Preparing the Medication for Administration
7. Scrub the top of the vial of the correct medication. State the correct dose to be drawn.
8. Remove the cap from the needle. Pull back on the plunger to draw air into the syringe equal to the dose.
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9. With the vial on a flat surface, insert the needle. Invert the vial and withdraw the correct amount of the medication. Expel any air bubbles. Remove the needle from the vial.
10. Using the scoop method, recap the needle.
11. Perform the second check of the six rights of medication administration, looking at the vial, syringe, and MAR.
12. Label the syringe with the name of the drug and dose.
Additional Preparation Steps When Mixing Two Types of Insulin in One SyringeIntermediate-Acting (NPH) and Short-Acting (Regular) insulins
a.
Place the vials side by side on a flat surface: NPH on left and regular insulin on the right.
b.
With an alcohol pad, scrub off the vial top of the NPH insulin. Using a new alcohol pad, scrub the vial top of the regular insulin. Discard any prep pads.
c.
Select the correct insulin syringe that will exactly measure the TOTAL dose of the amount of NPH and regular doses (30- and 50-unit syringes measure single units; 100-unit syringes only measure even numbered doses).
d.
Pull back on the plunger to draw air into the syringe equal to the dose of NPH insulin.
e.
With the NPH vial on a flat surface, remove the cap from the syringe, insert the needle into the NPH vial, and inject air. Do not let the tip of the needle touch the insulin solution. Withdraw the needle.
f.
Pull back on the plunger to draw air into the syringe equal to the dose of the regular insulin.
g.
With the regular vial on a flat surface, remove the cap from the syringe, insert the needle into the regular vial, and inject air.
h.
With the needle still in the vial, invert the regular insulin vial and withdraw the correct dose. Remove the needle from the vial. Cap the needle using the scoop method.
i.
Roll the NPH insulin vial between your hands to mix the solution. Uncap the needle and insert the needle into the NPH insulin vial. Withdraw the correct amount of NPH insulin. Withdraw the needle and recap using the scoop method.
j.
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Perform the second medication check of the combined dose looking at the vial, syringe, and MAR, verifying all the rights.
k.
Label the syringe with the name of the combined medications and doses.
Alternative Preparation Using an Insulin Pen
a.
Select the correct insulin pen to be used for the injection. Identify the dose to be given.
b.
Remove the cap from the insulin pen and clean the top (hub) with an alcohol prep pad. Attach the insulin pen needle without contaminating the needle or pen hub.
c.
Turn the dial to two units and push the injection button to prime the pen.
d.
Turn the dial to the correct dose.
e.
Perform the second medication check looking at the insulin pen and MAR, verifying all the rights.
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