Principles of drug Administration and ordering of drugs

Mr. Manasseh MvulaBSc.N IV student -UNZA

At the end of this lecture, a student should have knowledge on the principles of drug administration and ordering of drugs

General objective

Define a principleOutline principles of drug

administrationState the principles of ordering of drugsList common medication errors that can

be prevented by following principles of drug administration.

Specific objectives

Principles of drug administration can be described as what nurses should ensure before administering any drug.

Basic requirements for accurate drug administration, called the “5 rights”, require knowledge of the drugs to be given and the clients who are to receive them as well as well as specific nursing skills and interventions.

Introduction

A principle is a basic generalization that is accepted as true and that can be used as a basis for reasoning and conduct (Wordweb English Dictionary, 2012).

Definition

Principles of drug administration include Traditional “five rights” + “five additional

rights” of drug administration, Guidelines for correct administration of

medications, and routes of drug administration.

Principles of drug administration

By right client, a nurse must always verify the client by checking the identity.

Verification of a client can also be done by having the client state his name and by distinguishing clients with the same names.

Right client

Calls for a nurse to discriminate carefully among similar sounding names for e.g digoxin and desoxyn- all having similar-sounding names but are two different drugs.

A medication order may be prescribed by many health care staff like the physician, pharmacist, dentist and nurses.

Right drug

Therefore, a nurse giving medication should ensure that the drug is complete and legible.

A nurse must know general purpose of action, dosage and route of administration.

Cont’d

It is important also to compare drug cards

with drug label at least three times, that is, at a time of contact with the drug bottle or container, before pouring the drug, and after pouring the drug.

Anytime the patient comments that the drug seems unusual, the nurse should recheck the drug name and strength.

Cont’d

To ensure right dose, the nurse must be able to calculate and check the drug dose accurately.

The nurse can also check the drug package insert or drug handbook for recommended range of specific drug.

It is important to have the presence of another nurse when you are checking the dose of the drugs like IV digoxin, heparin, and insulin.

Right dose

Time in drug therapy is of essence. Thus, a nurse administering drugs must be done at specific times.

Drugs that are affected by food are to be given before meals and similarly drugs that can irritate the stomach are to be given with food.

Right time

Adjust the drug administration to fit the schedule of client’s life style, activities and diagnostic procedures.

Before administering a drug a nurse must check the expiration date.

Antibiotics are to be strictly given at even intervals.

Cont’d

A nurse must assess the ability of a patient to swallow before giving oral medications.

A patient should be instructed not to crush or mix medications in other substances before consulting with the physician or pharmacist.

Right route

The use of aseptic technique when administering the drug is advised.

Nurses should ensure that the drug is administered at appropriate sites and must ensure that the client has swallowed oral drugs by staying with them a bit longer or by talking to them.

Cont’d

Right assessment Right documentation Right to education Right evaluation Right to refuse

“five” additional rights

It may be illegal for a nurse to give medication which has not been written or signed for by the prescriber.

Telephone orders are not recommended as they can easily be miscommunicated, misinterpreted or not clearly heard and such an order often remains unsigned by the prescriber for a long time.

Principles of ordering drugs

Telephone orders should only be taken during an emergency of which the prescriber should sign all orders as soon as possible. This cannot be done by student nurses.

For orders that are not complete in medication name, dosage, route, time or signature must be clarified with the prescriber and completed before administration.

Cont’d

Although, it is the right and responsibility of the nurse and the student nurse to question any proposed action that is potentially harmful to the client/patient, nurses must realise that it is illegal to change an order by modifying any part of it without consulting the prescriber.

Cont’d

Administration of wrong medication and IV fluids.

Incorrect dose or rate Administration to the wrong patient Incorrect route Incorrect schedule interval Administration of known allergic drug or IV

fluids Omission of dose or discontinuation of the

medication that was not supposed to be discontinued.

Common medication errors

A principle is a basic generalization that is accepted as true and that can be used as a basis for reasoning and conduct.

In pharmacology, there are principles of drug administration which include the traditional “5 rights” + “5 additional rights” of drug administration

These principles exist to ensure accurate medication administration and to prevent common medication errors.

Take Home points

Any questions?

What is a principle? Which principles should be followed when

administering drugs? What are some of the common medication

errors that can be prevented with observance of principles of drug administration?

Can you remember?

Read and write brief notes about the types of drug orders.

Assignment

Clayton et al (2007) Basic Pharmacology for Nurses, 14th edition, St Louis Missouri.

Kee J.L., Hayes E.R., McCuistion L.E (2006), Pharmacology- A Nursing Care Approach,5th edition, Elsevier Mosby, Philadelphia.

Williams B.R., Baer C.L (1998), Essentials of Clinical Pharmacology in Nursing, 3rd edition, Elsevier, Pennsylvania

Pharmacology for Nursing Practice Module- content mastery series (2003), 2nd edition, Assessment Technologies Institute,

References

End of LectureHave a Blessed Day