Nursing Component Task
Nursing procedures & clinical learning

General Nursing (RGN)

ADMINISTRATION OF INTRAVENOUS MEDICATION (INFUSION)

This procedure describes preparation and monitoring of a prescribed intravenous fluid or medication infusion through suitable vascular access. It requires accurate prescription checks, aseptic handling, correct rate control, assessment of the patient and IV site, and prompt response to complications.

Purpose

  • Deliver prescribed fluid or medication directly into the vascular system
  • Maintain or correct fluid and electrolyte balance when ordered
  • Achieve a controlled therapeutic effect with close monitoring

Indications

  • A valid prescription for an intravenous fluid or infusion medication
  • Patient requires a prescribed IV route because oral or another route is unsuitable or insufficient
  • Suitable vascular access and monitoring arrangements are available

Equipment

  • Prescribed IV fluid or medication and treatment or infusion chart
  • Giving set, extension set, needleless connector or pump as appropriate
  • Approved IV stand, infusion pump or calibrated rate-control device
  • Antiseptic swabs, sterile dressing and approved flush if prescribed
  • Gloves and PPE according to risk assessment
  • Tourniquet and cannulation equipment only when cannulation is within the nurse's competence and prescription
  • Sharps container, waste receptacle, hand hygiene supplies and protective bed covering

Preparation

  • Review the prescription, allergies, patient identity, indication, fluid restriction, baseline observations and IV access.
  • Inspect the container for label, expiry, seal, leaks, clarity, colour, particles and prescribed volume.
  • Explain the procedure and possible sensations, obtain cooperation and ensure the patient can call for help.

Procedure steps

  • Perform hand hygiene, identify the patient and compare the prescription with the fluid or medication label.
  • Position and protect the patient, ensure the bed is safe and place the IV stand or pump appropriately.
  • Perform hand hygiene again as indicated, open the giving set without contaminating sterile ends and insert the spike into the container.
  • Prime the tubing fully, remove air, close the clamp and attach the appropriate connector or pump tubing.
  • Inspect the IV site for patency, pain, redness, swelling, leakage, coolness or a loose dressing before connection.
  • Disinfect the access port using the approved antiseptic and allow it to dry according to policy.
  • Connect the giving set aseptically, open the clamp or start the pump and set the prescribed rate.
  • Observe the patient and site closely at the start, recheck the rate and monitor for infiltration, phlebitis, fluid overload or systemic reaction.
  • Dispose of sharps immediately without recapping, remove PPE safely and perform hand hygiene.
  • Reassess the patient, maintain comfort and document fluid balance, response and any abnormality throughout the infusion.

Precautions

  • Only administer IV therapy within current competence, prescription and facility policy; seek support when required.
  • Never use a cloudy, leaking, expired, damaged or visibly contaminated container.
  • Do not force an infusion through resistance or continue when infiltration, extravasation or severe pain is suspected.
  • Escalate dyspnoea, chest pain, fever, rigors, rash, facial swelling, hypotension or acute deterioration immediately.

Aftercare

  • At completion, clamp or stop the infusion, manage the IV access according to the prescription and assess the patient and site.
  • Dispose of equipment and decontaminate the work area according to local policy.

Nursing considerations

  • Use aseptic non-touch technique and follow the facility's IV therapy, fluid balance and escalation policies.
  • Monitor patients at increased risk of fluid overload more frequently as prescribed.

Possible complications

  • Infiltration or extravasation
  • Phlebitis, local infection or bloodstream infection
  • Fluid overload or circulatory compromise
  • Air entry, medication error or acute hypersensitivity reaction

Patient education

  • Tell the patient to report pain, burning, swelling, wetness, chills, breathlessness, rash or feeling unwell.
  • Advise the patient not to pull the line or adjust the pump or clamp.

Documentation

  • Record fluid or medication, concentration, volume, start and completion times, rate, route and IV site.
  • Record observations, intake and output, patient response, interruptions, adverse effects and actions taken.

Educational resource only. Follow current Nursing and Midwifery Council guidance, local institutional protocols, scope of practice, and clinical supervision.

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