Lecture 8 - Medication Administration Flashcards
CNO’s Practice Standards for Medication Administration (3)
- Authority
- Competence
- Safety
Authority
nurses must have the necessary authority to perform medication practices
- nurses can accept orders for medication
administration that are clear, complete and
appropriate
- orders can be direct (one patient) or directives
(multiple) –> controlled substances require direct
orders
Competence
nurses ensure that they have the knowledge, skill, and judgement needed to perform medication administration practices safely
- nurses must never perform medication practices that
they are not competent in
Safety
nurses promote safe care, and contribute to a culture of safety within their practice environments when involved in medication practices
Prescriber (role)
issues a legal authorization for a medication to be dispensed to a designated individual by writing or odering a prescription for a medication
Pharmacist (role)
prepares, dispenses, labels, monitors, and evaluates the effects of prescribed medication
Nurse (role)
administration of the medication to the client
needs to know:
1. what med is prescribed
2. medication purpose
3. appropriate dosages and routes
4. therapeutic and adverse effects
5. assessment and monitoring requirements
6. patient education needs
7. appropriate timing for administration
Routine Medication Prescriptions
med administration orders that are carried out until canceled by:
a) writing a new prescription
b) the prescribed number of doses or days have elapsed
c) the medication stop date has passed
PRN Prescriptions
medication is administered only when the patient requires it
- prescriber sets a minimum interval between doses
- prescriber sets a maximum dosage per day
- nurse documents assessment findings, evaluations
(effects) and dosages given
One Time Prescriptions
a single dose of medication to be given one time only, at a specific time
- “on call” medications provided on the way to the OR
STAT Prescription
a single dose of medication to be given immediately and only once
- usually in emergency situations
NOW Order
a single dose of medication is to be administered within 90 minutes of order being given
- to be administered quickly, but not immediately (less
urgent)
Prescription
medication orders given to patients to self-administer outside of the hospital setting
10 Rights of Medication Administration
- Right Medication
- Right Dose
- Right Patient
- Right Route
- Right Time and Frequency
- Right Documentation
- Right Reason
- Right to Refuse
- Right to Patient Education
- Right Evaluation
Right Medication
verification that the medication being prepared is the correct medication, and the correct one for the patient (according to prescription)
- administer ONLY medications that you prepare
- compare against patient record, prescription
Right Medication: When to check
1) before removing the container from the storage location
2) when the medication prescribed is removed from the container
3) before returning the container to storage location
Right Dose
medicine dosage calculations should be checked by another nurse prior to administration
- only scored medication can be broken
- crushed medication can be mixed with small amounts
of liquid or food (NOT the patient’s favourite food)
Right Patient
verify patient’s full name and date of birth against their chart, name on the prescription, and patient bracelet prior to administration
Right Route
the medication must be administered in compliance with the designated route of adminstration per the prescription
- if a designated route is not specified, consult with the
prescriber
Right Time and Frequency
understand the designated administration frequency and schedule –> understand whether or not it can be altered
- routine, on call, pc, STAT NOW orders
Right Documentation
accurate documentation to communicate:
- patient name and date of birth
- prescribed medication (written in full) –> time of
administration, dose, route and frequency
- accurate administration of the medication –> evaluate
effects
Right Reason
verify medical rational for prescribed medication
- verify expected onset of action, effects, desired
responses
- verify the requirement of pre-administration and
follow-up nursing assessments
Right to Refuse
ensure that the patient is aware of the medications being administered to them, and that they can make an informed decision to refuse
- patient must be informed of rights
- patient must be informed of consequences of refusal
Right to Patient Education
patients need to be educated about their medications, desired effects, potential side effects, and consequences of medication refusal
Right Evaluation
pre-administration and follow-up nursing assessments are vital to ensure that:
a) medications are given at the right time, for the right
reason
b) ensure administration is possible and is the correct
intervention
c) to monitor the effectiveness, adverse effects, and
signs of adverse reactions post administration
Patient Rights (7)
Medication Errors
Assessment - Med Administration
the assessment is used to determine the appropriateness and safety of medication administration
Nursing Diagnosis - Med Administration
Planning - Med Administration
Implementation - Med Administration
Evaluation - Med Administration
