title: A practical guide for nurses in diluent selection for subcutaneous infusion using a syringe driver.
abstract: Appropriate diluent selection in continuous subcutaneous infusion optimises symptom management and client well-being. The responsibility of diluent selection is commonly one of the attending nurse. This paper was developed with the intention of providing nurses with practical instruction for diluent selection when preparing medications for administration subcutaneously using a syringe driver. A literature review was undertaken of published journal databases and published guidelines sites. Recommendations regarding diluent choice were reviewed in two iterations by an expert panel of palliative care nurse clinicians. The principles for diluent selection are presented. They are based primarily on expert opinion level of evidence given a lack of primary research evidence in the area of diluent selection. There is a pressing need for manufacturers' guidance on diluent selection and independent research to establish the impact of diluents on drug and drug combinations when using syringe drivers. Until such time that this evidence is available to guide practice, clinicians need to be trained to inspect solutions and assess the effectiveness of the medication in controlling symptoms. The capacity of this paper to provide practical instruction has been limited by the lack of rigorous evidence available, and indeed, the process of developing this guide identified perhaps more questions than answers available at the present time.
authors.affiliation: Heidelberg Centre, 100 Oriel Road, Heidelberg 3081, Victoria, Australia. fmcleod@rdns.com.au
authors.forename: Fiona
authors.initials: F
authors.lastname: McLeod
authors.forename: Charne
authors.initials: C
authors.lastname: Flowers
mesh_terms: D007275:Injections, Intravenous / Q000295:instrumentation*; D009726:Nurses; D017410:Practice Guidelines as Topic; D012996:Solutions; D013594:Syringes
chemical_list: D012996:Solutions