NURSING RESPONSIBILITY OF ORAL DRUG ADMINISTRATION

1. By WONG PEI YIN (Charissa)
BSN, SRN
ORAL MEDICATION
ADMINISTRATION

2. OBJECTIVE
 Define oral medication administration.
 Describe the use of the ten rights of medication
administration.
 Discuss nursing responsibilities for oral
medication administration.
 Demonstrate the procedure for safe
administration of oral medications correctly.
 Maintain efficiency when performing the
procedure of oral medication administration.

3. DEFINITION
ORAL MEDICATIONS
 In oral administration the drug is swallowed
through oral cavity.
 It is the most common, least expensive, and
most convenient route for most patients.
AIM : To treat client.
To eliminate symptoms of illness.

4. 10 “RIGHTS” OF MEDICATION
ADMINISTRATION
Right Medication
Right Dose
Right Route
Right Time
Right Client
Right Assessment
Right Client Education
Right to Refuse
Right Documentation
Right Evaluation

5. RIGHT MEDICATION
 Clarify with the doctor if in doubt.
 Check the drug three times:
- when removing container from the trolley
- when the drug is removed from the
container
- before returning the container to trolley

6. RIGHT DOSE
 Check label for medication concentration.
 Compare prepared dose with medication order.
 Check all medication calculations with another
nurses.
 Verify that dosage is within appropriate dose
range for patient and medication.

7. RIGHT ROUTE
 Verify medication route with medication
order before administering drug.
 Medication may only be administered via
route specified in order.
 know the abbreviations for the different
routes.

8. RIGHT TIME
 Verify schedule of medication with order.
1. Date
2. Time
3. Specified period of time
 Check last dose of medication given to
patient.
 Administer medication within 30 minutes
of schedule.

9. RIGHT PATIENT
 Always check patient’s identification
bracelet and compare to medication order.
 Ask patient to state their name and ID.

10. RIGHT ASSESSMENT
 Properly assess patient and tests to determine
if medication is safe and appropriate.
 If unsafe or inappropriate, notify ordering
physician.
 Document that medication was not administered
and the reason why that dose was skipped.

11. RIGHT EDUCATION
 Inform patient of medication being
administered.
 Inform patient of side effects of medication.
 Ask patient if they have any known allergies to
medication.

12. RIGHT TO REFUSE
 The legally responsible party (patient, parent, etc.)
for patient’s care has the right to refuse any
medication.
 Inform responsible party the consequences of
refusing medication.
 Notify physician that ordered medication.
 Document refusal of medication and that
responsible party understands consequences.

13. RIGHT DOCUMENTATION
 Never document before
medication is administered.

14. RIGHT EVALUATION
 Assess patient for any adverse effects.
 Assess patient for effectiveness of medication.
 Document patient’s response to medication.

15. NURSING RESPONSIBILITY OF
ORAL DRUG ADMINISTRATION
 Hand hygiene before drug administration.
 Ensure the patient is sitting up whenever possible to
facilitate swallowing.
 Administer medications which can irritate the stomach
mucosa with light snacks or after meal.
 Ensure patient takes the medication.
 Observe for adverse reaction from medication.
 Ensure patient fully understands the health education
so that there is no medication default.

16. MILD ALLERGIC REACTIONS
Skin rash: Pruritus:
Angioedema: Rhinitis:

17. REQUIREMENTS:
1. Medication trolley with drugs
2. Prescription chart/ medication administration record
3. Medicine cup
4. Ounce glass ( for liquid medicines)
5. Scissors
6. Tissues ( for liquid medication)
7. Pill cutter
8. Straw to administer medications that may discolour teeth
9. Glass of water/ juice/ milk
10. Stethoscope if necessary
11. Mortar and pestle (optional)
12. Pen (blue/ black)
13. MIMS for reference

18. PROCEDURE GUIDELINE FOR
ADMINISTER ORAL MEDICATION
1) Check medication
chart/MAR
 patient’s name, drug
name, dosage, route
and time of
administration.
2) Identify client
Ask client’s name
Check name on ID tag
Check name on MAR
3) Wash hands

19. CONT…
4) Select correct drug container from
the cupboard while checking label
on the container against the MAR
and expiry date - ( 1st check )
 Check dosage.
 Calculate correct drug
5) Check label on the container
against the medication chart before
taking out the medication from the
container - ( 2nd checks )

20. 6) TABLETS / CAPSULE
 Pour tablet/ capsule on to the bottle cap, and then
transfer to the medication cup.
 Place all tablets to be given at the same time in one cup.
 Use pill cutter to break tablets if necessary
 Keep narcotic and medications that requires specific
assessment separate from others.
 Crush the tablet if client has difficulty swallowing. (Do
not crush enteric coated tablet)

21. 7) SYRUPS
 Thoroughly mix medication before pouring.
 Remove cap and place it upside down on trolley top
 Hold bottle so that the label is against your palm.
 Hold medication cup to eye level and fill to the desired
amount.
 When giving small amount of liquids < 5ml, prepare
the medication in a sterile syringe without needle.
 Before capping the bottle, wipe the lid with tissue
 Recap bottle.

22. CONT…
8) Check the label on the container before returning to its
proper place. – ( 3rd check )
9) Bring medication together with MAR and water to the
client at a correct time.
10) Ask client for name. Check ID and compare with name
in the MAR.
11) Perform necessary pre- medication assessment for
specific medication.

23. CONT…
12) Assist client to sitting position or high fowler’s position
13) Explain the purpose and effect of medication served
14) Administer one medication at a time with sufficient
water
15) Stay with the client until all medication has been
swallowed
16) Assist patient to comfortable position.

24. CONT…
17) Document medication given
 Time, Date, Assessment (B.P / pulse rate/ respiratory
rate)
 Complaints, Refusal and Your signature
18) Discard used items
19) Replenish stock
20) Evaluate effectiveness of medication after 30 minutes
of administration

25. SUMMARY
 The nurse is responsible for ensuring that they have
the knowledge to ensure the correct administration of
drugs.
 Documentation must be completed accurately to
ensure that patients receive safe doses and prevent
medicolegal action.

26. THANK YOU