Applying a Transdermal Patch

  Instruction: Check under Correctly Done if identified skill is correctly performed;

Incorrectly Done if skill is not performed correctly; and Not Done if the student failed to
perform the skill. 
Procedure Correctly Incorrectly Not Done
Done Done
2 1 0
1.    Gather equipment. Check medication
order against the original physician’s
order according to agency policy. Clarify
any inconsistencies. Check the patient’s
chart for allergies.
2.    Know the actions, special nursing
considerations, safe dose ranges, purpose
of administration, and adverse effects of
the medications to be administered.
Consider the appropriateness of the
medication for the patient.
3.    Perform hand hygiene
4.    Prepare medications for one patient
at a time
5.    Read the MAR and select the proper
medication from patient’s medication
drawer or unit stock
6.    Compare the label with the MAR
(Medication Administration Record).
Check expiration dates and perform
calculations, if necessary.
7.    When all medication for one have
been prepared, recheck the label with the
MAR before taking them to the patient.
And return the medication stock to
patient’s drawer.
8.    Transport the medications to the
patient’s bedside carefully, and keep the
medications in sight at all times.
9.    Ensure that the patient receives the
medications at the correct time
10. Identify the patient; usually, the
patient should be identified using two
methods. Compare information with the
MAR;

a.    Check the name on the patient’s

identification band

b.    If the patient cannot identify him/

herself, verify the patient’s identification
to the significant others.
11. Complete necessary assessments
before administering medications. Check
allergy bracelet or ask patient about
allergies. Explain the purpose and action
of each medication to the patient.
12. Perform hand hygiene and put on
gloves
13. Assess the patient’s skin where patch
is to be placed, looking for any signs of
irritation or breakdown. Site should be
clean, dry, and free of hair. Rotate
application sites as per doctor’s order.
14. Remove any old transdermal patches
from the patient’s skin. Cut into half or
fold the old patch in half with adhesive
sides sticking together and discard
according to hospital policy. Gently wash
the area where the old patch was with
soap and water. Ensure the gloved hand
is thoroughly dry before holding the new
patch.
15. Remove the patch form its protective
covering. Write your initials and the date
and time of administration on the label
side of the patch.
16. Remove the covering on the patch
without touching the medication surface.
Apply the patch to the patient’s skin. Use
the palm of your hand to press firmly for
about 10 second. Do not massage
17. Remove gloves and perform hand
hygiene.
18. Evaluate patient’s response to
medication with appropriate time frame
19. Document the procedure in patient’s
chart