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Five plus Five rights of medication administration

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by

Teresa Villaran

on 24 December 2013

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Transcript of Five plus Five rights of medication administration

Five plus Five rights of medication administration and maintaining a culture of safety
Right patient
2 forms of identification are needed
Right Drug
The patient gets only the drug that was specifically ordered.
Right dose
This is the prescribed dose and is related to the patients physical status as well as renal and liver function.
Right time
Use military time
Know abbreviations for how many times daily (TID, BID, Q6h, etc..)
May need to give with meals or 1 hour before, 2 hours after meals, depending on absorption requirements of the drug.
Know your institution. Drugs used to be administered up to 30 min. before or after the prescribed time, but now this has been left up to the institutions on how to manage this time issue.
You may have to administer the drug around a procedure, or give as a pre-op for a procedure- KNOW your pt schedule for the day.
Right route
Right Assessment
Right Documentation
Right to Education
Right to evaluation
Right to Refuse
What is the reason for refusing?
Does the pt understand the risks of refusing?
Document the refusal and the pt reason.
Follow-up with the pt, he may want to take the medication at a later time.
My name is George Jones
My birthdate is 1/1/21
Components of a drug order:
Date and time
Drug name
Drug dosage
Route of administration
Frequency and duration of administration
Special instruction for withholding or adjusting dosage
Signature of prescriber
Signature of person taking order (TO or VO)
Nursing Interventions and the Drug order:
Does the drug fit with your patients history
Does the drug fit with a previously performed assessment
Are all pieces of the order present
Does this order conflict with patient allergies?
Why is this patient getting this drug?
Do your 3 checks before administration of the drug.
Is there an ending date for this medication?
Stock drug method
Several patients drug comes from one container
Unit dose method
Drugs are individually wrapped and labeled for each patient.
Double check all dosage calculations with another nurse
If your patient is taking medication orally, make sure he can swallow.
Do not crush or mix medications unless you know they can be given this way.
Do not leave medications for the patient to take, make sure they are taken before you leave the room.
Use aseptic technique when administering medications.
Use sterile technique when administering parenteral medications.
This could be a physical assessment.
labs (drug levels, electrolytes, PT/INR, etc....)
xrays (chest)
diagnostics (U/S for DVT)
Record administration immediately, so someone does not think it has not been given and gives it again.
drug
dose
route
time
nurses signature
You may have to document a patient response to the medication:
Effectiveness of narcotics
Non-narcotic analgesics
Sedatives
Antiemetics
Were there unexpected reactions? and what did you do about them?
The patient needs accurate and thorough education:
purpose
expected side effects
expected therapeutic effects
dietary considerations
if there are any labs that need to be drawn and when
does the patient know how to self-administer the medication
Did the medication do what it was supposed to do?
therapeutic effect
side effects
adverse effects
too much effect
not enough effect
Full transcript