medication administration

what are the 5 basic rights?

• right Patient

• right Drug

• right Dose

• right Route

• right Time

what are additional rights to safe medication administration?

• right reason

• right education (med sbar)

• right documentation

• right to refuse

what are some high alert medications?

• insulin

• heparin (anticoagulant)

• digoxin (treat heart failure and AFib by increasing force of heart contractions and slowing heart rate)

what are some things to be aware of relating to safety in medication administration?

• look alike and sound alike meds

• do not crush list

• time critical meds

• high alert meds

how can we prevent medication errors due to lack of communication?

reframing conversation using safety strategies

• two challenge rules

• CUS words: concerned, uncomfortable, safety

• check back

• time out

• critical language: “i need some clarification”

what is onset?

time it takes for medication to produce a response

what is peak?

time at which medication reaches its highest effective concentration

what is trough?

time at which drug is at its lowest amount in the serum

what is duration?

time medication effect lasts in the body

what are the guidelines for oral medications?

• NEVER crush sustained (slow) release, controlled (extended) release, or enteric coated pills

• capsules can’t be split

• scores tabs can be split in half

• place into plastic/paper administration cup without touching the med

• may use pudding or applesauce for patient’s with difficulty swallowing

• stay with patient until all medications are taken

• never leave meds at bedside

what are the guidelines for topical medications?

• make sure previous dose is removed, before applying new dose

• apply patches to non-hairy areas of the body

• take care not to touch topical medications with ungloved hands

what are the guidelines for enteral tube administration?

• use liquid form if possible

• crush pills individually and mix with 20-30 mL of warm water

• if medication should be given on empty stomach » stop feeding for 20-30 prior and after med administration

1. check placement

2. flush with water

3. administer medication

4. flush with water

5. repeat if needed