Administration Safety

PHCL 492

Standards for Medicines Management

‘When required to administer medication a practitioner is accountable for his or her own actions and omissions. The practitioner must satisfy himself or herself, they have the necessary information to ensure the safe administration of the medicine. This will include access to the patient’s record in addition to information about the medicine to be administered’ (NMC, 2007).

Authorization to administer

The first principle in the administration of a medication is the ‘authority’ to administer and identification of the appropriate authority for the clinical situation you are working in.

Authorization to administer Prior to the administration of medicine health

professional must have access to one of the following: A Patient Specific Direction (PSD) including a patient

medicines administration chart Patient Group Direction (PGD) Medicines exemptions (paramedics, midwives and

occupational health nurses) Homely medicines (General Sales List and Pharmacy Only

medicines

Obtaining Patient InformationAge, weight and height DiagnosisPregnancy and lactation statusAllergiesCurrent medications

Administration of medication Identifying the patient Check that you have the correct patient

Check the name of the patient against the documentation giving authority to administer

Ask the patient their name Check the patient’s identity against the identification

bracelet or barcode if available

Administration of medicationEnsure that the patient is ready to receive

the medication Medication should not be prepared in advance and

left for the patient to take or for another professional to administer

Check that, prior to preparing the medication, you have all the equipment required

Administration of medicationCheck the medication

Name of the medication Right formulation of the drug and route of

administration Strength of the preparation Right dose of the drug to be administered Frequency of administration Expiry date of the medicine Visibly check the product (where appropriate)

for any contamination

Drug and Dosing Information Access to reliable drug info resources

Typical dose and route of administration for new drug recently added to formulary

The compatibility of piggyback medication with primary IV solution

The typical dosing of mg/kg for common analgesic for pediatric patient

The dose conversion between IV and PO medications The rate of IV push or infusion Wither the medication can be crushed

Preparing medication prior to administration

All medication should be prepared in line with the recommendations from the manufacturers Tablets should not be handled, as the contamination may

alter the coating of the medication Tablets should not be crushed unless this has been identified

as a suitable method of administration of the medicine Capsules should not be split unless it has been identified as a

suitable method to administer the medication If liquid medications are being administered and a syringe is

being used, the correct equipment should be used

Preparing medication prior to administration

Proper training and competency assessment before: Withdrawing solution from an ampoule into a syringe Withdrawing a solution or suspension from a vial into a

syringe Reconstituting powder in a vial and drawing the resulting

solution or suspension into a syringe Adding a medication to an infusion Diluting a medication in a syringe for use in a pump or

syringe driver

Post-administration of medication Monitoring the patient

Continually evaluate patient to ensure safety and quality The need for follow-up blood tests/ monitoring The need to withhold other medication The need to complete the course of medication How any unused medication must be safely disposed for the

individual and the wider community

Record keeping Once medication dose has been administered should

be documented in MAR If a medication is omitted, there must be a clear

rationale provided in the patients’ records

Reporting errors / incidents Practitioner must ensure they have reported the error

and adverse event in accordance with organizational policies

This may include the reporting to Organization safety officer SFDA

Safety for staff The practitioner administering the medication must

be aware of any necessary precautions for protection against the medication being administered

This may include: the use of protective clothing the medication being prepared in a specific environment reducing the risk of needle stick injury

Summary Practitioners must ensure they have an up-to-date

clinical and pharmaceutical knowledge base to administer medication safely

They must be competent with techniques for administration and with the equipment to be used in the administration process

They must be encouraged to acknowledge limitations in knowledge and be encouraged to undertake additional updating as required

Practitioners must be encouraged to question any aspect of the administration process if they are unclear