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Registration Number: {{org_field_registration_no}}

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Syringe Driver Guidance and Best Practices for Nurses Policy

1. Purpose

The purpose of this policy is to ensure the safe, competent, and compassionate use of syringe drivers for individuals receiving care through {{org_field_name}} in their homes. Syringe drivers are used to deliver continuous subcutaneous infusions of medication, particularly in palliative and end-of-life care. This policy outlines best practices, legal responsibilities, and clinical governance procedures in accordance with Regulation 12 (Safe Care and Treatment), Regulation 9 (Person-Centred Care), and Regulation 17 (Good Governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, along with the Nursing and Midwifery Council (NMC) Code and NICE guidelines.

2. Scope

This policy applies to all registered nurses employed or contracted by {{org_field_name}} who are involved in setting up, monitoring, or managing syringe drivers in a home care environment. It also guides managers and senior care staff who support and oversee clinical activity involving syringe drivers.

3. Related Policies

• CH07 – Person-Centred Care Policy
• CH11 – Safe Care and Treatment Policy
• CH17 – Infection Prevention and Control Policy
• CH18 – Risk Management and Assessment Policy
• CH24 – Management of Accidents, Incidents, and Near Misses Policy
• CH27 – Staff Supervision, Training, and Development Policy
• CH38 – End of Life and Palliative Care Policy

4. Policy Statement and Principles

{{org_field_name}} ensures that syringe drivers are used appropriately, safely, and only by nurses who are trained, competent, and authorised. We uphold the highest standards of palliative care, ensuring the comfort, dignity, and informed consent of the person and their family. Syringe drivers are used when oral or other routes are inappropriate or ineffective. Our approach is grounded in best practice, clinical evidence, and a person-centred model.

4.1 Indications for Syringe Driver Use
A syringe driver may be considered when:

• The person is unable to swallow or absorb oral medications
• Persistent nausea or vomiting prevents oral intake
• Pain, breathlessness, or other symptoms require continuous control
• Medication regimens need consistent administration over 24 hours
  Use must be clinically justified, based on assessment, and documented with prescriber authorisation. Medication choices and dosages must follow guidance from a palliative care team or GP.

4.2 Nurse Competency and Training
Only nurses who have received accredited syringe driver training and have demonstrated clinical competency through supervised practice may manage syringe drivers. This includes:

• Understanding indications and contraindications
• Setting up the syringe driver (e.g. McKinley T34 or equivalent)
• Programming infusion rates and times
• Calculating medication dosages and compatibility
• Responding to alarms, occlusions, or malfunctions
• Providing emotional support and education to the person and their family
  Competency is assessed annually and overseen by the Registered Manager {{org_field_registered_manager_first_name}} {{org_field_registered_manager_last_name}} and the Deputy Manager {{org_field_deputy_manager_first_name}} {{org_field_deputy_manager_last_name}}.

4.3 Prescription and Documentation
All syringe driver use must be supported by a valid prescription clearly specifying:

• The medications to be used
• Dosages and diluents
• Infusion duration (typically 24 hours)
• Prescriber’s signature and date
  Documentation must include setup time, medication batch numbers, site of insertion, infusion start and finish time, and checks. Nurses must maintain accurate, contemporaneous records of all administration, site checks, and any changes.

4.4 Monitoring and Troubleshooting
Nurses must monitor syringe drivers at the start of the shift and at least every four hours, or as clinically indicated. Monitoring includes:

• Infusion site assessment for redness, swelling, leakage, or discomfort
• Confirmation that medication is being delivered at the correct rate
• Alarm checks and battery status
• Observation for adverse reactions or symptoms
  Any malfunction or unexpected event must be reported immediately and documented under CH24 – Incident Management Policy.

4.5 Infection Prevention and Site Care
All procedures must follow strict infection control practices per CH17 – Infection Prevention and Control Policy. This includes:

• Hand hygiene before and after contact
• Use of sterile gloves and dressings during cannula insertion
• Rotating sites if signs of inflammation or irritation are present
  The cannula site should be reviewed at least daily and changed every 72 hours or sooner if clinically required.

4.6 Communication with the Person and Family
Before initiating a syringe driver, the nurse must explain the purpose, benefits, and process to the individual (or their representative), and obtain informed consent. Written and verbal information should be offered in accessible formats. Family and informal carers should be informed of who to contact in case of concerns or emergencies. Their emotional responses should be acknowledged with empathy, particularly in end-of-life contexts.

4.7 Emergency and Out-of-Hours Protocols
Nurses must ensure families and out-of-hours services are informed of syringe driver use and given relevant contact information, including emergency GP services, community palliative teams, or on-call nurses. {{org_field_name}} ensures 24/7 availability of qualified nursing support to address urgent issues with syringe drivers.

4.8 Storage and Disposal
All equipment and medications must be stored securely, with access limited to authorised staff. Controlled drugs must be managed in accordance with legal requirements. Upon completion or discontinuation of the syringe driver, medications must be returned or disposed of per local protocols, and equipment must be cleaned and returned to the appropriate team or service.

4.9 Auditing and Quality Assurance
Syringe driver use is subject to regular audit by the Registered Manager to ensure safe practice, policy compliance, and continuous learning. Audits cover training, documentation, incident reports, medication records, and feedback. Any learning outcomes are shared through supervision, reflective practice, and policy updates.

5. Policy Review

This policy will be reviewed annually or sooner if prompted by changes in clinical practice, legislation, or CQC expectations. Updates will be made available to all clinical staff and on request via {{org_field_email}} or {{org_field_website}}.

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Responsible Person: {{org_field_registered_manager_first_name}} {{org_field_registered_manager_last_name}}
Reviewed on: {{last_update_date}}
Next Review Date: {{next_review_date}}
Copyright © {{current_year}} – {{org_field_name}}. All rights reserved.