Medication administration is just one of the important jobs that nurses must do on a daily basis. Mistakes can happen at any point in the process and because the pass becomes a part of any nurse’s daily work routine, it may be tempting to skip steps or cut corners. This can lead to mistakes, which in some cases can cause harm to a patient, or worse, result in a life-or-death situation for a patient. Always remember that you as the nurse are the final safety check before any medication gets to your patient.
Following the same steps for each medication pass will mitigate the risks of mistakes in your nursing practice. There are different routines and processes for passing medications depending on the type of facility or department, but every nurse can follow these simple steps to safely administer medications to their patients.
Be organized and practice proper hygiene
Before starting any medication administration ensure that you have cleaned and organized your space, supplies are stocked, and you have everything you will need to effectively and efficiently get your medication pass done promptly. It is important to keep your hands clean and to perform hand hygiene between each patient.
Check your charts and orders
Spend some time before passing medication to check each patient’s medication administration record to familiarize yourself with their medications. Take time to research any medications you may not be familiar with administering.
Follow the 7 rights of medication administration
1. Right individual – Follow your employer’s policy on how they want you to identify each patient. Always use at least two permanent identifiers, such as full name and date of birth to ensure you have the right patient. Using just a room number doesn’t qualify as a patient could be in the wrong room or be confused.
2. Right medication – Always follow the policy and procedure of your facility by either scanning both the patient and the medication before administering or by triple-checking each medication if a scanning system isn’t being utilized. You should always visually check all scanned medications before administering as well, just to make sure that they are the proper medication that is scanned in the computer, remember you are the last check before the patient getting these medications.
3. Right dose – Knowledge of most medications and proper dosing is a very important skill for nurses to have. If there is ever doubt about a dose of any medication always check with another source, i.e., the provider who ordered it or the pharmacist at your facility.
4. Right time – The timing of certain medications can be imperative to their effectiveness. Wrong timing can cause serious concerns for patients. A few examples would be administering an insulin too close to the last dose of the same drug, or too early prior to mealtime, causing the blood sugar to drop to a dangerous level. Time-released medications should also be taken into account for a safe medication pass, and care taken to give enough time in between each dose.
5. Right route – There are several routes to take medications, oral, intramuscular injection, subcutaneous injection, inhalation, vaginally, rectally, topically, IV piggyback, IV push, etc. Always question and research a route of a medication you may not be familiar with or have never done. You may also come across a route that is not the standard route for the administration of a specific medication. If in doubt always double-check with the provider and or pharmacy,
6. Right documentation – Always properly document your pass and any other imperative facts on each medication. Take time to educate your patients if they refuse a medication, document that you did so, and notify the appropriate provider.
7. Right response – Always document the response of medications where applicable. Such as after giving pain medication, diuretics, blood pressure medication, anti-anxiety medication, and so forth.
If you follow these guidelines and ensure that you treat each patient with respect, remembering to keep their information private and follow HIPPA regulations, you should have a smooth, error-free medication pass every time!