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A practical guide for nurses in diluent selection for subcutaneous infusion using a syringe driver.
1Heidelberg Centre, 100 Oriel Road, Heidelberg 3081, Victoria, Australia. fmcleod@rdns.com.au
International Journal of Palliative Nursing
|March 14, 2007
Summary
Selecting the right diluent for continuous subcutaneous infusions is crucial for effective symptom management. This guide offers nurses practical advice on diluent choice for syringe driver medications, highlighting the need for more research.
Area of Science:
- Palliative Care Nursing
- Medication Administration
Background:
- Diluent selection for continuous subcutaneous infusions (CSCI) significantly impacts patient symptom management and well-being.
- Nurses commonly bear the responsibility for choosing appropriate diluents for CSCI.
- A lack of robust evidence complicates optimal diluent selection in practice.
Purpose of the Study:
- To provide nurses with practical guidance on selecting diluents for medications administered via syringe driver.
- To review and present evidence-based principles for diluent selection in CSCI.
Main Methods:
- A comprehensive literature review of relevant journal databases and published guidelines was conducted.
- Recommendations for diluent choice underwent two iterative reviews by an expert panel of palliative care nurse clinicians.
- Principles were primarily based on expert opinion due to a scarcity of primary research.
Main Results:
- Key principles for diluent selection in CSCI were identified and presented.
- The review highlighted a significant gap in primary research and manufacturer guidance.
- The process revealed numerous unanswered questions regarding diluent impact on drug efficacy.
Conclusions:
- There is an urgent need for manufacturers' guidance and independent research on diluent effects in syringe driver therapy.
- Until further evidence emerges, clinicians must be trained to visually inspect solutions and assess medication effectiveness.
- Current practice relies heavily on expert opinion, underscoring the need for evidence-based guidelines.
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