Medication Preparation and Administration Process Notes

Medication Preparation and Administration Process

Medication Dispensing Protocol

• Double Check: After nurses sign out medication from the DD cupboard, they must verify the medication dose and expiry date against the order to ensure safety and accuracy.

• Medication Types Used:

  • Morphine: Used for pain relief.

  • Midazolam: Used for sedation.

Preparation of Medication

• Vial Opening Technique:

  • Glass vials should be snapped using an unopened alcohol swab. This protects fingers from sharp edges when opening the vials.

• Drawing Up Process:

  • Draw up morphine first.

  • Midazolam 2nd

  • Finally, draw the diluent, which is typically normal saline or water for injection, up to a total volume of 20 mL.

Documentation and Syringe Preparation

• Documentation:

  • Fill out all necessary details on the orange Subcut infusion Adderive.

  • Both nurses must sign the documentation to confirm accuracy.

• Syringe Labeling:

  • A sticker is placed on the syringe avoiding any covering of measurement markings for clarity.

• Priming the Line:

  • The line needs to be primed, which reduces the total volume in the syringe appropriately.

Nicky Pump Setup

• Turning on the Pump:

  • Press and hold the button on the Nicky pump to turn it on.

• Checking Details:

  • Verify the information displayed on the pump screen is correct.

• Syringe Positioning:

  • Pull the collar that holds the syringe up and turn it to 80 degrees.

• Patient Communication:

  • Even if the patient is unconscious, explain the procedure while attending to them, maintaining clarity about the actions being performed.

Safety Intima Insertion

• Preparing the Patient Area:

  • Expose only the necessary area needed for insertion after checking for appropriate site of insertion.

• Priming the Safety Intima:

  • Use water for injection to prime the safety intima through the injection side port.

• Swab the Insertion Area:

  • Clean the chosen insertion site thoroughly with alcohol.

• Insertion Technique:

  • Pinch up some tissue and insert the safety intima at a 45-degree angle until reaching the hub.

  • After insertion, remove only the needle, leaving the plastic cannula in place.

• Securing the Site:

  • Cover the butterfly end with an occlusive dressing (e.g., Tegaderm or Opsite).

  • Date and time the insertion on the sticker attached to the dressing.

Connecting the Line

• Clamping and Connection:

  • Clamp off the safety intima and connect the infusion line after swabbing the end to ensure sterility.

• Post-Connection Protocol:

  • Remove gloves and clean hands thoroughly before handling the Nicky pump again.

• Final Checks:

  • Recheck the orders displayed on the screen with another nurse for double verification.

Security Procedures

• Storage of Keys:

  • Once all procedures are complete, secure the medication in a locked plastic container and remove the key.

  • Place the key with the DD keys for safekeeping to ensure access control and security of medications.

This thorough process ensures that medication is prepared and administered safely while adhering to the necessary protocols and regulations in the healthcare setting.