Explain the two types of order and the responsibilities in carrying out order List and elaborate the 6 right of administering medication Identify the do and don’t in administering medication Identify the common abbreviation when administering medication Discuss the important consideration of medication administration Practice the right technique in administering medication by following the 6 rights
Drug(pharmacological definition): A chemical substance administered for the diagnosis, cure, treatment, relief or prevention of disease. Used to otherwise enhance physical or mental well-being
Drug administration is very important and can be a dangerous duty › Given correctly – restore patient to health › Given incorrectly – patient’s condition can worsen
Nurses must:› Understand principles of pharmacology› Understand fundamentals of drug administration Routes Dosage calculations Techniques for injection Six rights Patient education
Standing Order- it is carried out until the specified period of time or until it is discontinued by another order. Single Order- it is carried out for one time only. Stat Order- it is carried out at once or immediately. PRN Order- it is carried out as the patient requires.
1. Observe the “6 Rights” of drug administration. › 1. Right drug › 2. Right dose › 3. Right time › 4. Right route › 5. Right patient › 6. Right documentation
2. Practice asepsis 3. Nurses who administer medications are responsible for their own actions. Question any order that you consider incorrect. 4. Be knowledgeable about medications that you administer. 5. keep narcotics and barbiturates in locked place. 6. Use only medications that are clearly labeled containers in.
7. Return liquid that are cloudy or have changed in colour to the pharmacy 8. Before administering a medication, identify the client correctly. 9. Do not leave the medications at the bedside. 10. If the client vomits after taking oral medication, report this to the nurse in charge and/or physician.
Identify the drug from the Dr.’s order. Clarify with the Dr. if in doubt. Check the drug three times: - before removing it from the trolley or shelf - when the drug is removed from the container - before the container is returned to storage - check the expiry date of the drugCheck the drug with another RN for DDA & barbiturate.
The nurse should be familiar with the generic drug name as well as the trade name. The use of generic name in clinical practice is preferred to reduce the risk of medication errors.
- Check the dose, read the container label, calculate the dose & check with a RN if necessary. - Use proper measuring devices for liquids, do not crush tablets or open capsules unless directed to by the pharmacist. (do not crush enteric coated tablets).
If a drug is required in another form you may get it from the pharmacy. Pediatric & elderly more sensitive to medications – need extra caution with drug dosage.
For routine medication orders, the medications must be given no more than 30 min before or after the actual time specified in the prescriber’s order. E.g., 9.00am med, may be given between 8.30am-9.30am. The effect of changing in dosing or timing of medication should never be underestimate because one missed dose of certain medication can be life threatening.
Other factors must be considered when determining the right time e.g., multiple drug therapy, drug-drug or drug-food compatibility, scheduling of diagnostic studies, bioavailability of drug (e.g., the need for consistence timing of doses around the clock to maintain blood levels), drug actions, and any biorhythm effects such as occur with steroids.
Oral Route Forms: a) solid: tablet, capsule, pill, powder. b) liquid: syrup, suspension, emulsion. Enteric coated tablets should not be crushed before administration. Suspensions are never administered intravenously. If the patient vomits within 20 – 30mins of taking the drugs, notify the physician. Do not readminister the drug without a physicians order.
2. Sublingual- drug placed under the tongue, where it dissolves. 3. Buccal- medication is held in the mouth against the mucous membranes. of the cheek until the drug dissolves. 4. Topical a) Dermatologic- lotions, liniments, ointment, pastes and powders. b) Ophthalmic- instillations and irrigations. c) Otic, d) Nasal, e) Inhalation, f) Vaginal- tablet, cream, jelly, foam, suppository 5. Rectal- (objectionable taste or odor)
6. Parenteral- administration of medications by needle. a) Intradermal (ID)- under the epidermis (into the dermis). b) subcutaneous (SC)- in the subcutaneous tissue (also, hypodermic) c) intramuscular (IM)- into the muscle. d) intravenous (IV)- into a vein. e) intraarterial- into an artery. f) intraosseous- into the bone.
› Checking the pt’s identity before giving each medication dose is critical to the pt’s safety.› Ask the patient to state his/her name and check his ID band to confirm pt’s name, ID number, age, and allergies against the medication chart.
Documentation of information r/to administrations is crucial to pt safety. The pt’s chart should always have the following: › Date & time of the medication administered › Name of medication, dose, route & site of administration. › Drug action – to assess the changes of symptoms the pt experiencing, adverse effects, toxicity & other drug-related physical & physiologic symptoms.
Improvement of the pt’s condition, symptom, disease process. No changes/lack of improvement. Patient’s teaching/degree of pt’s understanding.
Other info: › if a drug not administered & reason why? › Refusal of a medication & reason for refusal. › Actual time of drug administration › Data regarding clinical observations & treatment of the pt if a medication error has occurred.
Drugs can have three types of names:a. chemicalb. genericc. trade/brand/proprietary
a.Chemical name:- a very precise description of the drug’s chemical composition, identifying the drug’s atomic and molecular structure. - this name is of significance to the pharmacist.
b. Generic name:- The name assigned by the manufacturer who first develops the drug. Often the generic name is derived from the chemical name.- the official name is the name by which the drug is identified in the official publication.
c.Trade/ Brand/ Proprietary name:- Is selected by the drug company selling the drug and is copyrighted- a drug can have several trade names when produced by different manufacturers
e.g. Chemical name= Acetylsalicylic acid Generic name = AspirinTrade names include Aspro, DisprinBe aware that in different countriesgeneric and trade names will also differ,e.g. in Australia & the United States onedrug has the generic names ofparacetamol & acetaminophen, i.e.Panadol/Tylenol.
Drugs can be classified from different perspectivese.g. drugs may be classified by -(a) body systems i.e. drugs affecting the respiratory system drugs affecting the cardiovascular system OR(b) the symptom relieved by the drug, or the clinical indication for the drug i.e. analgesic, antibiotic
MANE morning MIDI midday NOCTE Night BD/BID twice a day three times a day TDS/TID four times a day QID give immediately STAT when required PRN when necessary
ac before meals Pc after meals q.h.or1/24 every hour q2h or 2/24 every two hours q4h or 4/24 every four hours qod Every other day
BUC inside cheek O/P.O oral/per oral S/L sublingal (under the tongue) ID intradermal IM intramuscular SC/SQ subcutaneous