Overview
- Medication administration is one of the most frequently performed nursing procedures. Client and drug identification procedures are trending toward an electronic identification process, coupled with manual identification when possible, although manual records are still used in some settings. ALWAYS use the proper procedures for identifying the client AND the drug.
- Precision is essential in administering medication to ensure the maximum therapeutic effectiveness of the medication. Under- or overdosage, inappropriate administration techniques, or inaccurate client identification can lead to numerous complications, including death.
- Preassessment and post client assessment are crucial in safe medication. The nurse must consider principles related to the client's age, developmental stage, weight, physiological status, mental status, educational level, and past physical history. Be sure to document the assessment data.
- Legal liability remains a major concern in medication administration; however, using a few basic guidelines can significantly decrease the nurse's risk of involvement in a lawsuit:
- Know the medication being administered.
- Know the correct technique for administration.
- Know client-related factors that might affect the administration methodology (see above).
- Know the agency policy on administering drugs by any technique.
- Know the client's rights in relation to medication administration.
- Remember the five rights of medication administration each time drugs are administered: THE RIGHT CLIENT, DRUG, ROUTE, TIME, AND AMOUNT.
- A recent sixth right of medication administration is THE RIGHT DOCUMENTATION. Document administration immediately after giving medication.
- Never use the client's room number as a form of identification. Room numbers should only be used to locate the client.
- Always ask if you are unsure about any aspect of drug therapy or administration.
- Some medications require that two nurses check the medication before it is administered.
- Medications given by the oral route usually are the least expensive, but the oral route is the least dependable route of administration.
- Generally, medications given by parenteral routes act faster and have more reliable results than drugs given by other routes. Because errors in parenteral medication can quickly become debilitating or lethal, USE EXTREME CAUTION!
- Although exposure to blood is often minimal during parenteral medication injection, the use of gloves is recommended.
- Administration of parenteral medications may require manipulation of needles, placing the nurse at risk for a needlestick injury. When available, the nurse should use a needleless methodology and equipment for medication administration.
- Before administering ordered medication, check with client for use of complementary and alternative therapies such as herbal remedies and over-the-counter medications to decrease the risk of possible drug interactions.
- The nursing diagnostic labels applicable to medication administration vary greatly with type of drug and route. However, some of the more common diagnoses include acute pain, chronic pain, knowledge deficit, and anxiety.
- If nausea or pain medication has been ordered in multiple forms (oral, parenteral, or rectal), determine the client's preference before preparing the medication.
- As a basic standard of care, medication preparation, teaching, and administration are done by a licensed registered or vocational nurse. Some drugs may be given by registered nurses only. Policies vary by agency and state. BE SURE TO NOTE SPECIFIC AGENCY POLICIES FOR A GIVEN ROUTE AND DRUG BEFORE DELEGATING ADMINISTRATION!
- Use abbreviations sparingly and as per agency policy in documenting medication administration to avoid miscommunication and error.
- Should an error in medication administration occur, follow procedures for ascertaining that the client is safe and report the information immediately through the proper channels. This includes completion of a variance report.