Medication Administration

 Principles of Medication Administration

I. “Six Rights” of drug administration

1. The Right Medication – when administering medications, the nurse compares the label of the medication container with medication form.

The nurse does this 3 times:

  1. Before removing the container from the drawer or shelf
  2. As the amount of medication ordered is removed from the container
  3. Before returning the container to the storage

2. Right Dose –when performing medication calculation or conversions, the nurse should have another qualified nurse check the calculated  dose

3. Right Client – an important step in administering medication safely is being sure the medication is given to the right client.

  1. To identify the client correctly:
  2. The nurse checks the medication administration form against the client’s identification bracelet and asks the client to state his or      her name to ensure the client’s identification bracelet has the correct information.

4. Right Route – if a prescriber’s order neither does nor designates a route of administration, the nurse consult the prescriber. Likewise, if the specified route is not recommended, the nurse should alert the prescriber immediately.

5. Right Time

  1. The nurse must know why a medication is ordered for certain times of the day and whether the time schedule can be altered
  2. Each institution has are commended time schedule for medications ordered at frequent interval
  3. Medication that must act at certain times are given priority (e.g insulin should be given at a precise interval before a meal)

6. Right Documentation –Documentation is an important part of safe medication administration

  1. The documentation for the medication should clearly reflect the client’s name, the name of the ordered medication, the time, dose, route and frequency
  2. Sign medication sheet immediately after administration of the drug
Client’s Right Related to Medication Administration

A client has the following rights:

  1. To be informed of the medication’s name, purpose, action, and potential undesired effects.
  2. To refuse a medication regardless of the consequences
  3. To have a qualified nurses or physicians assess medication history, including allergies
  4. To be properly advised of the experimental nature of medication therapy and to give written consent for its use
  5. To received labeled medications safely without discomfort in accordance with the six rights of medication administration
  6. To receive appropriate supportive therapy in relation to medication therapy
  7. To not receive unnecessary medications
II. Practice Asepsis
  • Wash hand before and after preparing the medication to reduce transfer of microorganisms.
III. Nurse who administers the medications is responsible for their own action
  • Question any order that you considered incorrect (may be unclear or appropriate)
IV. Be knowledgeable about the medication that you administer
  • A fundamental rule of safe drug administration is: “Never administer an unfamiliar medication”
V. Keep the Narcotics in locked place
VI. Use only medications that are in clearly labeled containers. Relabeling of drugs is the responsibility of the pharmacist.
VII. Return liquid that is cloudy in color to the pharmacy.
VIII. Before administering medication, identify the client correctly
IX. Do not leave the medication at the bedside. Stay with the client until he actually takes the medications.
X. The nurse who prepares the drug administers it. Only the nurse prepares the drug knows what the drug is. Do not accept endorsement of medication.
XI. If the client vomits after taking the medication, report this to the nurse in charge or physician.
XII. Preoperative medications are usually discontinued during the postoperative period unless ordered to be continued.
XIII. When a medication is omitted for any reason, record the fact together with the reason.
XIV. When the medication error is made, report it immediately to the nurse in charge or physician
  • To implement necessary measures immediately. This may prevent any adverse effects of the drug.
Oral Administration
  1. The easiest and most desirable way to administer medication
  2. Most convenient
  3. Safe, does nor break skin barrier
  4. Usually less expensive
  1. Inappropriate if client cannot swallow and if GIT has reduced motility
  2. Inappropriate for client with nausea and vomiting
  3. Drug may have unpleasant taste
  4. Drug may discolor the teeth
  5. Drug may irritate the gastric mucosa
  6. Drug may be aspirated by seriously ill patient.