Medication Administration - Implement and Take Action, Evaluate

Medication administration is a complex process which involves the application of a prescribed medication to a patient. As the nurse, you must identify medication safety risks, follow safe administration principles, and evaluate your patient's condition after administration.

Now, risks associated with medication administration include adverse medication reactions, cross-infection, or injury. Adverse reactions are unwanted effects that occur related to administration of a medication, which can be mild, like rash or nausea, or more severe, like kidney damage or GI bleeding.

Next, cross-infection is when organisms, like bacteria or viruses, are transferred to your patient during administration. This can occur when administering a medication through your patient's IV without thoroughly cleaning the hub or when touching the tip of an eye dropper to your patient's eye during administration. Lastly, injury can occur to your patient when administering medications, like giving a hypertension medication to a patient who's hypotensive or injecting a medication intramuscularly using incorrect technique, causing a hematoma or nerve injury.

Alright, so there are several different routes for medication administration. The most common routes are oral, also known as per os or PO; parenteral, which includes IV, intramuscular, or IM, subcutaneous; and intradermal. Other routes for medication administration include inhalation, sublingual, rectal, topical, otic, and ophthalmic.

Now, regardless of the route, prevent harm to your patient by following safe medication administration principles each time you administer a medication. The standard practice for safe medication administration involves adhering to the rights of medication administration, which include the: right patient, right medication, right dose, right time, right route, right indication, and right documentation. It's important to note that there might be additional rights and you should follow the protocol outlined by your institution.

Right patient means you're giving the correct medication to the correct patient. You can verify this by using at least two patient identifiers prior to administration, like having the patient state their full name and date of birth while simultaneously verifying the information against the medication administration record, or MAR. Next, right medication means you're administering the correct medication, so be sure to verify the label on the medication with what's ordered in the MAR. While verifying the correct medication, also be sure you have the right dose of medication and are administering it at the right time.

Then, be sure you've prepared the medication for administration through the right route. Some medications, like acetaminophen, can be given either orally or intravenously, so be sure you have the right formulation. You'll also ensure you're administering the medication for the right indication, meaning if you're administering insulin, first check their blood glucose level. Following administration, be sure to complete the right documentation in your patient's chart.

Finally, promote safe self-administration by teaching your patient about their prescribed medications including goals of treatment, how and when to take their prescribed medications, how to store or dispose of them properly, possible side effects, and when to notify their health care provider. Also, remember to encourage your patient to keep an up-to-date list of all their medications, including over the counter and supplements. Lastly, determine if they can afford and access their medications and make referrals as necessary.

Alright, as a quick recap... Medication administration is a complex process which involves the application of a prescribed medication to a patient. Risks associated with medication administration include adverse medication interactions, cross-infection, or injury. Standard practice for safe medication administration involves adhering to the rights of medication administration, including the right patient, right medication, right dose, right time, right route, right indication, right documentation, and providing education for safe self-administration. Finally, as the nurse, remember you are the patient's last line of defense against medication errors.