medication administration & preventing errors ?· principles of medication administration talk...
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M E A G A N R A Y , R N
A M G S P E C I A L T Y H O S P I T A L
Medication Administration & Preventing Errors
Principles of Medication Administration
Talk with the patient and explain what you are doing before giving medications (answer questions)
Help the patient to be as involved as possible in the process Provide patient privacy Give medication administration your
complete attention - give medications in a quiet area, free of distractions - never leave medications unattended Wash your hands before and after giving medications Read the medication label at least 3 times (when picking up the medication,
just prior to administering the medication, & just after administering the medication)
Medications must be administered by the individual who prepared the dose, except for unit doses or sterile preparations from the pharmacy
Medication Reconciliation & Administration
When ordering or administering drugs and biologicals, health care providers must include/review the following
information: Name of the patient Allergy information Age, weight or other dose calculation requirements Date and time of the order Dose, frequency, and route Exact strength and/or concentration Quantity and/or duration Specific instructions for use, if applicable Name of the prescriber
Six Rights of Medication Administration
Prior to administering medications, nurses must utilize the 6 Rights of Medication Administration:
Right Patient
Right Medication
Right Dose
Right Time
Right Route
Right Documentation
Right Patient
Employees must compare the patients name on the prescription label, the medication order and medication administration
record (MAR). Acceptable patient identifiers include: - patients full name - identification number assigned by the hospital - date of birth Identifiers must be confirmed by patient wrist band, patient
identification card, patient statement (when possible), or other means outlined without the hospitals policy
Prepare medications for one patient at a time Give the medication as soon as you prepare it Avoid distractions
Right Medication
In order to be sure that you are giving the right medication, you must:
Read the medication label carefully (brand name/generic, look alike/sound alike)
Ensure that the medication name on the label, order and MAR match before giving the medication
Label medicines that are not labeled (syringes, cups and basins)
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Right Dose
The right dose is how much of the medication is to be administered to
the patient. To determine the dose, you must first know the strength of each
medication - In the case of liquid medications, you need to know the strength
of medication in liquid measure The dose equals the strength of the medication multiplied by the
amount Compare the dose on the prescription label, medication order and
medication log
Right Time
Some medications must be administered only at very specific times of the day:
- Before meals
- One hour after meals
- Bedtime
Compare the time on the prescription label, medication order and the medication log
Medications must be given within a hour of time that is listed on the medication log (does not apply to PRN medications)
Right Route
The route means how and where the medication gets into the body.
Most medication is taken into the mouth and swallowed, but others enter the body through the skin, rectum, vagina, eyes, ears, nose and lungs, through a g-tube or by injection/infusion
Compare the route on the prescription label, medication order and the medication log
Right Documentation
Each time a medication is administered, it must be documented
Documentation must be done in black ink
No pencil or white out may be used
Never cross out or write over documentation
If you make a mistake when you are documenting on the medication log, circle your mistake and write a note explaining what happened
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Medication Errors
Medication errors are among the most common health threatening mistakes that affect patient care (increased mortality rate, length of hospital stay, increased
medical expenses, etc.)
According to the Institute of Medicine of the National Academies, medication errors are among the most common medical errors, harming at least 1.5 million people each year
Studies indicate that 400,000 preventable drug-related injuries take place in hospitals each year, as a result of errors that occur at various points in the medication administration process
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Types of Medication Errors
Medication errors include prescribing errors, dispensing errors, medication administration errors, and patient compliance
errors Drug product nomenclature (look-alike or sound-alike) Illegible handwriting Improper transcription Inaccurate dosage calculation Inadequately trained personnel Inappropriate abbreviations used in prescribing Labeling errors Excessive workload Lapses in individual performance Medication unavailable
Under Staffing
Fatigued Nurses
Medication Errors
Vague Communications
Common Causes of Medication Errors During Medication Administration
Medication Administration
Process
Medication is Prescribed
Medication Order is
Transcribed & Verified
Medication is Dispensed
Medication is Administered
Opportunities to Prevent Medication Errors
The Nurses Role in Preventing & Reporting Medication Errors
Reporting medication errors is an ethical duty to maximize the benefits of patient care, thereby promoting patient safety and
health.
Report medication errors to the patients physician and your nursing supervisor immediately or when the error is first identified (monitor & treat patient as needed)
The medication administered in error or omitted in error and the action taken must be properly recorded in the patient's medical record.
- the entry in the patient's medical record need not indicate that an error occurred.
Complete the event reporting process (ActionCue)
If a medication error causes an adverse drug reaction, a medication error report and an adverse drug reaction report must be completed
References
ASHP Guidelines of Preventing Medication Errors in Hospitals.
Iranian Journal of Nursing and Midwifery Research. Types and Causes of Medication Errors from the Nurses Viewpoint.
Hospital National Patient Safety Goals 2014.
Centers for Medicaid and Medicare Services. Medication Administration http:/
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