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Oral Medication Administration
Transcript of Oral Medication Administration
Revise resposibilities/accountabilities for nurses
Introduce the practicalities of safe oral drug administration
Practice the psychomotor skills of reading, dispensing and administering drugs to patients (via simulation)
The drug chart should contain.....
4 key identifiers for patient: Descriptive information about first name/last name/NHS number/DOB/
Sections/pages for: stat (once only) drugs, regular oral drugs, as necessary (prn) drugs, IV drugs (eg antibiotics fluids), variable dose drugs (eg chlordiazepoxide, steroids), anticoagulant drugs
Prescribing medication is normally the role of doctors, and some nurses (qualified as ‘nurse prescribers since 1992)
Dispensing medication and routine checking of the prescription is normally the role of pharmacists.
Administering medication is normally the role of nurses, and in some situations doctors (e.g. general anaesthetics).
The prescription in the drug chart must show:
Approved pharmacological name of drug
Start date/end date
Time of administration
Any additional instructions (e.g. after food)
Confirm patients identity – check patient (open question), id band, chart
Check for allergies
Locate correct medication
Read and check medication in hand to drug chart
Dispense tablets in medicine pot using non touch technique
Pour glass of water
Explain to patient /client & gain consent
Check name band
Administer medication to patient/client
Are there any reasons to withold?
Change in patient condition eg withhold atenolol if patient is hypotensive or bradycardic
Patient is having specific tests
Patient is going to theatre
Patient cannot or will not comply with administration instructions
Patient is unwell
Document as 'nurse decision' and explain rationale
Oral Medication Administration
Medication containers must show:
The approved name
The form (e.g. oral suspension)
The strength (e.g. 50mg in 5ml)
The expiry date
Do I know:
my patient, their current condition and their plan of care? (is the order/prescription appropriate for the client?) Have they consented to take medication?
Each and every drug I am about to administer
AND: the 5 Rights....
(Check ID band & ask patient's name &date of birth. Know of local policy re alerting staff to similar names. Explanation of why receiving this treatment, what to expect/ any precautions)
(know the potential side effects. Some medication require pt. assessment before administration and include specific parameters. Appropriate follow up monitoring effects and side effects)
(Give right frequency / time / or according to PGDs. Medication given within 20 mins of prescription is considered acceptable)
(ensure his is clear and appropriate)
(Does the calculation result in a ‘reasonable’ quantity for the patient to take?
Know the ‘usual’ dosage for the medication & know were to go an check any doubts you have)
1) practice reading drug chart to establish a safe 'flow' and ensure all key aspects are read
2) using BNF look up any drugs you do not know (paracetamol, atenolol, lactulose, citalopram) and indications, normal dose range, side effects, contraindications & cautions
3) practice safe patient identity check (are identifiers clear?/Open question/what if no name band/what if unconscious?/refuses to wear nameband/refuses to take medications
4) practice administration simulation using equipment provided
Patients refuse to take medication
Informed consent, capacity of the patient, Duty of Care & clinical judgement
Autonomy, informed consent and the Human Rights Act 1998.
Disguising medication to deceive the patient if they have expressly refused is inappropriate. ( covert)
If the patient/client is unable to give informed consent, has no capacity to do so and the administration of the medication is in the patient/client best interest- This is not covert. (NMC)
The crushing of tablets and or altering the form of the medication should not be undertaken unless it has been authorised by the pharmacist.
Ask the pharmacists advice about the appropriate form of medication for patients/clients who may have difficulty swallowing. (legal and biological issues)