From the Guidelines
In a hospital setting, medications can be administered through various methods, including IV push, Y-site, IV pumps, and gravity infusion, each with specific applications based on medication properties, urgency of treatment, and patient needs. Intravenous (IV) push involves directly injecting medication into a vein or IV line using a syringe, typically for medications like furosemide (40mg), morphine (2-4mg), or metoprolol (5mg) 1. This method provides rapid drug delivery but requires careful administration to prevent adverse reactions. Y-site administration allows two compatible medications to be given simultaneously through a Y-connector in the IV line, such as administering antibiotics like ceftriaxone (1-2g) alongside maintenance fluids. IV pumps, such as smart infusion pumps, deliver medications at precise rates, essential for drugs requiring exact dosing like heparin (initial bolus of 80 units/kg followed by 18 units/kg/hr) or insulin drips (0.1 units/kg/hr) 1. These pumps contain a “brain” consisting of customized software that contains a drug library, which alerts staff if an infusion is programmed outside of a particular medication’s recommended parameters. Gravity infusion involves hanging medication bags without a pump, relying on gravity and manual flow rate adjustment using roller clamps, commonly used for normal saline (1L over 8 hours) or certain antibiotics like ampicillin (1-2g every 6 hours). Some key considerations for medication administration in hospitals include:
- Proper technique
- Aseptic practices
- Thorough patient assessment
- Involvement of clinical pharmacists in the medication process to reduce medication errors 1 Each method has its own set of advantages and disadvantages, and the choice of method depends on the specific medication, patient needs, and clinical context. The use of smart infusion pumps and involvement of clinical pharmacists can help reduce medication errors and improve patient safety 1.
From the Research
Methods of Medication Administration in a Hospital Setting
The following are different methods of medication administration in a hospital setting:
- Intravenous (IV) push: a method where medication is administered directly into a vein using a syringe 2
- Y-site: a method where two or more medications are administered simultaneously through the same IV line, using a Y-shaped connector 2
- Pump: a device used to administer medication at a controlled rate, often used for IV medications 3
- Hanging a bag without a pump: a method where an IV bag is hung and allowed to drip into the patient's vein at a rate determined by gravity, without the use of a pump
Other Methods of Medication Administration
Other methods of medication administration include:
- Intra-arterial: medication administered directly into an artery 4
- Intraspinal: medication administered directly into the spinal canal 4
- Intraventricular: medication administered directly into the ventricles of the brain 4
- Intraperitoneal: medication administered directly into the peritoneal cavity 4
- Intraosseous: medication administered directly into the bone marrow 4
- Intramuscular (IM): medication administered into a muscle 5
- Subcutaneous (SC): medication administered under the skin 5
Considerations for Medication Administration
When administering medications, considerations must be made for:
- Compatibility of medications with IV fluids, such as lactated Ringer's injection 2
- Potential interactions between medications and nutrients 3
- Patient characteristics, such as body mass index, age, and medical status 5
- Medication administration-related factors, such as dose, frequency, and formulation characteristics 5
- Health care staff and institution-related factors, such as knowledge and human resources 5