Remember to complete and verbalize the 7 rights of

MEDICATION ACTIVITY

This is a timed medication administration check off. It is worth 6 points. It is divided into 3 points for clinical

reasoning, being able to correctly identify which meds should be administered, and 3 points for appropriately

administering the medications within a 20 minute time frame. Remember to complete and verbalize the 7 rights

of medication administration.

Review the SBAR you were given. You will find labs/VS/data associated with the patient SBAR. You do not

need to do a new assessment. The assessment data from the information you have been given is accurate. The

time is 0745 and you need to administer the 0800 medications. On the form, list the medications you

administered and list any medications not administered (if any). If there are medications that you did not

administer (based on patient data) please document on the form why the medication was held. In some scenarios

there will be no indications to hold any of the medications. For IVPB infusions document your rate using

ml/hour. For IV Push medications, document your rate of administration broken down into how many mls you

will administer every 15 seconds. You may use your medication book. At the end of the check off, please give

this form to the faculty member.

Student name: ________________________________Section: _______ Date: _______________________

Patient initials: _______ Time began: ____________ Time ended: __________ Points: __________

Faculty: _________________

Points deducted due to:

________________________________________________________________________________________

List Medications Administered

Include ml/hr for IVPB and rate for IV Push

List Medications (if any) not administered: document

rationale for holding medication

Rubric for Medication Activity

This is a timed administration check off and is worth 6 points. It is divided into 3 points for clinical reasoning,

being able to correctly identify which meds should be administered, and 3 points for appropriately

administering the medications within a 20 minute time frame.

Clinical Reasoning: 3 points Medication Administration: 3 points

To receive the full 3 points student must:

Correctly identify which medications should be

administered as ordered. Identify if any medications

should not be administered and provide appropriate

rationale for not administering the medication *

Identify appropriate rate of IVPB/ IVP medications

if meds administered

(Prior to check off, a form will be provided to students to document

the above items)

To receive the full 3 points student must:

Appropriately administer medications, correctly

exhibiting the 7 rights of medication administration

Includes drawing up/administering correct

dose

Verbalizing rights out loud

Correctly utilize appropriate needle/syringe size if

applicable

Follow appropriate steps of cleansing skin/IV hub

prior to medication administration

Administer medication correctly and in appropriate

anatomical site (example: subcutaneous injections)

Incorrectly identifies which medications should be

administered

=0 points

Fails to complete one of the above criteria

=2 points

Identifies incorrect rate of administration for

medications

= 0 points

Fails to complete more than one of the above

criteria

=0 points

Timer will be set for 20 minutes. If timer goes off prior to completion of medication administration,

no points will be award for the administration component of check off. Student may still receive

points for clinical reasoning if criteria in clinical reasoning achieved.

* Nurses must have orders from healthcare providers (HCP) to withhold medications unless indications for

withholding are written into the order. If you do not administer a medication in this medication check off,

faculty will know that communication with the HCP will occur after the check off is completed.

FACULTY GUIDE:

For the patient listed SG there are four scenarios- marked as SG- (for SG1) SG- - (for SG2) SG- - - (SG3) and

SG - - - - (SG4) Forms for students were marked in this manner to ensure students do not pass information to

other students based on initials/numbers. There is a data sheet with VS/Labs and MAR with each SBAR.

For setting up SG simulation you will need NS @75 ml/hr per pump and the following medications.

SG- meds: Zosyn, Cardizem, Lovenox

1 SG- Hold lovenox Creatinine 2.0. Administer Cardizem and Zosyn

2 SG- - Hold Cardizem SBP 98, Pulse 52. Administer Lovenox and Zosyn

3 SG - - - Hold Lovenox, PLT 49,000 and H 8.2. Administer Cardizem and Zosyn.

4 SG- - - - No indications to hold any med. Administer Zosyn, Cardizem, Lovenox

The students will be performing the activity in front of you in a Learning Resource Center room on a

mannequin. Medications, syringes, needles, blunts, IV tubing, etc should be available to students in the room.

This is timed for 20 minutes. Follow the rubric for grading. Students have previously been given the direction

sheet, an example, and rubric on blackboard. They may use a medication or resource book.

Print the SBARs, data sheets, MARs and give the appropriate ones for each scenario to the student. Ensure that

you have stapled the appropriate SBAR/data sheet/MAR together- different actions will be based on VS/labs.

Remind the student of the directions on their form:

Review the SBAR you were given. You will find labs/VS/data associated with the patient SBAR. You do not need

to do a new assessment. The assessment data from the information you have been given is accurate. The time is

0745 and you need to administer the 0800 medications. On the form, list the medications you administered and

list any medications not administered (if any). If there are medications that you did not administer (based on

patient data) please document on the form why the medication was held. In some scenarios there will be no

indications to hold any of the medications. For IVPB infusions document your rate using ml/hour. For IV Push

medications, document your rate of administration broken down into how many mls you will administer every

15 seconds. You may use your medication book. At the end of the check off, please give this form to the faculty

member.

Observe the activity, document on the form, record score and turn in items to faculty leader.

S

SITUATION

Initials/Age/Sex

SG- 85 Male Admit DR.

Smith Room:

333

Adm. Dx: UTI Adm. Date:

Last night at 1900

Consult DR.

Code Status: Full Code Advanced Directive: Y/N

Consult DR.

Surgery Date: Consult DR.

History of this admission: Admitted from Nursing Home last night at 1900

B

BACKGROUND

Past History: Labs/Procedures/Tests:

Allergies: NKA

HTN; COPD; current smoker CBC/ CHEM @ 0600

A

ASSESSMENT

Activity: Up with assist

Weight: (kg) GU Voiding: cloudy yellow, adequate UO

Adm: 75 kg Foley:

Today: I & O:

Trends: Urine:

Neuro

Intact: Alert and oriented Dialysis/access/days:

LOC: Grips: Skin Color/Temp/Turgor: Warm/dry/pink

MAE: PERRLA: Edema: none

CV

Rhythm/Tones: Regular rate and rhythm Braden Scale/Fall Risk:

Metabolic Blood Glucose:

Peripheral Pulses: +2 bilat

Attach Strip with interpretation: sinus rhythm Pain

Lungs

02/02 Sat: 94% RA Meds:

Breath Sounds: CTA Drains/Incisions/Closure Device/Dressings

SMI/PEP: encourage Resp Tx: IV Site Insertion Date

Hanging Adj/gtt Dsg

#1 Right AC Last night

NS @75 ml/hr

GI

Abdomen: Soft, non-tender #2

Bowel Sounds: Positive Last BM: yesterday

#3

NG/FT: PICC/Central

Diet/Appetite: General diet Other Information

R

RECOMMENDATION

To Do or Report: Smoking Cessation

SG-

Today’s am lab

Chemistry and CBC

VS:

1900 2400 0700

ETC

This column:

CBC from

one month

ago

42

2.0

66

99

Room air Room air Room air

0800 DUE

0800 DUE

0800 DUE

0600 New bag hung

TODAY’s EMAR

PT: SG - DOB: 8/26/19__ Allergies: NKA

0200 Given

S

SITUATION

Initials/Age/Sex

SG- - 85 Male Admit DR.

Smith Room:

333


Last night at 1900

Consult DR.


Consult DR.



B

BACKGROUND


Allergies: NKA


A

ASSESSMENT



Adm: 75 kg Foley:

Today: I & O:

Trends: Urine:

Neuro




CV

Rhythm/Tones: Regular rate and rhythm/SB Braden Scale/Fall Risk:




Lungs

02/02 Sat: 94% RA Meds:



Hanging Adj/gtt Dsg

#1 Right AC Last night ETC

NS @75 ml/hr

GI



#3

NG/FT: PICC/Central


R

RECOMMENDATION


TODAY’s EMAR

PT: SG - - DOB: 8/26/19__ Allergies: NKA

SG- -

CBC and Chemistry

from this am

VS:

1900 2400 0700

ETC

CBC from one

month ago

4.8

13.9

39.2


R

o

o

m

a

i

r

98/56

Supine

S

SITUATION

Initials/Age/Sex

SG- - - 85 Male Admit DR.

Smith Room:

333


Last night at 1900

Consult DR.


Consult DR.



B

BACKGROUND


Allergies: NKA


A

ASSESSMENT



Adm: 75 kg Foley:

Today: I & O:

Trends: Urine:

Neuro




CV





Lungs

02/02 Sat: 94% RA Meds:



Hanging Adj/gtt Dsg

#1 Right AC Last night ETC

NS @75 ml/hr

GI



#3

NG/FT: PICC/Central


R

RECOMMENDATION


TODAY’s EMAR

PT: SG- - - DOB: 8/26/19__ Allergies: NKA

Hold for Systolic BP <100

SG- - -

Today’s am lab

Chemistry and CBC

3.2

8.2

25.1

80.2

49

VS:

1900 2400 0700

ETC


S

SITUATION

Initials/Age/ Sex

SG- - - - 85 Male Admit DR.

Smith Room:

333


Last night at 1900

Consult DR.


Consult DR.



B

BACKGROUND


Allergies: NKA


A

ASSESSMENT



Adm: 75 kg Foley:

Today: I & O:

Trends: Urine:

Neuro




CV





Lungs

02/02 Sat: 94% RA Meds:



Hanging Adj/gtt Dsg

#1 Right AC This am in ETC

NS @75 ml/hr

GI



#3

NG/FT: PICC/Central


R

RECOMMENDATION


TODAY’s EMAR

PT: SG - - - - DOB: 8/26/19__ Allergies: NKA

SG- - - -

Today’s am lab

Chemistry and CBC

Documents

Remember to complete and verbalize the 7 rights of