Administration Of Medicines

Question 1

What are pre-administration checks ?

Answer 1

Weighing all children in kg before medication
Sometimes body surface area (BSA) is used for specific medicine doses.

Most medicines are given on the basis of dose per kg of body weight

Question 2

What to do when checking a prescription

Answer 2

Check it meets legal requirements before proceeding
Check that text and numerals are documented legibly
Check the child’s name, weight and age/DOB are present
Check the medicine has a clear name, route and strength
Check the prescribers signature, printed name and date are preseng

Question 3

What are the ‘six rights’

Answer 3

1. Right patient - visual checks against the MAR and identity band should be at bedside including name, dob and hospital number
2. Right medicine - consult the BNFc for cautions
3. Right dose
4. Right route - oral and intravenous routes are common, should avoid painful intramuscular and subcutaneous injections
5. Right time/frequency - check how often and what time medication should be given
6. Right documentation - errors can still occur at this stage

Question 4

What are administration challenges? How to deal with it

Answer 4

Children with limited understanding sometimes refuse medicines
It will be necessary to carry out a dynamic risk assessment with parent/carer to assess appropriateness of giving the medicine.

Consider using distraction, encouragement and positive reinforcement like sticker charts

Disguising medicines in food or drink or crushing tablets

Question 5

What are examples of high risk medicines

Answer 5

Heparin - different strengths available
Warfarin - impact of diet and medicine
Morphine - individual response varies
Oxycodone -different brands and formulations available
Insulin - selection of wrong syringe
Methotrexate - potential for overdose