Neonatal IV Guide

A guide for healthcare professionals working on the neonatal unit to safely prescribe, prepare and administer neonatal injectable medicines.

Prescribed doses of medicine for neonates should be measurable and able to be administered. Nursing staff should not have to round doses to give nearly the prescribed dose. Safely giving injectable medicines to premature neonates often requires access to appropriate information detailing how to prepare and administer aliquots from adult preparations.


To provide easy access to reliable and consistent information on how to correctly order injectable medicines for neonates.

To give nurses information on how to prepare and administer doses of injectable medicine.


A neonatal injectable medicines guide has been developed over the last 15 years, with very useful ongoing feedback to enable greater clarity and accuracy. It provides information on how to prescribe safely and clearly and select doses of medicine that can be measured and administered.

It includes background information on safe prescribing and provides nurses with information on how to prepare and safely administer doses of medicine.


The guideline was initially developed to cover the small range of commonly used neonatal injections and has grown to cover all injectable medicines used on the unit.

It is available as laminated pages within a folder, to allow nurses to see a paper copy during the preparation of doses. It is also on the Trust intranet so can be accessed throughout the Trust.

Challenges and Learning

The key to success is rapid amendment based on user feedback. All staff are encouraged to feedback on clarity. If anything is “confusing”, it can be rewritten and improved. Common guidelines have been improved and refined many times based on user feedback. As all staff see how quickly suggestions can be incorporated into the guide, there is clear departmental ownership.

All monographs undergo widespread consultation before being included. Once used in clinical practice the monograph may be revised and improved based on feedback.

All new guidelines are emailed to the multidisciplinary team and placed on noticeboards for comment. Individuals are asked for comments. Trainee paediatricians and pharmacists are asked for comments. All guidelines are approved by the Children’s Guideline Group and ratified by the Divisional Clinical Governance Committee.


Project Lead: Neil Caldwell, Consultant Pharmacist of Children’s Services; Oliver Rackham, Consultant Paediatrician.

Organisation: Wirral University Teaching Hospital

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