Hanging an IV Piggyback

Overview

1. Purpose
   1. Some IV infusions are hung as secondary, or piggyback, infusions with primary infusions of IV fluids
   2. This method ensures all of the medication is infused
   3. It also ensures the primary infusion is restarted immediately once the secondary is complete

Nursing Points

General

1. Supplies needed to hang an IV piggyback
   1. Primary infusion – already spiked, primed, and infusing to patient
      1. Ensure fluids are compatible
   2. Secondary tubing
   3. Bag of med for piggyback infusion

Nursing Concepts

1. Steps and Nursing Considerations
   1. Verify provider order
   2. ALWAYS follow 5 rights BEFORE preparing medication
      1. Right Patient
      2. Right Drug
      3. Right Dose
      4. Right Route
      5. Right Time
      6. Right Documentation
   3. ALWAYS prepare medications at the patient’s bedside
   4. Gather supplies
   5. Perform hand hygiene
   6. Don clean gloves
   7. Let the patient know what meds they will be receiving
   8. Remove IV med bag from package if applicable
   9. Open Secondary IV tubing package
   10. Clamp tubing with roller clamp
   11. Spike and prime the tubing appropriately
   12. Clamp tubing once fully primed
   13. Attach the secondary IV tubing to the port on the primary IV tubing that is above the pump
       1. Scrub the hub for 30 seconds with alcohol scrub
       2. Twist the leur-lock in place
   14. Set the pump for a secondary infusion per manufacturer instructions and according to the ordered rate
   15. Unclamp the secondary tubing , THEN Start Infusion
   16. AFTER administration
       1. Document administration
       2. If using barcode medication administration
          1. Scan all meds before preparing
          2. Confirm administration AFTER giving to patient
   17. Discard all used supplies
   18. Remove gloves
   19. Perform hand hygiene

Patient Education

1. Indication and possible side effect(s) of medication(s)
2. Signs to report to nurse or provider