Syringe drivers in palliative care: Nursing management

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A subcutaneous infusion device is generally an electronic, battery-powered device that holds medications in a syringe (or alternatively, a cassette or reservoir), to administer a continuous 24-hour dose of medication via the subcutaneous route and maintain a consistent level of the medication in the blood.

Syringe drivers are used in palliative care to provide continuous medication via the subcutaneous route. Nurses must be proficient in the use of syringe drivers to ensure patient safety and to avoid adverse events and harm to patients as a result of equipment misuse.

This module provides a step-by-step guide to the management of subcutaneous infusion via syringe drivers in palliative care. The module has a particular focus on ambulatory syringe driver devices.

The module is appropriate for all nurses providing care to patients using syringe drivers, in the residential care setting community and hospital.

This course is linked to and consistent with the Australian Quality and Safety Commission’s National Safety and Quality Health Service (NSQHS) Standards, Standard 5: Comprehensive Care.

It specifically relates to Actions:

5.01: Integrating clinical governance - Implement policies and procedures, Manage risks, and identify training requirements;
5.07: Planning for comprehensive care;
5.10: Screening of risk;
5.11: Clinical assessment;
5.12: Developing the comprehensive care plan - documentation;
5.13: Developing the comprehensive care plan - shared decision making.

This course is linked to and consistent with the Aged care quality standards. It specifically relates to:

Standard 1: Consumer dignity and choice - The consumer’s right to make informed choices, to understand their options, and to be as independent as they want, all affect quality of life;
Standard 2: Ongoing assessment and planning with consumers - Assessment and planning informs the safe and effective care and services;
Standard 3: Human Resources - a skilled and qualified workforce, sufficient to deliver and manage safe, respectful, and quality care and services.

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At the end of this module participants will be able to:

Describe what a syringe driver is and how it can be used to deliver a subcutaneous infusion.
Discuss the indications and contraindications for a subcutaneous infusion in palliative care.
Outline the advantages and limitations of using a syringe driver for subcutaneous infusion in palliative care.
Explain how the nurse can contribute to a more positive experience for the palliative care patient requiring a subcutaneous infusion via syringe driver and their family/carer.
Discuss the steps required to commence a subcutaneous infusion via a syringe driver.
Describe the steps required for ongoing care, including for subsequent infusions.
Outline the management principles and guidelines for the preparation, set-up, and ongoing care of subcutaneous infusions via syringe driver.
Discuss the patient assessment and management required when providing nursing care for palliative care patients with a subcutaneous infusion via a syringe driver.

At the end of this module participants will be able to: