1. Gather equipment. Check each medication order against original physician’s order according to agency policy. Clarify any inconsistencies. Check patient’s chart for allergies.
  2. Know actions, special nursing consideration, and adverse effects of medications to be administered.
  3. Perform proper hand hygiene.
  4. Move medication cart outside patient’s room or prepare for administration in medication area.
  5. Unlock medication cart or drawer.
  6. Prepare medications for one patient at a time.
  7. Select proper medication from drawer or stock and compare with Kardex or order. Check expiration dates and perform calculations if necessary.
    1. Place unit dose-package medications in a disposable cup. Do not open wrapper until at bedside. Keep narcotics and medications that require special nursing assessments in a separate container.
    2. When removing tablets or capsules from a bottle, pour the necessary number into bottle cap and then place tablets in a medications cup. Break only scored tablets, if necessary, to obtain proper dose.
    3. Hold liquid medication bottles with the label against palm. Use appropriate measuring device when pouring liquids and read the amount of medication at the bottom of the meniscus at eye level. Wipe bottle lip with a paper towel.

8.      Recheck each medication package or preparation with the order as it is poured.

9.      When all medications for one patient have been prepared, recheck once again with the medication order before taking them to patient.

10.  Carefully transport medications to patient’s bedside. Keep medications in sight at all times.

11.  See that patient receives medications at the correct time.

12.  Identify the patient carefully. There are three correct ways to do this.

a.       Check name on patient’s identification bracelet.

b.      Ask patient his or her name.

c.       Verify patient’s identification with a staff member who knows patient.

13.  Complete necessary assessments before administration of medications. Check allergy bracelet or ask patient about allergies. Explain purpose and action of each medication to patient.

14.  Assist patient to an upright or lateral position.

15.  Administer medications.

a.       Offer water or other permitted fluids with pills, capsules, tablets, and some liquid medications.

b.      Ask patient’s preference regarding medications to be taken by hand or in cup and one at a time or all at once.

c.       If capsule or tablet falls to the floor, discard it and administer a new one.

d.      Record and fluid intake I-O measurement is ordered.

16.  Remain with patient until each medication is swallowed unless nurse has been patient swallow drug, she or he cannot record drug as having been administered.

17.  Perform hand hygiene.

18.  Record each medication given on medication chart or record using required format.

a.       If drug was refused or omitted, record this in appropriate area on medication record.

b.      Recording of administration of a narcotic may require additional documentation on a narcotic record stating drug count and other specific information.

19.  Check on patient within 30 minutes of drug administration to verify response to medication.


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