Transcript Chapter 1

Chapter 7
Responsibilities and Principles
of Drug Administration
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Responsible Drug Administration
• Responsibilities of the health care provider
– Adequate, up-to-date information about all
medications to be administered
– Wisdom and judgment to accurately assess
the patient’s needs for medications, to
evaluate the response to medications, and to
plan appropriate interventions as indicated
– Skill in accurate delivery of the medication, in
the best interests of the patient, and with
adequate documentation
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Responsible Drug Administration
(cont’d.)
– Patient education to provide the necessary
information to the patient and family about
why, how, and when medications are to be
administered and potential side effects and
precautions with administration by the
layperson
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Responsible Drug Administration
(cont’d.)
• Requirements
– Be familiar with medication before
administration
• Typical and most frequently used drugs of the
systems
– Plan thoroughly for patient care
• Prior assessment, interventions, and evaluations
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Responsible Drug Administration
(cont’d.)
– Train to develop skills in delivery of
medications
• Maximize the effectiveness of the drug with the
least discomfort to the patient
– Educate patients
• Emphasize the importance of taking medications in
the proper dosage, on time, and in the proper way
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Responsible Drug Administration
(cont’d.)
– Take moral, ethical, and legal responsibilities
into account
• Consult those in authority—supervisors or
administrators—and/or policy and procedure books
• Documentation on the patient’s record is always
required
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Medication Errors
• Occur in all health care settings
– More errors are reported from acute care
settings, where the risk is greatest
– Common situations in which errors occur
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•
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Administering a drug to the wrong patient
Administering the wrong drug
Administering a drug via the wrong route
Administering a drug at the wrong time
Administering the wrong dosage
Wrong documentation
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Medication Errors (cont’d.)
• Meticulous care in preparation and
administration reduces chances of error
– However, if a mistake is made, report it
immediately
• Medication Errors Reporting (MER) program
• Institute for Safe Medication Practices (ISMP)
Patient Safety Organization (PSO)
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Medication Errors (cont’d.)
• Medication reconciliation
– Method used to compare what the patient is
taking to what the patient’s physician ordered
• Performed every time there is a change in the
patient’s care
• Aims to prevent medication errors caused by
omissions, duplications, errors in doses, or
medication interactions
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Medication Errors (cont’d.)
• Steps in medication reconciliation
– Develop a list of current medications
– Develop a list of medications to be prescribed
– Compare the medications on the two lists
– Make clinical decisions based on the
comparison
– Communicate the new list to appropriate
caregivers and to the patient
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Principles of Administration
• Basic principles
– Cleanliness of self and area
– Organization of medications and supplies
– Preparation area location and lighting
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Principles of Administration
(cont’d.)
• Six Rights of Medication Administration
– Right medication
– Right amount
– Right time
– Right route
– Right patient
– Right documentation
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Right Medication
• Confirm that you have the right medication
– Compare the name of the drug prescribed
with the label on the package, bottle, or unitdose packet
– Never give medication when the name of the
medication is obscured in any way
– Never give medications that someone else
has prepared
– Never leave medications at the bedside
unless specifically ordered by the doctor
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Right Amount
• Administering the right amount of drug is
extremely important
– Drug dosage ordered must be compared very
carefully with the dose listed on the label of
the package, bottle, or unit-dose packet
– Consult a table of equivalents if necessary, to
convert from one system to another
• Calculations must be checked by another trained
health care practitioner, pharmacist, or doctor to
verify accuracy
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Right Time
• For maximum effectiveness, drugs must
be given on a prescribed schedule
– Physician’s order specifies the number of
times per day that the medicine is to be
administered
• Intervals
• Before or after meals
• Hour of sleep
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Right Route
• Route of administration effects vary
– Degree of absorption, speed of drug action,
and side effects
– Physician’s order specifies the route of
administration
– Route may not be changed without the
physician’s order
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Right Patient
• Identify the patient by use of certain
techniques to reduce the chance of error
– Wrist identification band
– Call or ask patient to state their name
– Date of birth in ambulatory care setting
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Right Documentation
• Every medication given must be recorded
on the patient’s record
– Dose, time, route, and location of injections
– Unusual or adverse patient reactions
– PRN basis
– Administrator signature
– Narcotics administered
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MedWatch
• FDA form to assist health care
professionals in reporting serious, adverse
events or product quality problems
– Associated with medications, medical
devices, or nutritional products regulated by
the FDA
• Goal is to help the FDA better monitor product
safety and take swift action to protect patients and
healthcare providers
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