IV meds and dilution

[Dragonfly949697]

I am returning to med surg after 8 years of another speciality. I am trying to find good resources concerning IV meds that need to be diluted in NS as well as iv compatability. Can anyone shout out meds that need to be diluted or reference a resource page or site? Thanks!

[IVRUS, BSN, RN]

There is the KING'S GUIDE to compatibilities... you can buy one of their charts for a small fee.

King Guide IV Drug Compatibility Wall Charts

[smf0903]

A good drug guide has all of this information. Most places also have online drug reference that you can refer to (Lexicomp, etc).

[GerberaDaisy]

I just came back from a nursing convention, and there was a seminar on best practice for IV push meds. The presenter said that it is not necessary or safe to dilute IV meds, unless you are giving lorazepam, levothyroxine, protonix, famotidine or promethaxine. . But obviously you would want to follow your facility policy!

[bd2rn]

Not SAFE? That's weird. What was their rationale for that statement?

[SammieRN940]

I too want to know rationale!

[JKL33]

Safety concerns are related to the overall idea that diluting medications at the point of care complicates the process of medication administration, which leads to errors.

The safety concerns almost invariably involve other co-existing nursing errors/unsafe practices, such as not labeling a syringe that has medication in it, for example.

Probably best if I reserve the rest of my comments and you read source of the information:

https://www.ismp.org/sites/default/files/attachments/2017-11/ISMP97-Guidelines-071415-3.%20FINAL.pdf

The document is worth reading in its entirety, but the section most germane to this particular discussion is the section on Acquisition and Distribution of Adult IV Push Medications. ISMP has other statements/publications related to the general topic as well that will come up in a basic search.

[bd2rn]

Thank you for the reply. I'll look it over. I expect to stand by my practice of diluting just prior to administering in order to avoid "losing" the Med in the tubing and especially the connectors, but I am open to learning something new if-IF-they can convince me that my process is flawed.