UNIVERSITY OF WISCONSIN MEDICAL FOUNDATION
CLINICAL POLICY AND PROCEDURE
TITLE: MEDICATION ADMINISTRATION FROM AN AMPULE
Effective Date: February, 2002 Approval: See Authorization
Supersedes Protocol: None Contact: Clinical Staff Education
Reviewed October, 2003 March, 2005 Nov., 2007 May 2009 April 2010
PURPOSE: To provide guidelines for the removal of medication from an ampule at UWMF Clinics.
POLICY: Clinical staff will utilize the following guidelines to remove medication from an ampule. The
preparation and administration of a medication should be completed by the same person
DEFINITION: An ampule is a clear glass container with a constricted neck. It contains a specific dose of a
medication in liquid form. The ampule’s neck must be snapped off to gain access to the medication.
SUPPLIES: syringe, filter needle, small gauze pad, alcohol pad, provider’s order, ampule of medication
1. Check the name and dose of medication against the provider’s order. Clarify any inconsistencies.
2. Wash hands and gather equipment.
3. Verify name of drug on ampule with that ordered for patient.
4. Verify correct patient, including date of birth. Verify allergies.
5. Draw up medication, adhering to the five rights of drug administration.
Right – drug, dose, time, route, patient
Check the expiration date of the medication.
6. Tap ampule stem while holding ampule vertically to remove any medication from the top half of ampule.
7. Wrap small gauze pad or dry alcohol swab around neck of ampule.
8. Use a “snapping” motion to break off the top of ampule along the pre-scored line at its neck, breaking
ampule away from your body.
9. Discard top of ampule immediately into sharps container.
10. Remove cap from filter needle by pulling it straight off.
11. Insert needle into ampule, being careful not to touch the rim.
12. Withdraw the amount of medication ordered. Use either of
the following methods:
A: Insert tip of needle into ampule, which is upright on a flat surface and
withdraw fluid into syringe. Touch plunger at knob only.
B: Insert tip of needle into ampule and invert ampule.
Keep needle centered and not touching sides of ampule.
Remove prescribed amount of medication and touch plunger at knob only.
11. Do not expel any air bubbles that may form in the solution.
12. Wait until needle has been withdrawn to tap syringe and expel air carefully.
13. Remove filter needle and immediately discard into sharps container.
14. Place new needle of desired gauge and length onto syringe and prime with surplus medication.
15. Discard any remaining surplus medication.
16. Immediately discard ampule into a sharps container and wash hands.
17. Documentation (HealthLink)
Manufacture, Lot #, Expiration date (as indicated)
VIS# (if applicable)
Name, dosage, route of medication, site of injection, and time given
Progress Notes utilizing SmartPhrases: .npinjectstart and .npinjectend
Assessment and laboratory results relevant to purpose of the medication
Effects of the medication on patient
Teaching about the drug or injection technique
How patient tolerated procedure, i.e., desired effect, adverse reactions
REVEIWED BY: Carol Decker, RN, MSN, Clinical Staff Educator
LaVay Morrison, RN, BSN, Clinical Staff Educator
WRITTEN BY: Ronnie Peterson, R.N., M.S., Manager of Clinical Support
Perry, A.G. & Potter, P.A. (2002). Clinical nursing skills & techniques. (5th ed.). St. Louis, MO: Mosby.
Perry, A.G. & Potter, P.A. (2009). Fundamentals of nursing. (7th ed.). Hall, A. & Stockert, P.A. (Eds.).
St. Louis, MO: Mosby Elsevier.
Kowalak, J. P. (Ed.). (2009). Lippincott’s nursing procedures (5th ed.). Ambler, PA: Lippincott
Williams & Wilkins.
Medical Director Date