Principles of Medication Administration Medsurg I (Week 1)

The “Rights” of Medication Administration

- The 5 basic rights

• The right medication

• The right dose

• The right patient

• The right route

• The right time

- Additional rights

• The right documentation

• The right patient education

• The right assessment

• The right to refuse

• The right evaluation

Oral Medication Safety and Effectiveness

• Use syringes specific for oral use when giving liquid meds

• Do not administer a med if a patient has concerns → address concerns and verify med with healthcare provider

Tube Administration Safety and Effectiveness

When administering medications via a Corpak or NG tube, use liquid meds if possible to ensure proper absorption and prevent tube blockages

Transdermal Patches Safety and Effectiveness

• Never apply heat to a transdermal patch → it can increase the rate of med absorption and potentially cause an overdose

• Always remove the old patch before applying a new one to avoid double dosing and ensure proper med delivery

Ear and Eye Drops Safety and Effectiveness

• (Ear) Pull the pinna up and back for adults and children over 3 years old

• (Ear) Pull the pinna down and back for children under 3

• (Eye) Drop the eye drops into the lower conjunctival sac to reduce discomfort and ensure proper absorption

• (Eye) If several eye drops need to administered, space them out 2-5 mins to allow for proper absorption

Nasal Sprays and Inhalers Safety and Effectiveness

• For nasal sprays, occlude the unused nostril before administering the med to ensure it’s delivered effectively

• For inhalers, shake before use and wait 20-30 secs between puffs of the same med or 2-5 minutes between different meds to ensure proper dosing and effectiveness

Suppositories Safety and Effectiveness

Use a lubricant before administering to reduce discomfort and facilitate insertion

Parenteral Medications

• Administered by injection or infusion → bypasses the digestive system for faster absorption

• Ideal for patients who cannot take meds orally due to nausea, vomiting or difficulty swallowing

• Several routes (ID, SubQ, IM)

Subcutaneous (SubQ) Injections

• Administered into the tissue under the skin

• Suitable for medications that require slow, sustained absorption

• Typically given at a 45-90 degree angle

Intradermal (ID) Injections

• Administered into the dermis (below epidermas)

• Often used for allergy tests and TB screening

• Typically given at a 15 degree angle

Intramuscular (IM) Injections

• Administered into a muscle

• Preferred for larger volume doses and more viscous or irritating meds

• Less painful and recommended for pediatric IM injections

• Typically given at a 90 degree angle

Sites include ventrogluteal, vastus lateralis, deltoid

Ventrogluteal Injection Site

• Located on the hip

• Considered best site for IM injections

• Recommended for pediatric patients

Vastus Lateralis Injection Site

• Located on the outer thigh

• Recommended for infants up to 12 months

Deltoid Injection Site

• Located on the upper arm

• Often used for vaccinations in adults

• Easily accessible but not well developed

• Can be used for pediatrics aged 18 months and older

Prevention Strategies for Needlestick Injuries

• Use the needleless system

• Do not recap needles after use

• Plan for disposal before giving an injection

• Use the sharps container

• Use the safety lock system

• Participate in the selection and evaluation of needleless systems

Reporting Medication Errors (Steps)

The patient’s safety and wellbeing is the top priority

1. Examine the patient

2. Notify the healthcare provider

3. Inform the manager or supervisor

4. Prepare a written incident or occurrence report within 24 hours

Ways of Medication Distribution

• Computerized provider order entry

• Distribution systems

• Unit dose

• Automated medication dispensing system

• Bar coding