Administration Safety PHCL 492

Standards for Medicines Management  ‘When required to administer medication a practitioner is accountable for his or her own actions and omissions. The practitioner must satisfy himself or herself, they have the necessary information to ensure the safe administration of the medicine. This will include access to the patient’s record in addition to information about the medicine to be administered’ (NMC, 2007).

Authorization to administer  The first principle in the administration of a medication is the ‘authority’ to administer and identification of the appropriate authority for the clinical situation you are working in.

Authorization to administer  Prior to the administration of medicine health professional must have access to one of the following:  A Patient Specific Direction (PSD) including a patient medicines administration chart  Patient Group Direction (PGD)  Medicines exemptions (paramedics, midwives and occupational health nurses)  Homely medicines (General Sales List and Pharmacy Only medicines

Obtaining Patient Information  Age, weight and height  Diagnosis  Pregnancy and lactation status  Allergies  Current medications

Administration of medication  Identifying the patient  Check that you have the correct patient  Check the name of the patient against the documentation giving authority to administer  Ask the patient their name  Check the patient’s identity against the identification bracelet or barcode if available

Administration of medication  Ensure that the patient is ready to receive the medication  Medication should not be prepared in advance and left for the patient to take or for another professional to administer  Check that, prior to preparing the medication, you have all the equipment required

Administration of medication  Check the medication  Name of the medication  Right formulation of the drug and route of administration  Strength of the preparation  Right dose of the drug to be administered  Frequency of administration  Expiry date of the medicine  Visibly check the product (where appropriate) for any contamination

Drug and Dosing Information  Access to reliable drug info resources  Typical dose and route of administration for new drug recently added to formulary  The compatibility of piggyback medication with primary IV solution  The typical dosing of mg/kg for common analgesic for pediatric patient  The dose conversion between IV and PO medications  The rate of IV push or infusion  Wither the medication can be crushed

Preparing medication prior to administration  All medication should be prepared in line with the recommendations from the manufacturers  Tablets should not be handled, as the contamination may alter the coating of the medication  Tablets should not be crushed unless this has been identified as a suitable method of administration of the medicine  Capsules should not be split unless it has been identified as a suitable method to administer the medication  If liquid medications are being administered and a syringe is being used, the correct equipment should be used

Preparing medication prior to administration  Proper training and competency assessment before:  Withdrawing solution from an ampoule into a syringe  Withdrawing a solution or suspension from a vial into a syringe  Reconstituting powder in a vial and drawing the resulting solution or suspension into a syringe  Adding a medication to an infusion  Diluting a medication in a syringe for use in a pump or syringe driver

Post-administration of medication  Monitoring the patient  Continually evaluate patient to ensure safety and quality  The need for follow-up blood tests/ monitoring  The need to withhold other medication  The need to complete the course of medication  How any unused medication must be safely disposed for the individual and the wider community

Record keeping  Once medication dose has been administered should be documented in MAR  If a medication is omitted, there must be a clear rationale provided in the patients’ records

Reporting errors / incidents  Practitioner must ensure they have reported the error and adverse event in accordance with organizational policies  This may include the reporting to  Organization safety officer  SFDA

Safety for staff  The practitioner administering the medication must be aware of any necessary precautions for protection against the medication being administered  This may include:  the use of protective clothing  the medication being prepared in a specific environment  reducing the risk of needle stick injury

Summary  Practitioners must ensure they have an up-to-date clinical and pharmaceutical knowledge base to administer medication safely  They must be competent with techniques for administration and with the equipment to be used in the administration process  They must be encouraged to acknowledge limitations in knowledge and be encouraged to undertake additional updating as required  Practitioners must be encouraged to question any aspect of the administration process if they are unclear