Admissions: Intravenous Infusion Charting (IV)

IV charting is a critical part of medication management, ensuring accurate documentation of intravenous therapies throughout their lifecycle. From initiating an infusion to administering bolus doses and appropriately ending or ceasing treatment, clear and consistent charting supports patient safety, clinical decision-making, and continuity of care.

This article outlines the key components of IV charting, including how to start an infusion, record bolus administrations, and correctly document when an infusion is ended or ceased. It also highlights the distinctions between these actions and when each should be used in clinical practice.

Contents:

1. Viewing Infusions

2. Creating an Infusion

3. Bolus Doses

4. Starting an Infusion

5. Ending an Infusion

6. Ceasing an Infusion

Viewing Infusions

The Infusions list is divided into two views: Active and Ceased. Active infusions are displayed by default, while ceased or ended infusions can be accessed by selecting the Ceased tab. 

For infusions that have been started, administration details are displayed within the active list. These details are not shown for infusions that have not yet commenced. From the Active view, users can create a new infusion or perform actions on existing records, such as starting, ending, or ceasing an infusion.

In the Ceased view, records are read-only. However, if an infusion was started and then ceased, users can still complete the End Infusion action to record final administration details.

Additional information can be viewed by hovering over the information icon next to an infusion. This includes key details such as who created the record and when it was created.

1. Click on Admissions in the side-navigation.
   
    
2. Select the name of the patient. If the patient is not yet listed, click on New Admission and follow the steps in Admissions: The Admissions List, Admitting Patients, & Moving Patients first.
   
   
    
3. Open the Medications section.
   
    
4. Click on the Infusions section.
   
    
5. All current Infusions will be displayed. If you would like to se any Ceased or Ended Infusions, click the Ceased tab above the list.
   

Creating an Infusion

1. Click on Admissions in the side-navigation.
   
    
2. Select the name of the patient. If the patient is not yet listed, click on New Admission and follow the steps in Admissions: The Admissions List, Admitting Patients, & Moving Patients first.
   
    
3. Open the Medications section.
   
    
4. Click on the Infusions section.
   
    
5. Click the New Infusion button or select the New Infusion shortcut.
   
    
6. Search for a Fluid Type using the generic name in the field provided, and select from the options provided. 
   
    

📌 Important: Any allergies recorded for the patient are displayed in the left panel. If a potential interaction is identified for the selected medicine you have chosen, it will appear in the Interactions box below the Allergies list. The Interactions box only loads after a medicine has been selected. For more information, see Medications - MediSpan Clinical Decision Support Interactions Service.

7. If you would like to specify a Brand for the medicine, enter this into the Brand Name field. 
   
    
8. Enter the Strength by free-typing into the field provided. 
   
    
9. Enter the Volume to be infused - this must be recorded in mLs.
   
    
10. Begin typing the Additive into the Additive field, and select the relevant option. Alternatively, you can click into the Additive field, scroll through the available options, and select as required. 
    
     

11. Select the Route from either Intravenous or Subcutaneous.
    
     
12. Enter a Rate, in mL/hr.
    
     
13. Enter a numerical Duration - you will add the unit next. For example, if the Duration was 20 minutes, enter '20' as the Duration, and we will later set the Duration Unit to 'minute(s)'.
    
     
14. Select a Duration Unit from hour(s) or minute(s).
    
     
15. Click into the Indication field, begin typing, and select from the relevant options. If an appropriate option cannot be found, you can use free-text instead by clicking the first suggestion in the results.
    

16. If you would like to set a Due Date, click the calendar icon and select the relevant date from the calendar provided. 
    
    
     
17. Enter a Due Time by clicking the clock icon beside the field, and selecting from the options.
    
    
     
18. If required, add Comments into the field provided.
    
    
     
19. If a Bolus Dose is required, move onto Bolus Doses. Otherwise, click Save.
    
    
     
20. The Infusion will then be added to the Infusions list against the patient's admission.
     
     

Bolus Doses

A bolus dose is a prescribed volume administered rapidly, typically to achieve an immediate therapeutic effect. Bolus doses are documented as part of the infusion order to ensure the dose, rate, and administration details are clearly recorded alongside the infusion.

To prescribe a bolus dose:

1. Enter all of the information mentioned in the Creating an Infusion section.
2. Slide the Bolus toggle to the On position.
3. Enter the Bolus Dose and Bolus Rate as required. 
4. Click Save when finished.

Checking Due Infusions

The Intravenous Infusion Chart displays important information related to the administration of the infusion in the Start Date/Time column. 

	The infusion is due to be given. This alert will be displayed in these scenarios: 75 minutes before administration time. At administration time. 75 minutes after administration time.
	The infusion is overdue by more than 75 minutes.
	The infusion's Start Date/Time and the initials of the user who started the infusion.
	A blank cell may be displayed in these scenarios: The infusion is not due yet. The infusion was created with a Due date but no Due Time.
	The infusion was administered within 12 or 24 hours of the due time (depending on system configuration). Missed infusions cannot be administered, and must be ceased to be removed from the active infusion list.

Starting an Infusion

Starting an infusion documents the commencement of intravenous therapy, including key administration details such as the start date and time, double check details, and any relevant administration comments. This establishes the administration record for ongoing monitoring and documentation throughout the infusion.

Once an Infusion has been added to the patient's admission record, you then begin the infusion process.

1. Click the ellipses icon (... icon) beside the record in the Infusions list, and click Start Infusion. 
   
    
2. The Start Date and Start Time will be automatically populated for you, based on the current time and date. If you need to change this information, click into the Start Date or Start Time field and make the changes as required.
   
    
3. Enter the name of a Checked By user, and select them from the drop-down menu.
   
    
4. The Checked By user must then enter their password into the field provided, and click Verify. 
   
    
5. Enter any Comments as required.

6. Click Save when finished. 
   
    
7. The Infusion will then be updated to Started, and the Start Date/Time and Administered By information will appear on the patient's Infusions list.
   

Ending an Infusion

Ending an infusion occurs when a prescribed IV infusion has been completed as intended. This action documents the conclusion of treatment and records the final administration details of the infusion.

1. Click the ellipses icon (... icon) beside the record in the Infusions list, and click End Infusion.
   
   
    
2. The End Date and End Time will be automatically populated for you, based on the current time and date. If you need to change this information, click into the End Date or End Time field and make the changes as required.
   
    
3. Enter the Total Volume Infused value in mLs.
   
    
4. Enter any Comments as required.
5. Click Save once finished.
   
    
6. The Infusion will then be stopped, removed from the current Infusion list, and moved to the Ceased Infusions list. 
   
   
    

Ceasing an Infusion

Ceasing an infusion is used when an IV infusion order is discontinued before completion or is no longer required. This may occur before administration has started or after the infusion has commenced, typically due to a clinical decision or change in patient condition. Recording the cessation accurately ensures clear documentation of why the infusion was discontinued.

1. Click the ellipses icon (... icon) beside the record in the Infusions list, and click Cease. 
   
    
2. Select a Reason for ceasing the infusion from the drop-down menu provided.
   
    
3. Click Save. 
   
    
4. The Infusion will then be ceased, removed from the current Infusion list, and moved to the Ceased Infusions list. 
   

Related Reading

• Admissions: Prescribing Medications
• Admissions: Recording Pre-Hospital Medications
• Admissions: Understanding Medication Charting
• Admissions: Administering Medications