Safe Practice Guidelines for Adult IV Push Medications

The ISMP Safe Practice Guidelines for Adult IV Push Medications were developed to help healthcare facilities standardize the safe administration of parenteral IV push medications and prevent unsafe practices and at-risk behaviors associated with IV push administration of adult medications.

The consensus statements presented in this guidance document are based on the proceedings from a summit held by ISMP in September 2014 of key stakeholders, as well as feedback received through public comment. Agreement was reached regarding common risks associated with IV push administration and best practice recommendations for the safe use of medications administered to adults via the IV push route. Evidence-based research and regulatory evidence were also used, as available, to support the development of the guidance statements. 

The guidelines outline the risks associated with IV push administration of medications using the following Key Elements of the Medication Use System™

• Patient information
• Drug information
• Communication of drug information
• Drug labeling, packaging, and nomenclature
• Drug storage, stock, standardization, and distribution
• Device use
• Environment, staffing, and workflow
• Staff education and competency
• Risk management and quality improvement challenges

The recommendations contained within the safe practice guidelines focus on the following processes:

• Acquisition and distribution of adult IV push medications
• Aseptic technique
• Clinician preparation
• Labeling
• Clinician administration
• Drug information resources
• Competency assessment
• Error reporting

The guidance document also identifies and describes a number of unresolved issues that impact the safety of IV push injection practices, which require additional study and further inquiry.

Download the Guidelines

_{How to cite: Institute for Safe Medication Practices (ISMP). ISMP Safe Practice Guidelines for Adult IV Push Medications. ISMP; 2015.}