Medication can be administered once the nurse assesses the patient and determines that the medication can be administered safely. The nurse follows implementation procedures for administering medication.
The initial step in administering medication is to read the medication order that is written by the prescriber to make sure that the proper medication and dose is administered to the patient. The prescriber’s medication order is found in the patient’s chart.
The medication administration record is a transcription of the prescriber’s medication order. Many times the MAR is a computer-generated document, but sometimes there will be handwritten entries in the MAR. Compare the MAR with the prescriber’s medication order to assure that the proper medication, dose, and other aspects of the medication order have been properly transcribed.
The MAR lists all medication that the patient receives including those already given to the patient and medication that has been discontinued. It is critical for the nurse to review all medications and not just those that will be given on the nurse’s shift because previous medications may still be active in the patient’s body. Remember that some drugs have a long half-life making them still a potential conflict with other medication days after it was administered to the patient.
Although the patient’s chart might indicate that the patient does not have any allergies to medication or food, the nurse must review whether or not the patient has allergies before administering medication. Sometimes the patient may not have recalled any allergies when the patient’s history was taken, but will recall an allergy after being questioned again by the nurse.
Although the MAR lists medications and the times they are to be administered, the patient may be scheduled for tests and procedures that conflict with the medication schedule. It is best to create a medication administration worksheet that schedules both medication and the patient’s other activities so there is one schedule for the patient.
It is common for some medications to be administered to the patient by the nurse on an as needed basis (PRN) such as analgesics (pain medication). PRN medication isn’t scheduled on the MAR but is listed in a different section of the MAR. Therefore, the nurse must determine when PRN medication was administered and what PRN medication was administered before giving any medication. This avoids any potential interaction between medications.
PREPARING THE MEDICATION
Once the nurse is assured that the medication can be administered properly to the patient, the nurse can administer it by following these steps:
AT THE PATIENT’S BEDSIDE
After medication is prepared, it is taken to the patient’s room where the nurse administers the medication to the patient. In doing so, the nurse must follow precautions to assure that the medication is administered safely. Here’s how it is done:
HANDY TIPS WHEN ADMINISTERING MEDICATION
Medication can taste bad. You can minimize this adverse effect by giving the patient ice chips prior to administering the medication. Ice chips numb the taste buds so the patient is unable to taste the medication.
Give bad-tasting medications first followed by pleasant-tasting liquids. This shortens the time the patient experiences the bad taste. The patient is left with the taste of the pleasant tasting medication in his/her mouth. Use the liquid form of the medication where possible because patients find it easier to ingest a liquid. Offer water after giving a medication if it is not contraindicated.
Administer medication to a patient who needs extra assistance taking the medication after you give medication to your other patients. In this way, you can devote the necessary time to assist this patient without being pressured to administer medication to your other patients.
AVOID MEDICATION ERRORS
Medication errors are the most common cause of patient injuries in a hospital. It is therefore critical that the nurse avoid situations that frequently result in medication errors. If an error occurs, assess the patient and notify the nurse in charge and the physician. Follow your hospital’s policy for preparing an incident report. Review the steps that caused the error to occur.
Here are ways to avoid common errors:
PROPERLY DISPOSE OF MEDICATION
Hospitals have strict policies that govern how unused medications and supplies used to administer medication are handled. Here are steps typically found in hospital policies.
ADMINISTERING MEDICATION AT HOME
The nurse is responsible for educating the patient on how to self-medicate at home by providing the do’s and don’ts of administering the medication. The nurse must explain the following:
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