CHECKLIST 44

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Bow Valley College, Calgary *

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NURS1203

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Health Science

Date

Feb 20, 2024

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docx

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9

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CHECKLIST 44: ADMINISTERING MEDICATION BY MOUTH Disclaimer: Always review and follow your hospital policy regarding this specific skill. Safety considerations: Perform hand hygiene . Check room for  additional precautions . Introduce yourself to patient. Confirm patient ID using two patient identifiers (e.g., name and date of birth). Check allergy band for any allergies. Complete necessary  focused assessments  and/or  vital signs , and document on MAR. Provide patient education as necessary. Plan medication administration to avoid disruption: o Dispense medication in a quiet area. o Avoid conversation with others. o Follow agency’s no-interruption zone policy. o Prepare medications for ONE patient at a time. o Follow the SEVEN RIGHTS of medication administration. STEPS  ADDITIONAL INFORMATION 1. Check MAR against doctor’s orders. Check that MAR and doctor’s orders are consistent. Compare physician orders and MAR Night staff usually complete and verify this check as well. 2. Perform the SEVEN RIGHTS x 3 (must be done with each individual medication): The right patient The right medication (drug) The right patient: check that you have the correct patient using two patient identifiers (e.g., name and date of birth). Compare MAR with patient wristband. The right medication (drug): check that you
The right dose The right route The right time The right reason The right documentation Medication calculation: D/H x S = A ( D  or d esired dosage/ H  or h ave available x  S  or s tock =  A  or a mount prepared) have the correct medication and that it is appropriate for the patient in the current context. The right dose: check that the dose makes sense for the age, size, and condition of the patient. Different dosages may be indicated for different conditions. The right route: check that the route is appropriate for the patient’s current condition. The right time: adhere to the prescribed dose and schedule. The right reason: check that the patient is receiving the medication for the appropriate reason. The right documentation: always verify any unclear or inaccurate documentation prior to administering medications. Check the right patient, medication, dose, route, time, reason, documentation NEVER document that you have given a medication until you have actually administered it. 3. The label on the medication must be checked for name, dose, and route, and compared with the MAR at three different times: 1. When the medication is taken out of the drawer 2. When the medication is being poured 3. When the medication is being put away/or at bedside Perform seven checks three times before administering medication These checks are done before administering the medication to your patient. If taking drug to bedside (e.g., eye drops), do third check at bedside. 4. Place all medications that patient will receive in one cup, except medications that require pre-assessment (e.g., blood pressure or pulse rate). Place these in a separate cup Keeping medications that require pre- assessment separately acts as a reminder and makes it easier to withhold medications if necessary.
and keep wrapper intact. 5. Do not touch medication with ungloved hands. Use clean gloved hands if it is necessary to touch the medication. Using gloves reduces contamination of the medication. 6. Circle medication when poured. Pour medication. Circle MAR to show that medication has been poured. Circle medication once it has been poured 7. Patient education Discuss purpose of each medication, action, and possible adverse effects. Ask patient if they have any allergies. The patient has the right to be informed and provided with reasons for medication, action, and potential adverse effects. Giving this information will likely improve adherence to medication therapy and patient reporting of adverse effects. Confirms patient’s allergy history. IMPORTANT:  If patient expresses concern over medications, do not give medication. Verify doctor’s order and explore patient concerns before administering medication. 8. Positioning Help patient to sitting position. If patient is unable to sit, use the side- lying position. Have patient stay in this position for 30 minutes after administering medication. Offer patient water or desired oral fluid. Ensure proper body mechanics for health care provider. Position patient appropriately for medication administration. Correct positioning reduces risk of aspiration during swallowing. Water or other oral fluids will help with swallowing of medication. Proper body mechanics reduces risk of injury to health care provider. 9. Administer medication orally as prescribed. Tablets: place in mouth and swallow using water or other oral fluids. Orally disintegrating medications: Remove carefully from packaging. Place medication on top of patient’s tongue, and have patient avoid chewing the medication. Water is Follow any specific descriptions for administration of the medication. Wear gloves if placing the medication inside the patient’s mouth.  
not needed. Sublingually: Place medication under patient’s tongue and allow to dissolve completely. Ensure patient avoids swallowing the medication. Buccal: place medication in mouth and against inner cheek and gums and allow to dissolve completely. Powdered medication: mix at bedside with water to avoid thickening of medication that may occur with time. 10. post-medication safety check Stay with patient until all medications are swallowed or dissolved. Perform post assessments and/or vital signs if applicable. Sign MAR and place in appropriate chart. Perform hand hygiene . Document any additional information, such as patient education, reasons why medication not administered, and adverse effects, as per agency policy. Do not sign for any medications if you are not sure the patient has taken them. Post assessments determine effects and potential adverse effects of medications. 11. Return within appropriate time to evaluate patient’s response to the medications and to check for possible adverse effects. If patient presents with any adverse effects: Withhold further doses. Assess vital signs. Notify prescriber. Notify pharmacy. Most sublingual medications act in 15 minutes, and most oral medications act in 30 minutes.  
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