Missiaen L*, De Schoenmakere G, Valcke L and Decroix N
Purpose: Hospitalised patients are often treated with Intravenous (IV) antibiotics due to their critical illnes or inability to swallow oral medication. Intravenous therapy can be achieved by intermittent IV infusion, IV push administration or continuous infusion regimens. Tubing residuals impact the administration of adequate drug doses. We evaluated whether IV push injection is superior to intermittent IV infusion for antibiotics in a theoretical model. Based on these findings we describe the implementation of this administration protocol in a large size non-university hospital (1.403 beds) in Belgium, with its benefits and disadvantages.
Methods: All Antibiotics on the formulary of the hospital were evaluated for their aptness to be administered by slow IV push injection. The nursing practice of the two administration techniques was analysed on a pilot ward. The financial impact was also briefly considered, with emphasis on the materials used.
Results: For the intermittent infusion technique the tubing residual was 12 mL, resulting in a net loss of 24% per dose. For the IV push technique, there was no residual volume as the syringe is connected directly the injection site of the patient. Practice on the pilot ward showed that less intervention were needed with IV push administration as compared to intermittent infusion, resulting in time saving for the nurse.
Conclusion: The IV push administration is the technique of choice, is time-saving and results in cost reduction. The implementation of this protocol has to be well prepared, supervised and guided but is relatively easy.
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