility report. / Assessor witnesses the nurse clearly and accurately documenting all details
6. Able to discuss the potential complications of a transfusion and actions to be taken if they occur. / Assessor asks the nurse to identify the signs and symptoms of an acute transfusion reaction and what actions would be taken.

Clinical Skills June 2006