Lecture Notes: Safe Medication Administration and Prescriptions

Types of Prescriptions

• Time-critical scheduled medications

  • Examples: antibiotics, anticoagulants, insulin
  • Must be given within 30 minutes of the scheduled time (up to 30 mins early or late).

• Non-time-critical scheduled medications

  • Daily, weekly, monthly: Can be given within 2 hours of the scheduled time.
  • More frequent (BID, TID): Must be given within 1 hour of the scheduled time.
  • Always follow facility guidelines.

• One-time or single-dose prescription

  • Given once at a specified time.

• STAT order

  • Given once immediately.

• PRN (as-needed) prescriptions

  • Include dose, frequency, and circumstances for administration.
  • Common examples: pain medications, nausea medications.

• Standing orders

  • Pre-written orders for specific scenarios (e.g., hypoglycemia, chest pain).
  • Allows for quick administration without waiting for a doctor's order.

Components of a Prescription

• Patient's name
• Date and time of prescription
• Medication name
• Dose, strength, and form
• Frequency of administration
• Route of administration
• Refills, if allowed
• Provider's signature

Telephone Orders

• Best practices include:
  • Having a second RN listen in
  • Repeating the prescription back for accuracy
  • Ensuring the provider signs within 24 hours

Error-prone Abbreviations to Avoid

• MS, MSO4: Use "morphine" instead.
• MgSO4: Use "magnesium sulfate".
• U, IU: Use "units".
• QD, QOD: Use "daily" or "every other day".
• SC, SQ, sub-Q: Use "subcutaneously".

Decimals and Zeroes

• Leading zero: Always use (e.g., 0.5 mg).
• Trailing zero: Never use (e.g., 2 mg, not 2.0 mg).

Rights of Safe Medication Administration

• Common core rights:

  • Right patient
  • Right medication
  • Right dose
  • Right route
  • Right time

• Additional rights (varies by source):

  • Right patient education
  • Right to refuse
  • Right nursing documentation
  • Right assessment before and after

Best Practices for Medication Administration

• Identify patient allergies
• Question illegible/incomplete orders or inappropriate prescriptions
• Prepare medications for one patient at a time
• Only administer medications you have prepared
• High-alert medications may require an independent double-check (e.g., heparin, insulin)
• Never leave medications at patient's bedside
• Complete an incident report for any medication error (do not include in patient's chart)

Quiz Questions

1. True/False: Time-critical scheduled medications should be given within 30 minutes before or after the scheduled time. True
2. Which of the following is correctly written: 0.5 mg, .5 mg, or .50 mg? 0.5 mg
3. True/False: If a medication error occurs, you need to complete an incident report and include that in your patient’s chart. False

Conclusion

• Review video or flashcards if any quiz questions were missed.
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