Medication Administration - Nebulizer Policy

Medication Administration - Nebulizer Policy 

Purpose: 
To ensure the safe and effective administration of nebulized medications to residents as prescribed, in compliance with CMS guidelines and the State Operations Manual (SOM) for long-term care facilities. 

Procedure: 

I. Medication Preparation: 

• Remove the nebulizer lid from the cup. 

• Fill the medication cup with the prescribed medication, following the physician’s orders. If ordered, mix the medication with the 0.9% sodium solution. 

• Screw the lid onto the cup securely. 

II. Equipment Setup: 

• Attach the tubing to the nebulizer cup if not already attached. 

• Connect the opposite end of the tubing to the air compressor. 

• Turn on the air compressor switch and set the flow to 10 to 14 L/minute. 

III. Resident Positioning: 

• Have the resident sit upright whenever possible for the treatment. 

• Ensure the resident places the nebulizer mouthpiece firmly in their mouth and closes their lips tightly around it. 

• Instruct the resident to breathe through their mouth only and to breathe slowly and deeply until the medication is finished (usually 10 to 15 minutes). 

IV. Post-Treatment: 

• Turn off the air compressor when all the medication is gone from the cup. 

• If possible, remove the tubing from the nebulizer cup and curl the tubing around the air compressor. 

• Remove the lid from the nebulizer cup and rinse the cup and mouthpiece with clear water. 

• Screw the cup and lid together and place them on a clean paper towel until the next treatment. 

V. Cleaning the Equipment: 

• Warning: High humidity environments are natural breeding grounds for bacteria, such as pseudomonas. Once started, most bacteria multiply rapidly. Clean your nebulizer after each use, or after 24 hours during continuous use. 

• Take apart the pieces of the nebulizer. 

• Wash the pieces in warm, soapy water, using a mild, liquid dishwashing detergent. Rinse with clear water. 

• Place the cleaned pieces in a clean, plastic bag. 

• Replace the connecting tubing and nebulizer as per facility protocol. 

References: 

• Centers for Medicare & Medicaid Services (CMS), Requirements of Participation for Long-Term Care Facilities. 

• State Operations Manual (SOM), CMS.