Running head: MEDICATION ADMINISTRATION 1

Medication Administration

Tiffany Miller

Baker College
MEDICATION ADMINISTRATION 2

Medication Administration

Medication errors happen every day in the medical field. Nurses are trained to be able to

do conversions and calculations to prevent these medication errors, but nurses still make

mistakes.

Quality

There are many safety precautions that nurses are required to take before administering

medications to their patients. The 5 rights helps the nurse check their medications for the right

patient, right drug, right dosage, right time, and right route, along with the additional 5 rights

which include assessment, education, right to refuse, documentation, and evaluation

(McCuistion, Vuljoin-Dimaggio, Winton, & Yeager, 2018). Doing the first 5 rights is supposed to

be performed 3 times by the nurse, before the medications are given to each patient. Some

common mistakes that nurses make are with look- alike, sound-alike drugs (McCuistion et al.,

2018).

Another step to avoiding medication errors is by making sure that your environment,

such as the medication room or the patients’ room, is distraction free and as quiet as possible

(McCuistion et al., 2018). A lot of times, nurses are trying to multi-task while getting ready to

administer medications to their patients, and this is where medication errors happen. Patient

safety is number one in a nurse’s book, so having that distraction free environment is extremely

important.

One safety and quality issue is recapping needles. Most needles have a safety cap on

them, which helps avoid injury, but not all needles have safety caps. Most insulin needles still
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need to be “recapped”, but with the scooping method. The scooping method is the best way to

avoid injury from a needle stick.

Another safety and quality issue is making sure that patients are swallowing their

medications before the nurse leaves the room. It is the nurse’s responsibility to make sure that all

medication is taken properly, to be able to do her evaluation of the patient for adverse effects of

their medications. If a patient does not swallow their medications before the nurse leaves the

room, there is a possibility that the patient could save it for later, and possible overdose on their

medications.

The quality of medication administration is constantly changing. Syringe sizes are being

changed so that the nurse is more accurate in giving the correct dose of medications.

Intramuscular injection dosage amounts are being changed constantly for safety purposes

(Ogston-Tuck, 2014).

Safety

Nurses are responsible for their patients and making sure everything is done is a safe

manner. Nurses are responsible for passing medications to their patients without making any

errors, making sure that the patient is in a safe and comfortable environment, making sure that

the doctor is prescribing medications that do not conflict with the patients’ allergies or other

medications, and so much more!

Delegation is where accountability becomes frustrating for a nurse. When a nurse

delegated to an unlicensed professional, the nurse is still responsible for what the unlicensed

professional does (Hughes, Kirk, & Dixon, 2017). Nurses have to be aware of their facility’s

policies, and make sure that every task is followed through in the safest way. If a nurse delegates
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a certified nursing assistant to give an enema to a patient, the nurse must make sure that the

enema is done correctly, as well as charted. If the nursing assistant forgets to give the enema, the

nurse is accountable for the task not getting done.

Nurses are not the only ones in a care facility that are responsible for medications.

Doctors and physicians also have some responsibility when it comes to medications. The doctor,

physician, and nurse practitioner are the ones who write prescriptions for medications. The nurse

must collaborate with the doctor to verify orders and to make sure that the order is appropriate

for the patient’s condition.

Informatics

Care facilities have programs to help keep medications in track, and to help avoid

medication errors. These systems are helpful for nurses, but they are not always reliable. Nurses

should never rely on a medication administration record (MAR); nurses still need to be able to do

all calculations on their own, to avoid creating a medication error. These systems help nurses’

triple check their medications before administering them to their patients by requiring the nurse

to scan the patient’s wristband and each medication that the patient is taking; this is a positive

note on using MAR’s.

Teamwork/Collaboration

Having good communication skills between all health personnel is important in following

plans to make sure the patient is safe and being given the correct medications. Another example

of communication in the hospital is nurses being able to call the pharmacy for any questions for

medications they are administering to their patients.

Nurses and doctors are also responsible for communicating with surgeons, physical

therapy, educations therapy, and health care workers from a patient’s primary care office. Making

sure that a patient is being taken care of in every aspect relies on good communication skills

throughout health care staff. Nurses also need to communicate with nurses from other care

facilities if they are sending a patient to their facility. Making sure that the new nurse gets all

information about the patients needs such as rehab, medications, diet, etc., is critical when it

comes to giving report.

Evidence-based practice

According to Shimp (2017), medication errors happen primarily when a hospital is

understaffed. One way this could be changed is to create safe staffing needs that are unit specific

(Shimp, 2017). Different units have different types of patients, which go along with different

acuity levels of patients. One floor might need a ratio of 1 nurse to 2 patients, but another floor

may need 1 nurse to 4 patients. This all depends on the acuity level of the unit. These levels may

change over a period of time.

Adequate staffing needs depending on acuity of patients is a start of patient centered care.

Patient-centered care comes from individualizing care based on each patient’s needs and

problems. No two patients are the same; therefore, each patient will react differently. Some

patients are able to tolerate pain better than others, and that plays a big role of patient-centered

care; one patient might need a stronger dose of pain medications compared to someone else with

the same problem/diagnosis.

Patient centered
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Nurses create an individualized care plan for their patients, in order to have the best

short-term and long-term outcomes for him/her. Nurses are trained to create interventions

individualized for each patient, to care for their needs. This knowledge comes from nursing

school and years of experience in the health care field.

In conclusion, there are many ways to prevent medications errors. Systems, safety

measures, quality improvement, communication, evidence based practice, and patient-centered

care are the best ways to improve quality of care and to decrease the amount of medication errors

in a care facility. Nurses should be able to take their time, and have a routine down when it

comes to passing medications, to be positive that the correct medication is being given to the

right patient, the right dose, the right route and at the right time. Taking your time is much more

important than risking a patient’s life.

References

Hughes, M., Kirk, R., & Dixon, A. (2017, October). How and why nurses' direction and

delegation skills should be improved: A recent study has highlighted the need for greater

clarity about the skills needed for successful direction and delegation interactions

between nurses. Kai Tiaki: Nursing New Zealand. 23(9), 29+. Retrieved from

http://go.galegroup.com.bakerezproxy.palnet.info/ps/retrieve.

McCuistion, L. E., Vuljoin-Dimaggio, K., Winton, M. B., & Yeager, J. T. (2018).

Pharmacology: A patient-centered nursing process approach (9th ed.). St. Louis, MO:

Elsevier Inc.

Ogston-Tuck, S. (2014, September 24). Intramuscular injection technique: and evidence-base

approach. Nursing Standard,. vol. (29: 4), 52-59. Retrieved from

https://rcni.com/sites/rcn_nspace/files/ns.29.4.52.e9183.pdf.

Shimp, K. M. (2017). Systematic review of turnover /retention and staff perception of staffing

and resource adequacy related to staffing. Nursing Economics, vol. 35(5), 239-258,

266A. Retrieved from: https://search-proquest-

com.bakerezproxy.palnet.info/docview/1954857855/fulltextPDF/FA1A3AE278AA416F

PQ/5?accountid=8473.