12 RIGHTS IN ADMINISTERING - This can be an indication that - Medication orders may

MEDICATION calculation is incorrect. include specific parameters for

o Double check administration
D ocumentation E valuation A ssessment calculation that may 8. RIGHT PATIENT
R eason P atient T ime R oute; refuse appear questionable. - Medication is given to the
o Know the usual intended client.
E xpiration date; education D rug; dose dosage range of the - Check the client’s
medication. identification band with each
1. RIGHT MEDICATION
o Question a dose administration of a
- The medication given was the
outside of the usual medication.
medication ordered
dosage range. - Know the agency’s name alert
2. RIGHT ROUTE
5. RIGHT TIME procedure when client’s with
- Give the medication by the
- Give the medication at the the same or similar last names
ordered route.
right frequency and at the are on the nursing unit.
- Make certain that the route is
time ordered according to 9. RIGHT EVALUATION
safe and appropriate for the
agency policy - Conduct appropriate follow up
client.
6. RIGHT TO REFUSE - Ex. Was the desired affect
3. RIGHT EDUCATION
- Adult client has the right to achieved or not?
- Explain information about the
refuse any medication. - Did the client experience any
medication to the client
- The nurse’s role is to ensure side effects or adverse
(ex. Why receiving, what to
that the client is fully informed reactions?
expect, any precautions)
of the potential consequences 10. RIGHT DOCUMENTATION
4. RIGHT DOSE
of refusal and to communicate - Document medication
- The dose ordered is
the client’s refusal to the administration after giving it ,
appropriate to the client.
healthcare provider. not before.
- Give special attention if the
7. RIGHT ASSESSMENT - If time of administration
calculation indicates multiple
- Some medications require differs from prescribed time ,
pills/tablets or a large quantity
specific assessments prior to note the time in the MAR and
of a liquid medication.
administration explain the reason and follow
up through activities.
 - If the medication is not given,
follow the agency’s policy for
documenting the reason why.
MEDICATION ERRORS
• Report all medication errors.
• Patient safety is top priority when
an error occurs.
• Documentation is required.
• The nurse is responsible for
preparing a written occurrence or
incident report: an accurate,
factual description of what
occurred and what was done.
• Nurses play an essential role in
medication reconciliation.
• A medication error can cause or
lead to inappropriate medication
use or patient harm.
• Errors include inaccurate
prescribing or administration, or
giving a drug via the wrong route
or frequency.
• It is important to feel comfortable
in reporting an error and not fear
repercussions from managerial
staff.
• Even when a patient suffers no
harm from a medication error, the
institution can still learn why the
mistake occurred and what can be
done to avoid similar errors in the
future.
• When an error occurs, the nurse
first assesses and examines the
patient’s condition and notifies
the health care provider of the
incident as soon as possible.
• Once the patient is stable, the
nurse reports the incident to the
appropriate person in the
institution (e.g., manager,
supervisor).
• The nurse is responsible for
preparing a written occurrence or
incident report that usually needs
to be filed within 24 hours of the
error.
• The report includes patient
identification information; the
location and time of the incident;
an accurate, factual description of
what occurred and what was
done; and the signature of the
nurse involved.
• The occurrence report is not a
permanent part of the medical
record and is not referred to
anywhere in the record.
• This legally protects the nurse and
the institution. Agencies use
occurrence reports to track
incident patterns and initiate
quality improvement programs as
needed. Nurses play an essential
role in medication reconciliation.
Whenever a nurse admits a
patient to a health care setting, he
or she compares the medications
that the patient took in the
previous setting (e.g., home,
another nursing unit) with his or
her current medication orders.
• When the patient leaves that
setting for another setting (e.g.,
skilled care facility, intensive care
unit), the nurse communicates the
patient’s current medications to
the health care providers in the
new setting.
• The nurse also reconciles the
patient’s medications when he or
she is discharged from an agency
or is seen in an outpatient setting.
• Many agencies have computerized
or written forms to facilitate the
process of medication
reconciliation.
 • Advances in technology have
helped to decrease the occurrence
of medication errors.
MIXING MEDICATIONS FROM TWO VIALS
 ➢In (A), the diagram shows
injecting air into vial A.
 B shows injecting air into vial B
and withdrawing dose.
 C diagrams withdrawing
medication from vial A.
 The medications are now mixed.
 Use only one syringe with a needle
or needleless access device
attached to mix medications from
two vials.
 Aspirate the volume of air
equivalent to the dose of the first
medication.
 Inject the air into vial, making sure
that the needle does not touch the
solution. Withdraw the needle and
aspirate air equivalent to the dose
of the second medication.
 Inject the volume of air into vial.
Immediately withdraw the
medication from vial into the
syringe and insert the needle back
into vial, being careful not to push
the plunger and expel the Problem 2.
medication within the syringe into
the vial. MD writes an order for Xanax 2 mg by
mouth a day. Pharmacy dispeneses you
 Withdraw the desired amount of
with 1 mg per tablet of Xanax. How many
medication from vial A into the
tablets do you administer per dose?
syringe .
 After withdrawing the necessary Answer: 2 tablets/dose
amount, withdraw the needle and
apply a new safety needle or Problem 3:
needleless access device suitable
MD writes an order for Cytotec 0.1 gram
for injection.
by mouth daily for a patient with peptic
DRUG COMPUTATION ulcer disease. Pharmacy dispenses you
with 100 mg per tablet. How many tablets
do you administer per dose?
Answer: 1 tablet/dose
Problem 1:
Erythromycin 500 mg is ordered. It is
supplied in a liquid form containing 250
mg in 5 mL. To calculate the dosage, the
nurse uses the
formula: