Chapter 7 Responsibilities and Principles of Drug Administration

Responsible Drug Administration -Safe and accurate administration of medications requires:  Adequate, up to date info about all meds to be administered o purpose, potential side effects, cautions, contraindications and possible interactions  Wisdom and judgment to accurately assess the patient's needs, evaluate response and plan appropriate interventions.  Skill in delivery of medication accurately and with adequate documentation.  Patient education to provide necessary info. o Inform on the why, how and when meds are to be administered and potential side effects/precautions o -Responsibility for safe administration of medication requires:  That the health care practitioner be familiar with every medication before administration. Problem???         Resources: PDR, AHFS Drug Information, the USP/DI, package inserts and pharmacists. Complete planning, including: o prior assessment, interventions and evaluations of results of drug therapy Assessment: complete history (all health conditions, allergies, and all other meds/vitamins) and before/after observation. Appropriate interventions require judgment in timing, maybe discontinuation. DOCUMENTATION!!!!! If it isn't written down, it didn't happen!!! Skill in delivery: o Sensitivity to needs of individual patients (big pills, arthritis, bad eye sight) Patient education: o Movement to total health stop = More and more done in pharmacy now. Moral/ethical/legal issues: o Always go with authority (company policy, law)

Medication Errors -Can and do occur in all health care settings. -Can occur in the following situations: • Given to wrong patient • Given incorrect drug • Given via incorrect time or incorrect route • Given at incorrect dosage • Improper documentation on patient record

have those calculations checked. (To the best of your ability) Six Rights of Medication Administration 1. • Document corrective action on patient profile • Fill out incident report as legal requirement -Reporting is necessary for safety alerts and quality improvement programs. -LA/SA drugs can be very serious.-Meticulous care in prep and admin reduces chances of errors.  NEVER leave meds at bedside unless specifically ordered by MD. oral route is used unless current conditions do not allow (nausea. Right Medication  Confirm by comparing drug prescribed and labeling on container. Always wash hands before handling meds and keep prep area clean/neat.  If there is any question. Right Amount  If calculations are needed. 4. Principles of Administration -Cleanliness: essential to safe admin. they should be reordered immediately") -Preparation area: well-lit and away from distracting influences.  NEVER give med when the name is obscured in any way. . (I do not agree with "when stock drugs are used. drugs must be given on a prescribed schedule. Right Route  Important because of its effect on: o Degree of absorption o Speed of drug action o Side effects  If order does not specify route. you MUST: • Report it to one in charge to correct for patient welfare. -If a mistake is made.  Always recheck dose if: o Less than ½ tablet o Greater than 2 tablets o Greater than 2 mL for injection 3.  NEVER give med someone else prepared. vomiting or difficulty swallowing). Right Time  For maximum effectiveness.  Be careful when doses are in decimals or fractions. (Sulfa/PCN allergies) -Organization: make sure meds and supplies are in right area. it is your RIGHT and RESPONSIBILITY to question the MD and/or pharmacist 2.

o Any unusual or adverse patient reactions. 6. Right Documentation  Essential duty in patient care  The following must be recorded on patient’s record: o Every medication given (along with dose. route and location of injections). o Destroyed by partial dosage o Cancellation o Error . o If the medication is given on a PRN basis  Can be a critical factor in legal issues involving the patient. .  Also includes the recording of narcotics administered or destroyed on special controlled substances record.5. time.Welfare of the patient is the primary concern in administration of medications. Right Patient  Always verify any information you have available to identify the patient.

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