Chapter 7: Parenteral Medication Administration
7.2 Preparing Medications from Ampules and Vials
Critical Thinking Exercises: Questions, Answers, and Sources / References
- Describe three strategies the nurse might do to reduce distractions while preparing medication. Answer:
a. Implement changes to medication practices with staff involvement and staff champions
b. medication preparation areas and include signage that identifies distraction free zones
c. Staff to wear signage to educate patients, facilities / visitors in an effort to educate and involve them in safe medication practices
d. Encourage a culture where staff, patients and families / visitors recognize the importance of not interrupting the nurse during medication preparation.
Source: Connor, J., et al. (2016). Implementing a distraction free practice with the red zone medication safety initiative. Dimensions of Critical Care Nursing Vol. 35 / No. 3 Wolters Kluwer Health, Inc. DOI: 10.1097/DCC.0000000000000179
2. Identify three strategies the nurse should do to prevent infection associated with parenteral medication administration.
| Principle / strategy | Additional Information |
| Perform hand hygiene. | Always perform hand hygiene before administration and after removing gloves. |
| Prevent needle/syringe contamination. | Keep sterile parts of the needle and syringe sterile. Avoid letting the needle touch unsterile surfaces such as the outer edges of the ampule or vial, surface of the needle cap, or counter. Always keep the needle covered with a cap when not in use, and use the scoop-cap method to avoid needle-stick injuries. Avoid touching the length of the plunger. Keep the tip of the syringe sterile by covering with a cap or needle. |
| Prepare patient’s skin. | Wash the patient’s skin with soap and water if it is soiled with dirt, drainage, or fecal matter/urine. Follow agency policy for skin preparation. When using an alcohol swab, use a circular motion to rub the area for 15 seconds, and then let the area dry for 30 seconds. If cleaning a site, move from the centre of the site outward in a 5 cm (2 in) radius using friction. |
| Prevent contamination of solution. | Use single-dose vials/ampules whenever possible. Do not keep multi-dose vials in patient treatment area. Discard if sterility is compromised or questionable. Do not combine and administer medications from single-dose vials or ampules for later use. Ampules should not sit open and should be used immediately, then discarded appropriately. |
| Use new, sterile equipment with each injection. | Single use syringe and needle must be used with each patient. Always inspect packaging for intactness; inspect for dryness, rips, torn corners, and expiry date. If single use equipment is not available, use syringes and needles designed for steam sterilization. |
Copied from
Anderson, R. (2018). Clinical Procedures for Safer Patient Care – Thompson Rivers University Edition. Adapted from Clinical Procedures for Safer Patient Care