The siting, infusion and monitoring of syringe drivers.
Siting the needle
It is important to refer to your local area’s guidance and advice. However it is generally accepted to leave a sub cutaneous site in situ for up to seven days if it is patent and the site appears healthy.
In some organisations they are changed routinely every 72 hours.
Daily re-siting is sometimes required for patients experiencing problems, although clinicians should aim to minimise invasive procedures where possible.
Appropriate sites for infusion
Sites to avoid
- Oedematous areas
- Bony prominences
- Irradiated sites
- Areas where there is tissue damage, including broken skin in addition to tumour sites
Documentation and Monitoring of Syringe Drivers
It is important to document thoroughly after setting up a syringe driver. Upon commencement the nurse should check the driver regularly to ensure that it is running effectively.
In a care home environment it is good practice to check the device regularly and many use a chart to record their findings.
Monitor infusions regularly for precipitation and discolouration, and to ensure the infusion is running at the correct rate.
To assess pump function you must monitor volume infused over time remaining and battery life. Deviations must be investigated immediately.
Monitoring the patient is crucial to maintain symptom control.
Nurses can achieve this with regular observation and questioning, such as “do you have any pain?”.
With this method the nurse can maintain patient comfort as well as administer necessary breakthrough doses.
In conclusion, syringe drivers can have enormous benefits to patients suffering from symptoms requiring continuous medication.
It is important to fully explain them to patients and their families and also to reassure and dispel myths that using a syringe driver means death is imminent.
Nurses should have full training before setting up or nursing patients with a driver insitu. Nurses should also attend regular refresher courses to ensure that they are confident and furthermore competent to support patients using syringe drivers.