Rights of Drug Administration

THE SIX RIGHTS OF medicine ADMINISTRATION Right do do mediciness some(prenominal) do medicatess have similar spellings and variable concentrations. forrader the formation of the practice of medicine, it is imperative to comp be the lay claim spelling and concentration of the prescribed loony toons with the practice of medicine card or do social ailments profile and the medicinal do medicates container. Regardless of the do medicates distribution system utilizationd, the medicate magnetic discing commemorate should be read at to the lowest degree three clips 1. Before removing the acid from the shelf or building block dosage cart. 2. Before preparing or measuring the existing prescribed dose 3.Before replacing the medicate on the shelf or in front opening a unit dose container (just previous to parcel outing the drug to the affected role) Right epoch When scheduling the establishment cartridge clip of a music, factors such as timing abbreviations, standardised times, consistency of blood levels, absorption, symptomatic testing, and the use of p. r. n. medical specialtys must be careed. 1. banner AbbreviationsThe drug assure specifies the frequency of drug giving medication. Standard abbreviations apply as part of the drug site specify the times of administrati0n.The obtain should also ensure institutional policy concerning formation of medications. Hospitals often have like interpretations for abbreviations. The arrest must memorize and lend matchlessself standard abbreviations in interpreting, transcribing, and administering medications accu prescribely. 2. Standardized validation TimesFor affected role well(p)ty, certain medications are administered at unique(predicate) times. This all(prenominal)ows laboratory wee-wee or ECGs to be completed first, in tell apart to determine the size of the beside dose to be administered. 3.Maintenance of Consistent tune LevelsThe inscription for the court of a d rug should be planned to maintain consonant blood levels of the drug in order to maximize the healing(predicate) effectiveness. 4. Maximum Drug AbsorptionThe schedule for spoken boldness of drugs must be planned to continue incompatibilities and maximize absorption. Certain drugs require administration on an empty stomach. Thus, they are abandoned 1hour in the beginning or 2 hours by and byward meals. Other medications should be topn with viandss to lift absorption or reduce moods.Still other(a) drugs are not castn with daybook products or antacids. It is chief(prenominal) to maintain the recommended schedule of administration for maximum therapeutic effectiveness. 5. diagnostic TestingDetermine whether each diagnostic tests have been ordered for completion prior to initiating or continuing therapy. Before origination antimicrobial therapy, assure that all goal specimens (such as blood, urine, or wound) have been collected. If a doctor has ordered serum levels o f the drug, organize the administration time of the medication with the time the phlebotomist is going to draw the blood sample.When completing the requisition for a serum level of a medication, of all time make a notation of the run into and time that the drug was at last administered. Timing is pregnant if tests are not conducted at the resembling time intervals in the same affected role role, the data gained are of little value. 6. P. R. N. MedicationsBefore the administration of all p. r. n. medication, the uncomplainings graph should be experienceed to ensure that the drug has not been administered by someone else, or that the specified time interval has passed since the medication was last administered. When a p. rn. medication is given, it should be maped immediately.Record the receipt to the medication. Right Dose play off the drug sexually transmitted disease ordered against the place specified in the reference books getable at the nurses station. 1. Abnorm al Hepatic or Renal FunctionAlways consider the hepatic and renal assist of the specific uncomplaining who will receive the drug. Depending on the rate of drug metabolism and travel plan of excretion from the clay, certain drugs require a reduction in dosage to clog toxicity. Conversely, patient roles universe dialyzed whitethorn require higher(prenominal) than normal doses. Whenever a dosage is outside(a) the normal range for that drug, it should be substantiate before administration.Once verification has been obtained, a design explanation should be reposeed in the nurses notes and on the Kardex 9or drug profile) so that others administering the medication will not be repeatedly contacted with the same questions. The interest laboratory tests are utilize to monitor liver function aspartame aminotransferase (AST), alanine aminotransferase (ALT), gamma glutamyl transferase (GGT), alkaline phosphatase and lactic dehydrogenase (LDH). The blood urea nitrogen (BUN), serum creatinine (Crs), and creatinine clearance (Ccr) are used to monitor renal function. 2.Pediatric and Geriatric endurings peculiar(prenominal) doses for some drugs are not even so blottoly established for the elderly and for the pediatric patient. The nurse should question any order outside the normal range before administration. For pediatric patients, the close reliable system is by proportional criterion of system surface area or body weight. 3. Nausea and VomitingIf a patient is vomiting, spontaneous medications should be withheld and the medical student contacted for shift medication orders, as the parenteral or rectal highroad may be preferred. Investigate the onset of the nausea and vomiting.If itbegan afterwards the start of the medication regimen, consideration should be given to rescheduling the oral medication. government activity with food normally decreases gastric irritation. Consult with a physician for changes in orders. Right Patient When using the med ication card system, comparison the reboot of the patient on the medication card with the patients naming bracelet. With the unit dose system, compare the name on the drug profile with the individuals ac goledgement bracelet. When checking the bracelet below either system, always check for allergies, as well.Some institutional policies require that the individual be called by name as a core of identification. This practice must fetch into consideration the patients intellectual alertness and orientation. It is much safer ALWAYS to check the identification bracelet. 1. Pediatric PatientsNever consume children their names as a means of positive identification. Children may change beds, render to avoid you, or seek trouble by identifying themselves as someone else. deterrent identification bracelets either date. 2. Geriatric PatientsIt is a wise policy to check identification bracelets, in addition to confirming names verbally.In a long-term care setting, residents usu ally do not wear identification bracelets. In these instances, only a someone who is familiar with the residents should administer medications. Many errors may be voided by carefully undermentioned the practices just presented. Make it a fit out to check the identification bracelet EVERY TIME a medication is administered. The unbecoming effectuate of administration to the wrong medication to the wrong patient and the potential for a lawsuit th on a lower floor mug thus be avoided. Right Route The drug order should specify the travel guidebook to be used for the administration of the medication.Never substitute one dosage form of medication for another unless the physician is specifically consulted and an order for the change is obtained. on that point can be a immense variation in the absorption rate of the medication through various routes of administration. The intravenous route delivers the drug directly into the bloodstream. This route provides the fastest onset, but a lso the greatest danger of potential ill effects such as tachycardia and hypotension. The intramuscular route provides the close fastest absorption rate, base upon availability of blood append.This route can be quite painful, as is the possibility with many antibiotics. The subcutaneous route is next fastest, based on blood supply. In some instances the oral route may be as fast as the intramuscular route, depending on the medication being given, the dosage form (liquids are captive faster than tablets), and whether in that respect is food in the stomach. The oral route is usually safe if the patient is conscious and able to swallow. The rectal route should be avoided, if possible, due to irritation of mucosal tissues and erratic absorption rates.In case of error, the oral and rectal routes have the profit of recoverability for a short time after administration. Right Drug Preparation and Administration Maintain the higher standards of drug provision and administration. Fo cus your entire attention on the calculation, preparation, and administration of the ordered medication. A drug reconstituted by a nurse should be clearly designate with the patients name, the dose or strength per unit of volume, the date and time the drug was reconstituted, the amount and type of diluent used, the expiration date/ or time, and the initials or name of the nurse who rised it.Once reconstituted, the drug should be investment trustd consort to the manufacturers recommendation. retick the label of the container for the drug name, concentration, and route of catch administration. strike off the patients chart, Kardex, medication administration record, or identification bracelet for allergies. If no information is found, ask the patient, prior to the administration of the administration of the medication, if he or she has any allergies. CHECK the patients chart, Kardex, medication administration record for rotation schedules of injectable or topically applied me dications. CHECK medications to be mixed in one syringe with a disposition sanction by the hospital or the chemists for compatibility. Normally, all drugs mixed in a single syringe should be administered indoors 15 minutes after mixing. straightaway prior to administration, ALWAYS CHECK the contents of syringe for clarity and the absence of any precipitate if either is present, do not administer the contents of the syringe. CHECK the patients identity EVERY TIME a medication is administered. DO access the patient in a firm but kind manner that conveys the tang that cooperation is expected. DO adjust the patient to the most appropriate position for the route of administration (for example for oral medications, sit the patient upright to facilitate swallowing). Have appropriate fluids ready before administration. DO quell with the patient to be certain that all medications have been swallowed. DO use any opportunity to teach the patient and family roughly the drug being administered. DO give simple and honest answers or explanations to the patient regarding the medication and treatment. DO use a plastic container, medicine cup, medicine dropper, oral syringe, or nipple to administer oral medications to an infant or small child. DO reward the child who has been cooperative by giving praise comfort and utilize the uncooperative child after completing the medication administration. DO NOT prepare or administer a drug from a container that is not straitlacedly labeled or from a container where the label is not fully legible. DO NOT give any medication prepared by an individual other than the pharmacist. ALWAYS check the drug name, dosage, frequency, and route ofadministration against the order.Student nurses must k without delay the practice limitations instituted by the hospital or school and which medications can be administered under what level of supervision. DO NOT ease up an unused portion or dose of medication to a stock supply bottle. DO NOT attempt to administer any drug orally to a comatose patient. DO NOT intrust a medication at the patients bedside to be taken posterior remain with the individual until the drug is taken and swallowed. DO NOT dilute a liquid medication form unless there are specific written orders to do so. BEFORE DISCHARGE (1) Explain the proper method of taking prescribed medications to the patient. (2)Stress the compulsion for punctuality in the administration of medications, and what to do if a dosage is missed. (3)Teach the patient to store medications separately from other containers and personal hygiene items. (4)Provide the patient with written instructions reiterating the medication names, schedules, and how to obtain refills. Write the instructions in a language understood by the patient, and use LARGE BOLD garner when necessary. (5) Identify anticipate therapeutic response. 6)Instruct the patient, family member(s), or significant others on how to collect and record data for use by the physician to monitor the patients response to drug and other treatment modalities. (7)Give the patient, or another responsible individual, a list of signs and symptoms that should be reported to the physician. (8)Stress measures that can be initiated to minimize or prevent anticipated side effects to the prescribed medication. It is important to do this further encourage the patient to be complaint with the prescribed regimen.Right sustenance Documentation of nursing actions and patient observations has always been an important ethical responsibility, but now it is becoming a major medicolegal consideration as well. Indeed, it is becoming cognise as the sixth right. Always chart the following information date and time of administration, name of medication, dosage, route, and site of administration. Documentation of drug action should be made in the regularly scheduled assessments for changes in the disease symptoms the patient is exhibiting.Promptly record and report a dverse symptoms ob march. Document health teaching performed and prize and record the degree of understanding exhibited by the patient. DO record when a drug is not administered and why. DO NOT record a medication until after it has been given. DO NOT record in the nurses notes that an casualty report has been completed when a medication error has occurred. However, data regarding clinical observations of the patient related to the occurrence should be charted to serve as a baseline for emerging comparisons.Whenever a medication error does occur, an ensuant report is completed to describe the pot of the event. An incident report related to a medication error should include the following data date, time the drug was ordered, drug name, dose, and route of administration. Information regarding the date, time, drug administered, and dose and route of administration should be given, and the therapeutic response or adverse clinical observations present should be noted. Finally, re cord the date, time, and physicians ordered given. Be factual do not state opinions on the incident report.