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

-Meticulous care in prep and admin reduces chances of errors. -If a mistake is made, you MUST: Report it to one in charge to correct for patient welfare. 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. Principles of Administration -Cleanliness: essential to safe admin. Always wash hands before handling meds and keep prep area clean/neat. (Sulfa/PCN allergies) -Organization: make sure meds and supplies are in right area. (I do not agree with "when stock drugs are used, they should be reordered immediately") -Preparation area: well-lit and away from distracting influences. (To the best of your ability)

Six Rights of Medication Administration 1. Right Medication Confirm by comparing drug prescribed and labeling on container. NEVER give med when the name is obscured in any way. NEVER give med someone else prepared. NEVER leave meds at bedside unless specifically ordered by MD. If there is any question, it is your RIGHT and RESPONSIBILITY to question the MD and/or pharmacist 2. Right Amount If calculations are needed, have those calculations checked. Be careful when doses are in decimals or fractions. Always recheck dose if: o Less than tablet o Greater than 2 tablets o Greater than 2 mL for injection 3. Right Time For maximum effectiveness, drugs must be given on a prescribed schedule. 4. 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, oral route is used unless current conditions do not allow (nausea, vomiting or difficulty swallowing).

5. Right Patient Always verify any information you have available to identify the patient. 6. Right Documentation Essential duty in patient care The following must be recorded on patients record: o Every medication given (along with dose, time, route and location of injections). o Any unusual or adverse patient reactions. 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. o Destroyed by partial dosage o Cancellation o Error - Welfare of the patient is the primary concern in administration of medications.