UNIT 10

1. UNIT 10 Medication Administration Essentials

2. Key Terms Allergy Ethical Illegal Meniscus Opaque Precipitate Unethical

3. Legal Implications Those who administer medications must be Legally and ethically responsible for actions Licensed, registered, or authorized by physician Familiar with state laws Familiar with drugs being given

4. 7 Rights Patient Drug Dose Route Time Technique Documentation

5. Right Patient Call patient by name or ask to state name Do not rely on staff to identify your patient Patients in physicians’ offices do not wear ID bracelets as in hospitals Warning! If a drug is not given, you must state why You must properly dispose of drugs not given

6. Right Drug Check label three times When taken from storage Before removing from container When returning container to storage or prior to discarding

7. Right Dose Have proper knowledge of drug calculations Have another person verify accuracy Always compare dosage ordered to that on hand

8. Right Route Check medication order for correct route Be familiar with all routes in which particular drugs may be given If route is not specified, or if in doubt, verify with physician

9. Right Time Check the time interval specified in the medication order To maintain a drug at the proper blood level, timing is essential

10. Right Technique Know and follow proper technique for any drug administered Use the “7 Rights” and specific physician instructions Consider safety measures Follow specific preparation techniques Check medication label for specific directions

11. Right Documentation Chart is legal document Must include Patient name Date and time of administration Medication name and dosage Route and site Adverse reactions Complications in administration Signature of administering staff (continues)

12. Right Documentation Discussion Questions: What would be some possible reasons that an ordered drug may not be given? If a medical assistant commits a medication error, is the physician also held accountable?

13. Essential Guidelines Practice medical asepsis Work in well-lighted area without distractions Follow the “7 Rights” of proper drug administration Check for allergies before administration Give only drugs ordered by authorized prescriber (continues)

14. Essential Guidelines Check expiration date Do not give a drug if it is altered in any way Give only those medications that you prepared Do not allow someone else to give medications you prepared (continues)

15. Essential Guidelines Never give medication if there are questions about the order Confirm order with prescribing physician Be completely familiar with drugs you are giving (continues)

16. Essential Guidelines Do not leave prepared medication unattended Stay with patient until you are certain medication has been taken Keep drugs in safe storage place

17. Liquid Medication Guidelines Shake liquid preparations to mix Measure at eye level Measure from lowest point of meniscus Do not touch bottle to measuring device Do not contaminate the cap Hold bottle with label toward palm (continues)

18. Liquid Medication Guidelines Discussion Questions: When pouring liquid medication, should you hold the measuring cup at eye level or place it on a flat surface? What should you do if you do not feel comfortable giving a medication that the physician has ordered?

19. Universal Precautions Infection-control measures Blood and body fluids All persons treated as if contaminated with HIV

20. Barrier Precautions Gloves Masks Goggles Gowns Aprons

21. Sharps Precautions NEVER recap, bend, or break needles Place all sharps in puncture-proof containers Use extreme caution when cleaning instruments

22. Skin Precautions Wash hands immediately following exposure to blood or body fluids Workers with skin lesions should refrain from direct patient care or from handling equipment

23. Resuscitation Guidelines Where resuscitation is predictable, the following should be available: Mouth-to-mouth mouthpieces Resuscitation bags Ventilation devices

24. Pregnant Healthcare Workers Pregnancy is not a disability Pregnant workers are at no greater risk of contracting HIV than any other workers Pregnant workers should continue to follow strict universal precautions

25. Standard Precautions for Infection Control CDC recommended Combines universal precautions with body substance isolation (BSI) Applies to Blood All body fluids Nonintact skin Mucous membranes (continues)

26. Standard Precautions for Infection Control Discussion Questions: What is the difference between “universal precautions” and “standard precautions”? What should you do if you witness a coworker who fails to follow precautions?

27. Storage of Medications Medication room Well lighted Away from patient traffic Contains sink and refrigerator Plenty of cabinet space

28. Categorization of Medications By use: internal, external, otic, etc. By preparation: solid, liquid, etc. By route: oral, topical, rectal, etc. By therapeutic action: analgesics, antihistamines, etc. Alphabetical: generic, brand Principal actions: stimulants, depressants, etc. Actions of drugs: by body system

29. Storage Guidelines Some drugs require special storage Opaque containers Refrigeration Glass containers Samples kept separate from other medications (continues)

30. Storage Guidelines Controlled substances stored in a locked box Poisonous substances labeled in red All medications checked on regular basis to guarantee freshness

31. Emergency Medicationsand Supplies Be familiar with location of emergency medications and supplies Be familiar with your role in the event of an emergency Medications and supplies should be stored separately and checked regularly (continues)

32. Emergency Medicationsand Supplies Discussion Questions: What common emergency drug is used for anxiety, seizures, and as a muscle relaxant? Which emergency drug is used in the event of a narcotic overdose? What emergency drugs would be given for an anaphylactic reaction?

33. Documentation Patient name Date and time of administration Medication name and dose Route, site, and technique Adverse reactions (continues)

34. Documentation • Complications in administration • Patient data (BP, pulse, respiration) • Effectiveness • Signature of administering staff

35. Medication Errors Drug given to wrong patient Wrong drug is given Wrong dose is given Drug given by wrong route Drug given at wrong time Wrong technique is used Wrong data is documented (continues)

36. Medication Errors Warning! Although you must document the medication error, the incident report is not part of the patient’s record. DO NOT write “incident report filed” in the patient’s chart.

37. If Errors Occur… Recognize the error Stay calm; assess patient Report to physician Follow physician orders Document Complete incident report