2.1 Drug Administration and the Nursing Process

Medication administration is a critical nursing responsibility that requires a systematic approach and keen clinical judgment. The nursing process provides a framework for safe and effective drug administration, encompassing assessment, diagnosis, planning, implementation, and evaluation.

Nurses must adhere to the "rights" of medication administration, including right patient, drug, dose, route, time, documentation, reason, and response. Patient education, medication safety strategies, and continuous monitoring are essential components of quality medication management in nursing practice.

Nursing Process and Medication Administration

Steps of nursing process in drug administration

Top images from around the web for Steps of nursing process in drug administration

• 

  10.4 Nursing Process for Analgesics and Musculoskeletal Medications – Nursing Pharmacology View original

  Is this image relevant?

• 

  The Complete Subjective Health Assessment View original

  Is this image relevant?

• 

  The Nursing Process - Nursing Program Guide - LibGuides at Western Technical College View original

  Is this image relevant?

• 

  10.4 Nursing Process for Analgesics and Musculoskeletal Medications – Nursing Pharmacology View original

  Is this image relevant?

• 

  The Complete Subjective Health Assessment View original

  Is this image relevant?

1 of 3

Top images from around the web for Steps of nursing process in drug administration

• 

  10.4 Nursing Process for Analgesics and Musculoskeletal Medications – Nursing Pharmacology View original

  Is this image relevant?

• 

  The Complete Subjective Health Assessment View original

  Is this image relevant?

• 

  The Nursing Process - Nursing Program Guide - LibGuides at Western Technical College View original

  Is this image relevant?

• 

  10.4 Nursing Process for Analgesics and Musculoskeletal Medications – Nursing Pharmacology View original

  Is this image relevant?

• 

  The Complete Subjective Health Assessment View original

  Is this image relevant?

1 of 3

• Assessment (nursing assessment)
  • Collect patient data relevant to medication administration includes medical history, allergies, and current medications
  • Review medication orders and prescriptions verifies accuracy, appropriateness, and completeness
  • Assess patient's understanding of medication regimen determines their knowledge, beliefs, and concerns
  • Identify potential drug interactions or contraindications screens for possible adverse effects or incompatibilities (warfarin and vitamin K)
• Diagnosis
  • Identify potential or actual problems related to medication therapy such as non-adherence, adverse reactions, or ineffectiveness
  • Determine patient's readiness to learn about medications assesses their cognitive, emotional, and physical ability to receive education
• Planning
  • Develop a plan for safe and effective medication administration includes specific steps, timelines, and monitoring parameters
  • Collaborate with healthcare team to ensure appropriate medication therapy involves physicians, pharmacists, and other professionals (multidisciplinary rounds)
  • Establish patient education goals and strategies tailors teaching to individual needs, preferences, and learning styles
• Implementation
  • Administer medications according to the "rights" of medication administration ensures accuracy and safety at each step
  • Provide patient education about medications explains purpose, dosing, side effects, and precautions (teach-back method)
  • Monitor patient for therapeutic effects and adverse reactions assesses response, identifies problems, and adjusts therapy as needed
• Evaluation
  • Assess patient's response to medication therapy determines effectiveness, adherence, and satisfaction
  • Evaluate effectiveness of patient education measures knowledge, skills, and confidence in self-management
  • Modify medication plan as needed based on patient outcomes involves adjusting doses, switching medications, or discontinuing therapy (deprescribing)

Clinical judgment for medication safety

• Critically analyze medication orders and prescriptions for appropriateness reviews indication, dose, route, frequency, and duration (IDRF)
• Consider patient-specific factors when administering medications
  • Age, weight, and health status impact pharmacokinetics and pharmacodynamics (pediatric dosing)
  • Allergies and sensitivities require avoidance or premedication (penicillin allergy)
  • Comorbidities and concurrent medications affect drug interactions and side effects (renal impairment)
• Recognize and respond to potential medication errors or adverse events identifies risk factors, implements prevention strategies, and reports incidents (barcode scanning)
• Collaborate with healthcare team to ensure safe and effective medication therapy communicates concerns, seeks guidance, and coordinates care (pharmacy consult)
• Perform medication reconciliation to prevent discrepancies and ensure continuity of care

Principles of safe drug administration

• Verify the "rights" of medication administration before each dose confirms patient, drug, dose, route, time, documentation, reason, and response
• Follow proper infection control and aseptic technique prevents contamination and transmission of microorganisms (hand hygiene)
• Double-check high-alert medications with another qualified healthcare professional reduces risk of errors with potentially harmful drugs (insulin)
• Administer medications at the correct time and frequency ensures consistent therapeutic levels and avoids toxicity or ineffectiveness (antibiotics)
• Document medication administration accurately and completely provides legal record and communicates with other providers
• Monitor patient for therapeutic effects and adverse reactions assesses response, identifies problems, and adjusts therapy as needed
• Educate patients about their medications and the importance of adherence promotes understanding, self-management, and optimal outcomes (pill organizers)

Rights of medication administration

1. Right patient: Verify patient identity using at least two identifiers such as name, birthdate, or medical record number
2. Right medication: Confirm medication name, dose, and route matches the order and is appropriate for the patient
3. Right dose: Administer the correct amount of medication as prescribed, considering any necessary calculations or conversions (metric system)
4. Right route: Administer medication via the prescribed route such as oral, intravenous, or topical (transdermal patches)
5. Right time: Administer medication at the correct time and frequency as ordered, considering absorption, peak levels, and duration of action
6. Right documentation: Record medication administration accurately and completely in the patient's medical record, including date, time, dose, route, and response
7. Right reason: Confirm the appropriate indication for the medication and that it aligns with the patient's diagnosis, symptoms, and goals of care
8. Right response: Monitor patient for desired therapeutic effects and adverse reactions, documenting findings and communicating with the healthcare team

Strategies for medication education (patient education)

• Use plain language and avoid medical jargon facilitates understanding and reduces confusion (layperson terms)
• Provide written and verbal instructions accommodates different learning styles and serves as a reference (handouts)
• Encourage patients to ask questions and express concerns creates a safe, open environment for dialogue and clarification
• Discuss the purpose, benefits, and potential side effects of each medication promotes informed decision-making and adherence (risk-benefit analysis)
• Explain proper storage, handling, and disposal of medications prevents degradation, contamination, and accidental ingestion (childproof containers)
• Emphasize the importance of medication adherence and proper administration technique optimizes effectiveness and safety (pill cutters)
• Involve family members or caregivers in patient education when appropriate enhances support, monitoring, and assistance with medications
• Assess patient understanding through teach-back methods confirms comprehension and identifies areas for reinforcement or re-teaching
• Provide resources for additional information and support empowers patients to actively participate in their care (reliable websites)

Medication Safety and Monitoring

• Identify and report adverse drug reactions promptly to ensure patient safety and adjust treatment plans
• Implement strategies to improve medication adherence, such as simplifying regimens or using reminder systems
• Utilize therapeutic drug monitoring to optimize dosing and minimize toxicity for certain medications
• Implement safeguards to prevent medication errors, including double-checks and technology-assisted verification