2.3 Medication Administration Pt 2

Question 1

3 Checks of Medication Administration

Answer 1

Check unit package container 3 times before administering.
1st Check - Read eMAR/MAR and select proper medication
2nd Check - After retrieving, compare label with eMAR.
3rd Check - At bedside re-check eMAR after identifying patient before administration. If using multidose, check label on syringe or cup before administering.

Question 2

6 Rights of Medication Administration

Answer 2

1. Right Medication - 3 Checks
2. Right Patient/Client - Check MAR with Patient Armband
3. Right Dosage - Ensure right dosage with 3 checks
4. Right Route - Check drug handbook to make sure correct route for taking medication.
5. Right Time - Ensures therapeutic levels
6. Right Documentation - Document immediately after administering medication

Question 3

Other Rights of Medication Administration

Answer 3

Right Reason - Appropriate for medical condition
Right Assessment Data - Some medications require certain parameters of blood work or vitals
Right Response - Medication does what its supposed to
Right to Education - Patient should know how to take drug, action, side effects
Right to Refuse - Document reason for refusing medication. Except person is potentially dangerous due to mental illness, or emergency court order.

Question 4

Correct Medication Order

Answer 4

• Name
• Room Number
• Date
• Name of Drug (Generic or Trade)
• Dose
• Route of Administering
• Time to Administer

Question 5

When to hold Medication Order

Answer 5

• Hold based on vitals and lab values
• 1/2 hour before.. meals
• Blood Pressure Less than or Greater than

Question 6

Types of Medication Orders

Answer 6

Order with Termination - Taken for specified period of time
Order Without Termination - Taken for unspecified amount of time
PRN Order - Given as needed. Must be minimum amount of time before it can be administered again.
Single Dose - Given 1 time, new order needed to give again.
Stat Order - 1 Time order that must be given immediately
Protocols - Orders for common conditions that Nurse can administer for life saving measures, and then call provider. Usually agreed upon by provider.

Question 7

Medication Order Guidelines

Answer 7

Nursing students should not accept verbal orders.

Licensed nurses can take verbal orders but it is not recommended. If they do, write it down and read it back for confirmation.

If nurses follow a protocol order, make sure to follow facility guidelines.

Question 8

Types of Medication Errors

Answer 8

Inappropriate prescribing of drug
Extra or omitted doses
Wrong drug to patient
Wrong route or rate
Failure to give medication at correct time
Incorrect preparation of drug
Improper technique when administering drug
Giving drug that has deteriorated.

Question 9

Safeguards of Medication Administration

Answer 9

• Begin with Hand Hygiene (Some medications can be absorbed through the skin so wear gloves when handling these)
• Hand Hygiene before administering again
• Do not recap needles (drop into bin)

Question 10

Medication Supply Systems

Answer 10

Stock Supply - Medications commonly used on a unit and stocked for general use among patients
Medications Cart - Cart with medication in drawers for each patient
Computerized Automated Dispensing System - Stock supply of medication. Patients name and medication can be located and dispensed from designated drawer
Bar Code-Enabled Medication Cart (BCMA) - Scan and track medication at bedside.
Controlled Substances - 2 Nurses must check these medications to ensure they are administered correctly

Question 11

Advantages/Disadvantages of technology

Answer 11

Advantages
- Improves accuracy and efficiency
- Safeguards the 6 rights (especially bar-code)
- Records easily accessed
Disadvantages
- Human components in USE of system
- Human relying solely on system
- Extensive up front design and use planning

Question 12

Required Information for Controlled Substances

Answer 12

• Name of patient
• Amount of narcotic used
• Hour narcotic was given
• Name of physician prescribing
• Name of nurse administering
• Name of nurse who double checked

Question 13

Identifying bedside patient

Answer 13

• ID Bracelet
• Patients Name
• Validate Patient Identification #, MRN, Birthdate
• Compare with CMAR or MAR

Question 14

Documentation of Meds

Answer 14

• Complete schedule written or in computer
• Initial/sign appropriate med area IMMEDIATELY
• PRN only initial when medication given
• Document refused meds and document why it was refused or held.

Question 15

Using Mobile Cart System