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Master 6 Rights of Medication Administration with Picmonic for Nursing RNWith Picmonic, facts become pictures. We've taken what the science shows - image mnemonics work - but we've boosted the effectiveness by building and associating memorable characters, interesting audio stories, and built-in quizzing.DOWNLOAD PDFRecommended Picmonics6 Rights of Medication AdministrationThe 6 Right-answers host Administering Medication Sometimes considered 5 or 6 "Rights" the "R's" of medication administration are a systematic approach designed to reduce administration errors. These 6 rights include the right patient, medication, dose, time, route and documentation. Futhermore, nurses are also urged to do the three checks; checking the MAR, checking while drawing up medication and checking again at bedside. It is important to check for allergies as well before administration. Shortly after medication administration, the patient should be assessed, and they should also be educated on what they are given. 10 KEY FACTS Some facilities have differing protocols however it is imperative that the nurse verifies the name on the patient's armband prior to administering any medications. Read the medication label carefully! Be sure to compare the strength, concentration and type of medication to the order. Considerations include only administering a medication that you prepared yourself and being generally familiar with the medication. Compare the dose of the medication to the MAR. Be cautious as many medications come in different strengths based on route and a mistake could prove fatal. The nurse may also have to modify dosing based on weight, age, or variable tests like blood glucose. Some medications have very complex or specific doses and may require a second nurse to sign off. Examples of these medications include Insulin, Heparin, and Chemotherapeutic agents based on protocol. Compare the time the medication should be administered to the current time. Never administer additional or missed doses. Be familiar with abbreviations. Check the MAR to assure the last dose of medication was administered at the appropriate time.
Method of delivery of medications can substantially alter the effects of the drug. Broad classifications include enteral, through the digestive system, and parenteral, directly to the tissues and topical which is applied to the skin. Documentation is key to the nurse’s role. Proper documentation of your medication administration in the MAR is crucial. The "6 Rights" should be implemented at "three checkpoints". First compare the "rights" alongside the Medication Administration Record (MAR) immediately after obtaining it. Second, check the "rights" during medication preparation outside the room, whether this is by mixing, placing a pill into a cup for easier administration or preparing for an IV or injection. Third, check the "rights" again at the bedside before administering the drug to the patient. Developing a regular practice reduces errors. It is crucial to check if the patient has any allergies to the medication prior to administering it. Cross reference by checking the Medication Administration Record (MAR) and asking the patient. You may be required to do certain assessments prior to administering some medications. This may include vital signs, blood glucose, lab values, or a comprehensive assessment. The nurse's role is important in educating the patient on certain side effects a medication might have and drug interactions. Some drugs could have a synergistic effect or an antagonistic effects with other medications. DOWNLOAD PDFTake the 6 Rights of Medication Administration QuizPicmonic's rapid review multiple-choice quiz allows you to assess your knowledge. Picmonic for Nursing RN CoversRegistered Nurse (RN) *Average video play time: 2-3 minutes Our Story Mnemonics Increase Mastery and RetentionMemorize facts with phonetic mnemonics Unforgettable characters with concise but impactful videos (2-4 min each) Ace Your Registered Nurse (RN) Classes & Exams with Picmonic:Choose the #1 Registered Nurse (RN) student study app.Works better than traditional Registered Nurse (RN) flashcards.Safety and Ethics Safe Medication AdministrationSince nurses play a pivotal and hands-on role in all aspects of client care, the responsibility of ensuring client safety during medication administration often lies with them. The following sections summarize safety considerations for medication orders, medication administration, assessment/monitoring after medication administration, and documentation. Safety Considerations – Medication OrdersMedications must be administered in response to an order from a practitioner or on the basis of a standing order that is subsequently appropriately authenticated by a practitioner. All practitioner orders for the administration of drugs and biologicals must include at least the following:
Safety Considerations – Medication PreparationThe following safety considerations were taken from Clinical Procedures for Safer Patient Care by Glynda Rees Doyle and Jodie Anita McCutcheon.[1]
Safety Considerations – Medication Administration The Seven RightsFor the purposes of this textbook, we will discuss the 7 RIGHTS and 3 CHECKS of medication administration. It is important that nurses always follow their hospital and regulatory College policies and guidelines.[2] The 7 RIGHTS are:
These RIGHTS must be checked 3 times for each medication the nurse is administering. The 3 CHECKS are done at the following steps in the administration process:
Many agencies have implemented bar code medication scanning to improve safety during medication administration. Bar code scanning systems reduce medication errors by electronically verifying the “7 rights” of medication administration. For example, when a nurse scans a bar code on the client’s wristband and on the medication to be administered, the data is delivered to a computer software system where algorithms check various databases and generate real-time warnings or approvals. Studies have shown that bar code scanning reduces errors resulting from the administration of a wrong dose or wrong medication, as well as errors involving medication being given by the wrong route. However, it is important to remember that bar code scanning should be used in addition to performing the 7 rights of medication administration, not in place of this important safety process. Additionally, nurses should carefully consider their actions when errors occur during the bar code scanning process. Although it may be tempting to quickly dismiss the error and attribute it to a technology glitch, the error may have been triggered due to a client safety concern that requires further follow-up before the medication is administered. It is important for nurses to investigate errors that occur during the bar code scanning process just as they would do if an error is discovered during the traditional five rights of the medication process. Safety Considerations – Client EducationThe BCCNM Practice Standard for Medication states that “nurses educate the client about the medication they receive, including, as applicable:[3]
The book Preventing Medication Errors by the Institute of Medicine (2007), lists the following additional key actions to include when teaching clients about the safe use of their medications:
A nurse is preparing to administer metoprolol, a cardiac medication, to a client and implements the : ASSESSES the vital signs prior to administration and discovers the heart rate is 48. DIAGNOSES that the heart rate is too low to safely administer the medication per the parameters provided. Establishes the OUTCOME to keep the client’s heart rate within the normal range of 60-100. PLANS to call the physician and report this incident in the shift handoff report. Implements INTERVENTIONS by withholding the metoprolol at this time, documenting the incident of the medication being withheld, and notifying the provider. Throughout the shift, continues to EVALUATE the client’s status after not receiving the metoprolol. While providing client teaching to a client about the medication before discharge, the nurse provides a handout with instructions, as well as a list of the current medications. What other information should be provided to the client? Note: Answers to the activities can be found in the “Answer Key” sections at the end of the book. Safety Considerations – Assessment and Monitoring of Clients Receiving MedicationsClients must be carefully monitored to determine whether the medication results in the therapeutically intended benefit, and to allow for early identification of adverse effects and timely initiation of appropriate corrective action. Depending on the medication and route/delivery mode, monitoring may need to include assessment of:
The nurse should consider client risk factors as well as the risks inherent in a medication when determining the type and frequency of monitoring. It is also essential to communicate information regarding the client’s medication risk factors and monitoring requirements during hand-offs of the client to other clinical staff. Adverse reactions such as anaphylaxis or opioid-induced respiratory depression require timely and appropriate intervention per established protocols and should be reported immediately to the practitioner responsible for the care of the client. An example of vigilant post-medication administration monitoring would be for a post-surgical client who is receiving pain medication via patient-controlled analgesia (PCA) pump. Narcotic medications are often used to control pain but also have a sedating effect. Clients can become overly sedated and suffer respiratory depression or arrest, which can be fatal. In addition, the client and/or family members should be educated to notify nursing staff promptly when the client experiences difficulty breathing or other changes that could be a reaction to a medication.[5] Safety Considerations – DocumentationThe BCCNM outlines documentation requirements for registered nurses in the Documentation Practice Standard. Documentation is expected to occur after the actual administration of the medication to the client; advance documentation is not only inappropriate but may result in medication errors. Proper documentation of medication administration actions taken and their outcomes is essential for planning and delivering future care of the client.[6] A nurse is preparing to administer morphine, an opioid, to a client who recently had surgery.
Note: Answers to the activities can be found in the “Answer Key” sections at the end of the book. Putting it all together…Safe Medication AdministrationNow that you have reviewed the safety requirements and understand that safety is a critical component of medication administration, take some time to review this medication administration checklist from Clinical Procedures for Safer Patient Care by Glynda Rees Doyle and Jodie Anita McCutcheon. This checklist is a useful resource to help you safely administer medications. Consider printing a copy for yourself to take to clinical practice.[7] SAFE MEDICATION ADMINISTRATION
What must the nurse consider when administering a medication?These six rights include the following:. Right Patient.. Right Drug.. Right Dose.. Right Time.. Right Route.. Right Documentation.. What are the 7 factors to consider when administering medication?To ensure safe medication preparation and administration, nurses are trained to practice the “7 rights” of medication administration: right patient, right drug, right dose, right time, right route, right reason and right documentation [12, 13].
What should the nurse know about the medication before administering it to the client?Prior to the administration of medications, the nurse must check and validate the medication order, and also apply their critical thinking skills to the ordered medication and the status and condition of the client in respect to the contraindications, pertinent lab results, pertinent data like vital signs, client ...
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