six rights of drug administration

Who can administer drugs?

• Prescribers

• Pharmacists

• Nurses

What does the prescriber do?

Writes the orders

What does the pharmacists do?

Fills the order

What is the difference between community pharmacists and hospital pharmacists?

• Community: Has direct contact and communication with patient. Shorter work hours.

• Hospital: Works closely with the doctors orders and does not actually see patient. longer work hours.

What does the nurse do?

Administer the drug

What are the 6 components of an order?

• Right patient

• Right drug

• Right dose

• Right route

• Right time

• Right documentation

How should you ensure you have the right patient?

Use 2 patient identifiers

• Name and DOB

• Along with barcode scanning

Know the difference between generic and brand name of medications

What are others terms used to describe the trade name of a drug?

• patent name

• Brand name

• Proprietary name

What is a unit dose?

Individually wrapped dose labeled with drug name and strength (nausea meds)

What is a stock system?

Dispensed for at home use (Tylenol, advil)

What are dispensing systems good for?

They help enable a ready supply of meds on a unit

Abbreviations

g, mg, mcg, L, mL, t/tsp, T/Tbsp, oz, gtt, mEq, Units, kg, m²

g

grams

mg

miligrams

mcg

microgram

L

Liters

mL

milliliter

t or tsp

teaspoon

T or Tbsp

Tablespoon

oz

ounces

gtt

drops

mEq

mili-equivalent

Units

units

Weight based drugs

Weight determines dosage given

tab

tablet (Iron) (can be cut in half)

EC

Enteric coated (calcium, Advil)

Where do enteric coated drugs dissolve?

In the intestines

• DO NOT CRUSH, DISSOLVE, OR CHEW

cap

Capsule (stool softener)

• Can contain powder or liquid

What is a spansule?

Capsule that contains granules (can be sprinkled)

• NEVER CRUSH

What is a capsule?

Enclosed container of medications

• Can be power, granules, liquid

• DO NOT CRUSH

What does SR, ER, XL, LA, & DR stand for?

Sustained release, extended release, or delayed release

What does extended release, sustained release, and delayed release do?

Releases a controlled amount of drug over and extended period of time.

Can you crush, cut, and/or chew extended release, sustained release, or delayed release?

NO

supp

suppository

Examples of enteral route

PO, NPO, SL, buccal enteral tubes, NGT, PEG

PO

by mouth

NPO

nothing by mouth

SL

sublingual

Buccal

cheek pocket

What needs to happen with Enteral tubes?

meds need to be crushed and dissolved before administering

NGT

Nasogastric tube

PEG

Percutaneous Endoscopic Gastronomy

Examples of topical (cutaneous) routes

creams(cabtreo), ointments(acne treatment), sprays(anti fungal spray), powder(full body powder), transdermal patches

What are some other examples of topical routes?

• Inhalation(asthma)

• Ophthalmic (eye drops)

• Otic (ear drops)

• Nasal

• Vaginal

• PR (rectals)

PDI

Dry powder inhaler

MDI

Meter Dose Inhaler

Neb

Nebulizer

OS

Optic sinister (left eye)

OD

Optic Dexter (right eye)

OU

both eyes

AS

Left ear

AD

Right ear

AU

Both ears

PR

rectal

What syringe do you use for parenteral routes?

Luer lok syringe (needs needle)

What syringe do you use for oral administration?

Slip tip syringe

Examples of parenteral routes

IM, SQ/subQ, ID, IV, IVP, IVPB

IM

Intramuscular

SQ, sub Q

Subcutaneous

ID

Intradermal (just beneath the skin)

IV

Intravenous (into vein)

IVP

Intravenous push (given around the clock until discontinued)

IVPB

Intravenous piggy back (given around the clock until discontinued)

Q day

Daily

BID

twice a day

TID

three times a day

QID

Four times a day

AC

Before meals

PC

after meals

q4h, q6h, q8h, etc.

every 4 hours, every 6 hours, every 8 hours

PRN

as needed

HS

bedtime

q

Every

a

before

p

after

c

with

s

without

Where do you document administration?

MAR (medication administration)

What are the different types of orders?

• Verbal orders (VO)

• telephone orders (TO)

• single orders

• STAT

• ASAP

• Standing order

• Protocol

Verbal orders (VO)

Told to prescriber/nurse emergency in person

Telephone orders (TO)

Told over phone

VORB

Verbal order read back

TORB

Telephone order read back

Single orders

given once

STAT

Given immediately

ASAP

Give within 30 mins of writing

Standing orders

General for a group of patients on a unit/ facility

Protocols

Special set of orders used for patients with specific conditions

What do protocols tells us to do?

When to start, stop, change