10 R’s in Giving Medication

As nurses, our job description involves a number of tasks that we must be able to fulfill to ensure quality of care and to aid our patients towards the betterment of their health. They may range from the simplest to the most complex of activities, yet, it is most important that we do them correctly and accurately since even a single mistake can bring about consequences that may complicate the patient’s condition rather than help better it.

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One of those many tasks a nurse must be able to fulfill satisfactorily in the clinical setting is giving of medications. This may seem too mainstream to others, while there are also nurses who find joy whenever they get to administer medications. Some newly Registered Nurses even become too excited upon holding a medication-filled syringe thinking it’s their first time ever to administer it. It gives them pride and makes them really part of the nursing profession. Some nurses, especially those who’ve been in the profession for countless years already and those assigned in busy wards tend to find giving medications a hassle as it is time consuming and adds to their workload. Some do it quickly just to get over with it, while some risk delegating the task to their subordinates just to lighten their burden. They tend to overlook the true essence of giving medications that they focus more on other tasks at hand, forgetting that even a simple task as giving medicines requires a critical mind and a body of clinical knowledge to do it appropriately.

  1. Right Drug

Check first if it’s the right drug and form. There are drugs that look and sound alike. Don’t confuse yourself and give the wrong medication.

  1. Right Patient

Before you administer, ask first the name of the patient. Don’t just settle with the yes/no/nods/shakes head answer. Go with the patient stating his/her full name since misunderstandings can result from the “You’re patient X, right?” type of answer. There may be cases wherein the patient doesn’t really understand what you’re saying and just tend to nod in agreement to show that he/she somewhat understands you when he/she really doesn’t. You may also check the patient’s identification band located at the wrist.

  1. Right Dose

Consult the medication card, medication sheet and doctor’s orders first before administering the drug. Check if it matches the others. Pediatric and adult doses may differ. If you get confused on the dosage, ask first. Consult with the ordering physician. With that, you may be able to prevent under and overdosing your patients.

  1. Right Route

Check the order if it’s oral, IV, SQ, IM, etc.. Danger may also come from administering the right drug yet at the wrong route. Take for example injecting a drug that should be administered orally.

  1. Right Time and Frequency

You must also check the order for the time when it is scheduled to be given and when was the last time it was given. You have to observe the right intervals and prevent overdose.

  1. Right Documentation

Make sure that you document your activities correctly. Sign in the medication sheet with the time when you administered the drug and your signature. Document it also in your nurses notes whether or not you have given the drug. If you haven’t, state the rationale on the action. This will come in handy when time comes when a patient decides to sue you or the hospital. Also, this is to prevent misunderstandings among the health care team whether or not you have given the meds and on what time you have given it, it will also prevent overlapping.

  1. Right History and Assessment

This is particularly important since there are patients who are allergic to some drugs. Check first the patient’s records for documented allergies before administering it. You may also get to perform skin testing when administering IV antibiotics for the first time. It is important that you note and observe the patient for some reactions.

  1. Right to Refuse

Yeah, we know. Our aim is for the well being of our patients, but we must also take note that though we have good intentions in mind, there are patients who would want to refuse treatment as well as medications. We must respect their right and allow them with enough autonomy to refuse to the medication after thoroughly explaining the effects.

  1. Right Drug-Drug Interaction and Evaluation

We should be aware of the medicine’s interaction with other drugs, avoiding drug intoxications. Review first any medications previously given or the diet of the patient that can defer a bad interaction to the drug to be given.

  1. Right Education and Information

Let us not just administer the medication then leave with our patients confused on why we gave him/her that specific drug. It is the patient’s right to know what drug he/she is receiving and their expected therapeutic and side effects.

 

For years, we have been educated in nursing school on what roles and procedures we are expected to perform when we take hold of that precious license to practice and fulfill our crucial role in the hospital setting. In those years, we were taught its implications, when and how to do it. We have undertaken subjects and concepts that help us understand the profession more thoroughly as well as how important our role is when it comes to dealing with lives. Over the years, nurses have become too focused on getting a number of tasks done within and 8-hour frame that sometimes they tend to give attention to other important aspects of nursing care. At this time, let us not forget our purpose being nurses, which is to save people’s lives and that by neglecting other nursing duties, we are also welcoming the probability of errors that may harm our patient’s instead of helping them. It just takes a little time from our already busy schedule, but with that little time comes the assurance that what we are doing is right and what we deliver is quality nursing care.

Liane Clores, RN MAN

Currently an Intensive Care Unit nurse, pursuing a degree in Master of Arts in Nursing Major in Nursing Service Administration. Has been a contributor of Student Nurses Quarterly, Vox Populi, The Hillside Echo and the Voice of Nightingale publications. Other experience include: Medical-Surgical, Pediatric, Obstetric, Emergency and Recovery Room Nursing.

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