Adhering to strict protocols is fundamental to patient safety. These guidelines outline critical practices to always follow and always avoid when dispensing medication.
In long-term care settings, medication administration typically allows a one-hour window before or after the scheduled time.
Always adhere to facility-specific policy.
Pre-Shift Preparation
Upon arrival, ensure you are prepared to assume medication duties:
Obtain your patient assignment and log in to the facility's electronic medical record (EMR) system.
Receive report and keys to the medication cart.
Review the resident census to identify patients with specific needs, such as crushed medications or gastrostomy tube (G-tube) administration.
Verifying Patient Identity
If unsure of a resident’s identity:
Ask a fellow staff member for assistance.
Check the photograph in the Medical Administration Record (MAR).
Ask the resident to state their full name.
Do not ask a "yes/no" question (e.g., "Are you John Smith?"), as this can lead to misidentification.
The Five Rights of Medication Administration
Verify these five elements without exception for every medication pass:
Right Patient
Right Medication
Right Dose
Right Route
Right Time
Best Practices: Always...
Verify Orders: Read back verbal or telephone orders to the prescriber for confirmation.
Inspect Medications: Check expiration dates and look for any visual signs of tampering or deterioration.
Maintain Security: Keep the medication cart locked at all times when unattended.
Seek Knowledge: Look up any unfamiliar medications before administration.
Assess & Monitor: Evaluate residents for both the therapeutic effectiveness and any potential adverse reactions to medications.
Critical Errors: Never...
Rush the Process: Hastening medication administration significantly increases the risk of error.
"Borrow" Medications: Never use one resident's medication for another under any circumstances.
Pocket Medications: Never carry medications in your uniform pockets; this is a safety and security risk.
Leave the Cart Unattended & Unlocked: This is a major violation of medication security protocols.
Falsify Documentation: Never sign for a medication (MAR sign-off) that you have not personally administered.
Questions?
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