Medication Administration: Key Points

Importance of Medication Administration Record (MAR)

• Always check MAR against provider's orders before giving medication.

Six Rights of Medication Administration

1. Right Patient

   • Use two identifiers (e.g., ID band, full name, birth date).
   • Replace illegible or missing ID bands.
   • Verify with patient's MAR.

2. Right Medication

   • Compare drug label with MAR three times:
     • Before removing from shelf.
     • Before placing in medicine cup or taking to patient's room.
     • Before administering at bedside.
   • Hold medication if patient questions it and recheck.

3. Right Dose

   • Double-check calculations, especially if conversion is needed.
   • Verify calculations with another nurse.
   • Use only manufacturer-scored tablets for splitting.
   • Determine pharmacy assistance for splitting or alternative prescriptions.
   • Clean medication crusher after use.

4. Right Route

   • Use correct syringes for oral/enteral (oral syringes) and injectable (parenteral syringes) medications.
   • Label syringes with drug, dose, and route.
   • Consult prescriber if route is missing or inappropriate.

5. Right Time

   • Adjust timing based on food intake and patient schedule.
   • Understand time-related dosing differences (e.g., Q8H vs. TID).

6. Right Documentation

   • Record medications immediately after administration.
   • Ensure documentation is timely, thorough, and accurate.

Preventing Medication Errors

• Avoid interruptions during medication administration.
• Consult prescriber for illegible handwriting, unusual doses, or incomplete orders.
• Report medication errors per agency policy and intervene as needed (e.g., antidote, withholding dose).

Special Considerations

• Do not crush sublingual, enteric-coated, or time-release medications.
• Ensure compatibility when mixing crushed tablets with food.
• Follow up on medication errors with proper documentation and patient monitoring.