Assessment Rationale

1. Gather equipment. For easy accessibility and to avoid time

consumption

2. Know the actions, special nursing This helps the nurse assess and educate the
considerations, safe dose ranges, purpose of patient about medicine.
administration, and adverse effects of the
medications to be administered.

3. Perform Hand Hygiene Hand hygiene prevents the spread of

microorganisms

4. Move the medication cart to the outside of Organization facilitates error-free

the patient’s room or prepare for administration and saves time.
administration in the medication area.

5. Unlock the medication cart or drawer. Enter Passcode and ID scanning allow only
pass code and scan employee identification, authorized users enter the system and
if required. identify users for computer documentation.

Planning

6. Prepare medications for one patient at a This prevents errors in medication

time. administration.

7. Read the CMAR/MAR and select the This is the first check of the label.
proper medication from the patient’s
medication drawer or unit stock.

8. Compare the label with the CMAR/MAR. This is the second check of the label. Verify
Check expiration dates and perform calculations with another nurse to ensure
calculations, if necessary. Scan the bar code safety, if necessary.
on the package, if required.

9. If necessary, withdraw medication from an Accurately draw up medication from an

ampule or vial (as described in Skills 5-3 and ampule or vial to prevent compromised
5-4.) sterility

10. When all medications for one patient have Third check for correctness and error
been prepared, recheck the label with the prevention. Some facilities require a bedside
CMAR/MAR before taking the medications to third check after patient identification and
the patient. before administration.

11. Lock the medication cart before leaving it. Locking carts or drawers protects patient
medicine.

12. Transport medications to the patient’s Careful handling and close observation
bedside carefully, and keep the medications prevent accidental or deliberate
in sight at all times. disarrangement of medications.
13. Ensure that the patient receives the Agency policy may enable administration 30
medications at the correct time. minutes before or after authorized time.

14. Perform hand hygiene and put on PPE, if Hand hygiene and PPE prevent the spread of
indicated. microorganisms. PPE is required based on
transmission precautions.

Implementation

15. Identify the patient. Usually, the patient Identifying the patient prevents drug errors.
should be identified using two methods.
Compare information with the CMAR/MAR.

a. Check the name and identification number This strategy works best. Repair any missing
on the patient’s identification band. or erroneous identification bands.

16. Ask the patient to state his or her name The patient must respond, but illness and
and birth date, based on facility policy unfamiliarity can confound them.

17. If the patient cannot identify him- or Do not use the name on the door or over the
herself, verify the patient’s bed, because these may be inaccurate.

18. Close the door to the room or pull the This provides privacy to the patient.
bedside curtain.

19. Complete necessary assessments before Assessment is a prerequisite prior to

administering medications. Check allergy administration of medications to ensures
bracelet or ask the patient about allergies. patient safety

20. Scan the patient’s bar code on the Provides additional check to ensure that the
identification band, if required. medication is given to the right patient.

21. Put on clean gloves. Gloves help prevent exposure to

contaminants

22. Assist the patient to the appropriate Choosing and placing the location correctly
position for the site chosen. Drape as needed reduces damage and makes injection easier
to expose only area of site to be used and Draping protects patient privacy.

23. Identify the appropriate landmarks for the

site chosen.

24. Cleanse the site with an antimicrobial Pathogens on the skin can be forced into the
swab while wiping with a firm, circular motion tissues by the needle.
and moving outward from the injection site.
Allow the skin to dry.

25. Remove the needle cap with the This technique lessens the risk of accidental
nondominant hand by pulling it straight off. needlestick injury.
Administering Intramuscular Injection

26. Grasp and bunch the area surrounding Grasping or taut skin provides an easy
the injection site or spread the skin taut at the entrance into the skin tissue
site.

27. Displace the skin in a Z-track manner by This ensures medication does not leak back
pulling the skin down or to one side about 1 along the needle track and into the
inch (2.5 cm) with your nondominant hand subcutaneous tissue.
and hold the skin and tissue in this position.

28. Quickly dart the needle into the tissue so A 72-to-90-degree needle angle makes
that the needle is perpendicular to the muscle tissue entrance easier and reduces
patient’s body. pain.

29. As soon as the needle is in place, use the Moving the syringe could cause damage to
thumb and forefinger of your nondominant the tissues and inadvertent administration
hand to hold the lower end of the syringe. into an incorrect area.
Slide your dominant hand to the end of the
plunger. Inject the solution slowly (10 sec/mL
of medication).

30. Once the medication has been instilled, Allows medication given to begin to diffuse
wait 10 seconds before withdrawing the into the surrounding muscle tissue
needle.

31. Withdraw the needle smoothly and Slow needle withdrawal rips tissues and
steadily at the same angle at which it was hurts. As the needle is withdrawn, counter
inserted, supporting tissue around the traction prevents tissue tugging.
injection site with your nondominant hand.

32. Apply gentle pressure at the site with a Light pressure causes less trauma and
dry gauze. Do not massage the site. irritation to the tissues.

33. Do not recap the used needle. Engage Proper disposal of the needle prevents injury.
the safety shield or needle guard. Discard the
needle and syringe in the appropriate
receptacle.

34. Assist the patient to a position of comfort. This provides for the well-being of the patient.

35. Remove gloves and additional PPE, if Removing gloves and other PPE
used. Perform hand hygiene. appropriately prevents infection transmission
and contamination.

36. Document the administration of the Timely documentation helps to ensure patient
medication immediately after administration. safety.

37. Evaluate the patient’s response to patient needs to be evaluated for therapeutic
medication within appropriate time frame. and adverse effects from the medication.