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On Creating the IV Push Checklist by Loretta K. Dorn, MSN, RN, CRNI and Marlene Steinheiser, PhD, RN, CRNI ®
The risk for injury related to intravenous (IV) medication errors is well documented. Errors include wrong route, wrong drug, wrong preparation, and incorrect administration procedures. Considering the complications that can occur in the practices of IV push administration, it is surprising that until recently there had not been a standardization of the procedure in nursing schools and within many health care organizations. After conducting surveys between 2010 and 2014, the Institute of Safe Medication Practices (ISMP) realized that there was a gap in the standardization of IV therapy practice, and in 2015, after a summit was held, created the ISMP Safe Practice Guidelines for IV Push Medications.
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A 2018 ISMP survey of all the nursing school programs across the United States demonstrated only a slight change in practice. ISMP also used a gap analysis tool to survey 977 practitioners (mostly nurses) on adult IV push medication practices and compared these results to related ISMP surveys conducted between 2010 and 2014. The gaps seen consistently included inappropriate dilution, incorrect concentration, incorrect administration, and lack of labeling and medication identification processes. The ISMP information was available for public use; however, a survey undertaken in Arizona nursing schools in 2019 demonstrated a lack of consistency in teaching IV push medication administration in prelicensure nursing programs.