Administering Medication In An Inpatient Unit

“As a Registered Nurse you remain accountable for your actions and you have the duty to Prioritise People, Practice Effectively, Preserve Safety and Promote Professionalism and Trust at all times!”

Plaxedes talks to us about administering medication and explains the process behind how to do it.

Topics covered in this article

Introduction

What Medications Can Be Administered In Hospital?

What Qualification Does One Need To Administer Medication?

What Skills And Knowledge Does The Registered Nurse Need To Administer Medication?

What Are The Steps Taken Prior To Administering Medication?

What Precautions Are Taken Prior To Medications Administration?

What Steps Are Taken To Safely Dispense Medication?

What Are The 5 Important Points in Administering Medication?

What Other Steps Are Taken After Medication Administration?

Introduction

Medication Administration is a Nursing procedure which is not unique to inpatient units.

In this short account, I am going to take through the steps for preparation, precautions and dispensing.

I will also note the 5 important points in medication administration.

Medication is administered at various times with some given once daily, twice daily, thrice daily and four times daily.

What Medications Can Be Administered In Hospital?

Medications come in different forms like tablets, liquids, suspensions (which are taken orally), sublingual tablets or lozenges (which are dissolved on the tongue) and injections which can be administered in deep muscular injections on different sites.

Subcutaneous injections like insulin and drops for treating ear infections, sprays used in fungal infections and Nicotine Replacement Therapy also referred to as NRT. This is usually prescribed for service users who wish to quit smoking.

What Qualification Does One Need To Administer Medication?

One needs to be a Registered Nurse to administer medication.

However, Student Nurses can give medication under supervision after a period of observing Qualified Nurses.

What Skills And Knowledge Does The Registered Nurse Need To Administer Medication?

The Registered Nurse requires good knowledge of the service users on the Unit, medicines that are administered in their unit, effects, side effect, cautions and drug interactions. This is very important in mental health units due to similarity in colours of tablets and regular changes to suppliers.

They also skills for Drug Calculations to ensure the right doses are administered to enhance efficacy and also avoid overdosing resulting in medication errors.

Some medications might require weight and vital signs checked prior to administration and some medicines have very specific protocols especially in Titration and Sliding Scale for Diabetic patients.

Some doses may need to be calculated per body mass index hence the Nurses have to be up to date with them competencies.

They should undertake Annual Medication Competencies training sessions as per local Trust Policy.

What Are The Steps Taken Prior To Administering Medication?

In my work area, 2 qualified Nurses are allocated to do the medication round.

Prior to medication administration, it is important that one of the trained staff checks the Clinical Room to conduct the Daily Clinical Room checks.

The checks include cleanliness of the environment, good lighting, checking the Fridge and Room Temperatures and check the Controlled Drugs cupboard if its locked.

The extra task will be checking the Emergency Equipment in case of an emergency requiring intermediate support interventions.

They will also need to ensure medicine dispensing cups are ready on the worktop or paper trays provided in some places.

You will need a small piece of paper and pen for writing any medications needing ordering and concerns from the service user or observations which may need to be recorded on the main notes so the Doctors, Charge Nurse and Manager can be informed.

What Precautions Are Taken Prior To Medications Administration?

The Nurses administering medication work alongside other colleagues and they have to remind colleagues about medication time.

Medication time is protected time hence all other activities have to be stopped or withheld.An extra member or 2 will assist with calling service user to attend medication time and one will remain in the corridor.

This is to ensure incidents of violence and aggression are avoided or minimised and service users maintain good social distance.

What Steps Are Taken To Safely Dispense Medication?

The Nurse should always be aware of Infection Control and Prevention and follow Handwashing guidelines before administering medication.

Check the prescription chart for patient details, date of birth, date of admission, times for administration.

Name of prescribing Doctor and Signatures and if the Allergies have been recorded and signed for.

Check the number of charts in case there are more than 1 in case the service user has been in hospital for a while.

The Nurses should confirm they are giving the medication to the right person by greeting the patient by name to confirm.

Make sure the cup and small paper tray are ready.

Together with your colleague, check the medication box for the name, the manufacturer and expiry date check the strength and prescribed dosages.

The Nurses should remain vigilant as some tablets are of the same colour as this may result in medication errors.

The medication is dispensed, checked again.

The service user is offered some water and then medication.

The Nurse will ask them if they have swallowed their medication then the first Nurse will sign, and colleague will countersign.

In some instances, the other staff may be asked to confirm by checking if they don’t use the bathroom straight away or continue having a conversation with them.

What Are The 5 Important Points in Administering Medication?

To administer medication to the Right Person.

To administer medication at the Right Time.

To administer medication through the Right Route.

To administer the Right Dose. To administer the Right Medication or Drug.

What Other Steps Are Taken After Medication Administration?

The Nurses will clear the used cups and paper trays, tidy up the clinical Room and lock cupboards.

They will feedback on compliance of each service user especially those who might have refused or still asleep so this can be recorded on the Handover Notes and return the Clinical Room Keys to the Nurse in Charge of the shift.

Last but not least, any medication errors should be reported and local protocol followed to prevent future or further acts of omission.

It’s good practice to work closely with colleague and verify any concerns with the Charge Nurse, Ward Doctor or Manager.

As a Registered Nurse you remain accountable for your actions and you have the duty to Prioritise People, Practice Effectively, Preserve Safety and Promote Professionalism and Trust at all times!

Further information is available on the NMC Website and local Medicines Managements Policy.