Copyright © 2015 Cengage Learning® 1 Chapter 7 Responsibilities and Principles of Drug...

Copyright © 2015 Cengage Learning® 1Copyright © 2015 Cengage Learning®

Chapter 7Responsibilities and Principles

of Drug Administration

Copyright © 2015 Cengage Learning® 2

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


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



• 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



– 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



– 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


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 • 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


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)


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


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


Principles of Administration• Basic principles

– Cleanliness of self and area – Organization of medications and supplies – Preparation area location and lighting


Principles of Administration (cont’d.)

• Six Rights of Medication Administration– Right medication– Right amount– Right time– Right route– Right patient– Right documentation


Right Medication• Confirm that you have the right medication

– Compare the name of the drug prescribed with the label on the package, bottle, or unit-dose 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


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


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


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


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


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


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

Copyright © 2015 Cengage Learning® 1 Chapter 7 Responsibilities and Principles of Drug...

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