>> Instructor: This video has been provided by
the Johns Hopkins Home Care Group
and the Johns Hopkins Division of Infectious Diseases.
Thank you in advance for watching this video.
This video will be presented in eight sections:
Introduction,
How to Get Started,
Hand Hygiene,
Prepare a Clean Work Space,
Gather Supplies,
Arrange Supplies,
Prepare Supplies,
Prepare Medication.
Your medical provider has prescribed an IV medication
for you that you can safely take in your home.
This video will provide you with the instructions
on how to infuse or administer your medication.
Your nurse or pharmacist will also give you
special instructions for your medication.
Please watch this video as many times as you need.
If you have a caregiver, family member,
or friend helping you, please have them watch it as well.
How to Get Started.
The Mini-Bag Plus system can be used
with a gravity tubing set or a dial-a-flow tubing set.
Your infusion provider will tell you
which type of tubing to use.
Your nurse will tell you how to store
your infusion medication.
This also can be found on your medication label
and on your pharmacy prescription.
Your nurse will tell you when to take your medication
and how often.
Now, the first thing to do is to make sure that you have
a clean work surface and clean hands.
So let's talk about how we properly clean our hands.
If your hands are visibly dirty, wash your hands
using soap and warm water for at least 20 seconds.
Dry with a clean paper towel.
If your hands are not visibly dirty,
you can use alcohol-based hand sanitizer.
Place a dime sized amount of sanitizer
in the palm of your hand.
Rub your hands together vigorously
for at least 20 seconds until your hands are dry.
Make sure you rub between your fingers
and the backs of your hands.
Never blow on your hands or wave or wipe them
to speed up the drying.
You will wash or sanitize your hands several times
throughout this process.
Whether you wash or use hand sanitizer, remember that it is
important to wash or rub for 20 whole seconds each time.
Before each infusion, it is important to find
a clean, dry, hard work surface to set up
your medications and supplies.
You can place the provided SASH placemat
on the top of the selected work surface.
Wipe the work surface and or the SASH placemat down
with a household cleaning agent like Clorox Wipes, Lysol,
and a paper towel or an alcohol pad, and allow it to dry.
Now, wash or sanitize your hands again
for a full 20 seconds.
The same way we did the first time.
The next step will be to Gather your Supplies.
Your Home Infusion Agency should provide these supplies.
If you are missing any supplies,
please call your Home Infusion Agency.
You will need four to five Alcohol Pads,
two Prefilled Saline Syringes,
one Prefilled Heparin Syringe,
if indicated by your nursing provider.
One Mini-Bag Plus,
one Dial-A-Flow Tubing Set or IV Gravity Tubing Set,
one Red Cap,
one IV pole.
Arrange your Supplies above your clean SASH placemat
according to the picture.
Place the alcohol pads above their respective place
on the board.
Place the saline syringe above each S.
Place your mini-bag above the A.
If flushing with heparin is prescribed,
place a heparin syringe above the H.
S is for Saline,
A is for Administer or Antibiotic.
S is for Saline,
H is for Heparin, if needed.
You will also need the most recent medication orders
from your home infusion provider.
Now, check the label on the mini-bag
and compare it to your prescription.
It is important to always check the medication label
on the bag to make sure that your name is correct,
the medication and the dose of medicine is correct,
and that it matches what is on the prescription.
Look at the expiration date or the do not use after date
on the medication label.
If any of this information is incorrect,
STOP, and call your infusion pharmacy immediately.
Now wash or sanitize your hands for a full 20 seconds.
Remember if sanitizing, you want to always get a good amount
in your palm, then rub until dry.
Good job!
We are now ready to Prepare our Supplies.
Start with the first saline syringe
and remove the syringe from the plastic wrapper.
Remove the protective cap on the syringe
and place the cap flat side down on the table.
You will need to replace the cap on the syringe later,
so you wanna make sure that the inside of the cap
doesn't touch anything or get dirty.
Hold the syringe with the end up and the plunger
at the bottom.
Pull back on the plunger slightly to break the seal
on the syringe.
You will be able to see the tiny air bubble in the syringe.
Slowly push the plunger up to let that tiny air bubble out.
Once the air is removed, pick up the cap from the table
and replace the cap on the end of the syringe.
Place the syringe on a SASH mat under the first S.
Repeat this step for the other syringes on your board.
Once you have done this, you are ready to move
to the next step.
Place the mini-bag over the A on the SASH placemat.
Inspect the Mini-bag and vial for any Leakage,
Damage or Discoloration.
The Mini-bag fluid should be clear and not cloudy.
Remove any protective covering from your IV tubing set,
either dial-a-flow or gravity.
Remove any paper tabs that may be holding
the tubing together.
Place your IV tubing over the A on the SASH placemat,
which is for Administer or Antibiotic.
Now extend your IV pole to its fullest height.
Next, we will Prepare your Medication.
Your medication is in the vial attached
to the mini-bag of the fluid.
You are going to mix the powdered medication with the fluid
before administration.
Start by grasping the vial in one hand
and the bag in the other.
The connection between the bag and the vial
is a breakable plastic stopper.
Bend the connection in half until you feel
the plastic stopper break.
Hold the bag upright and squeeze the bag in order
to push fluid from the bag into the vial.
If the fluid is not flowing into the vial,
you may need to further bend the connection
until the fluid path is clear.
Once fluid has entered the vial, you may gently shake
the vial in order to better facilitate mixing.
Hold the vial now with the bag under it.
Squeeze air from the bag into the vial to push
the fluid mixture in the vial back into the bag.
Repeat this mixing process until you are certain
all the powder in the vial has mixed with fluid.
There may be a small amount of fluid left in the vial
after you administer your medication.
This is okay.
Place your mixed medication back on the A
until ready to infuse.
Now, follow the flush instructions for the Gravity Drip
or Dial-A-Flow video depending on the tubing set
that you have at hand.
Make sure to start the respective video at "spike the bag."