Medication Administration Procedures

Preparation Steps

• Verify Orders: Confirm the healthcare provider's orders.
• Gather Supplies: Collect necessary medication supplies.
• Hand Hygiene: Perform hand hygiene before starting.
• Avoid Interruptions:
  • Keep the medication room door closed.
  • Do not take phone calls.
  • Follow 'no interruptions' policy.
• Medication Organization:
  • Arrange medication tray and cup.
  • Prepare medication for one patient at a time.

The Six Rights of Medication Administration

1. Right Medication
2. Right Patient
3. Right Dose
4. Right Route
5. Right Time
6. Right Documentation

Medication Verification

• Three Checks: Verify medications three times against the Medication Administration Record (MAR).
• Dosage Verification: Ensure the dosage matches the MAR.
• Label Issues: Do not administer medications without clear labels.

Drug Preparation

• Unit-Dose Packaging:
  • Place tablets/capsules directly into medication cup without unwrapping.
  • Keep medications requiring assessment (e.g., blood pressure) in a separate cup.
• Splitting Pills:
  • Use a pill-splitting device for scored tablets.
  • Do not split non-scored tablets.
• Crushing Pills:
  • Use a pill crusher for patients with swallowing difficulties.
  • Mix crushed tablets with soft food.

Controlled Substances

• Storage: Kept in secure, locked compartments.
• Count Verification: Match the record count with the supply remaining.

Patient Identification and Administration

• Identify Patient:
  • Confirm patient’s name on the MAR (second check).
  • Perform the third check at the bedside.
• Administering Medication:
  • Apply the six rights at each step.
  • Perform hand hygiene and ensure privacy.
  • Identify with two identifiers (e.g., full name, DOB).
  • Check for allergies.

Administering Different Forms of Medication

• Tablets/Capsules:
  • Patient should be seated or side-lying.
  • Allow patient to swallow with a preferred drink.
• Liquid Medication:
  • Shake bottle unless unit-dose.
  • Pour accurately at eye level.
  • For doses <10ml, use an oral syringe.
• Orally Disintegrating Tablets:
  • Remove from package immediately before administration.
  • Place on top of tongue.
• Buccal/Sublingual Drugs:
  • Buccal: Contact with cheek mucosa.
  • Sublingual: Placed under the tongue.
• Powdered Medication:
  • Mix at bedside as per instructions.

Post-Administration

• Documentation: Log medication immediately after administration.
• Patient Monitoring: Observe patient’s response to medication.
• Education: Review medications with patient or family.