COAGULANT BLOOD PRODUCTS FOR BLEEDING DISORDERS (IV)

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ALWAYS establish patent IV access and flush PRIOR to mixing medication

Pharmacy specific orders / instructions always supersede the Agency guidance provided below. If in doubt, do not guess, call our office, or tag @TeamHelp-CareCoordination and ask for Clinical Support.

ALWAYS establish IV access prior to mixing any meds

ALWAYS make sure you have everything you need to complete infusion before you begin

ALWAYS confirm your medication dose against the medication label and orders

ALWAYS reach out to us first (not the Pharmacy) with any questions

NEVER tell a Pt you have not given a particular medication before

MIXING

Remember: Even if patient has drug out when you arrive, you MUST still verify that you have the correct dose to give. ALWAYS check the dose against the orders. If there is any confusion about the dose, reach out to the Agency before proceeding.

Obtain a clear/clean space to prepare medication
Be sure all the necessary supplies are available to complete infusion from beginning to end
Verify orders, check medication expiration date
- Factor is rarely dispensed in the exact dose as order, usually it is a range, with +/- 10% range being the most common
- Verify the dose is within the ordered range
Obtain access with NS flush attached and secure
- Never open or mix medications before obtaining access
- Access may be by butterfly or by PIV
Mix meds following manufacturer directions.

ADMINISTRATION

Take baseline vitals and document basic assessment
Administer factor as directed by orders (normally Slow IV push over 3-5 minutes)
Record vitals 5-10 minutes post infusion
Record lot numbers and expiration dates for vials used
Disconnect patient, flush line, and remove. Place pressure bandage at site.
Clean and dispose of used supplies
Documentation
- DOCUMENT the EXACT dose given (not the dose ordered)
- Document the site and type of access
- Document how patient tolerated infusion
- Document if patient has any signs of a bleed, document what the site looks like and any pain relief methods the patient is using
- Document how many doses of Factor are in the home – maintenance and prn

TEACHING

IF orders allow for RN to teach pt/family to administer factor teaching should focus on:

General knowledge of hemophilia
Recognition of bleeds and common complications
Dosage calculation u Preparation and storage
Aseptic techniques
Performing venipuncture (or access of central venous catheter)
Administration technique
Record keeping, proper storage and disposal of needles/sharps, and handling of blood spills.