The common saying goes: “to err is human.” As a nurse, making mistakes is bound to happen, but in healthcare mistakes may carry heavier consequences than in other work environments. And in the world of healthcare, there is the added the worry of malpractice suits against nurses or physicians that have made a mistake, not to mention lives hanging in the balance.
One of the most common mistakes made in nursing is medication errors. The consequences of a medication error can be critical and long-lasting. As such, it is especially important to follow medication guidelines to eliminate the chances of mistakes. Many medical institutions use a scanner system that nurses use when giving medication that is meant to prevent medication errors. However, those are not always available and can make errors. To safeguard both nurses and patients, nurses use the “five rights of medication administration” when administering medications. They are easy to remember, and following them adds a layer of medication error prevention.
When a nurse gives a medication to a patient, it is imperative that the patient receives the correct medication. Nurses should double and triple check the medication orders (MAR), making note of both the generic and brand name of the medication. When the medication is retrieved, the nurse should check that the labeled name against that on the medication order. Giving the wrong medication to the patient can have numerous adverse effects, many of which cannot be predicted due to the patient’s particular medical history. When in doubt, ask for advice or help with making sure the medication on the order and the medication retrieved match exactly.
Once you the correct medication has been retrieved, the nurse needs to make sure they are giving it to the right patient. The nurse should verify the patient’s identity using a couple of different forms of identification. The room and bed number can be helpful in identifying patients, but it is not foolproof. The recommended practice of patient identification includes asking the patient their name and date of birth and comparing that to their ID band and the chart. If the patient cannot state their name and date of birth correctly, the nurse should check the patient’s ID band against the chart.
When the nurse has located the right mediation and the right patient, the next step is to make sure the dose is correct. To do this, the medication packaging will be double-checked with the order. Nurses should check when the medication is retrieved and again when it is administered. Getting the dosage correct is absolutely vital; an incorrect dosage can have devastating effects and lead to serious problems or even death.
The timing of medication administration needs to be followed exactly according to the orders. As such, the nurse should pay special attention to the times of day each patient needs their medication. This will help determine the order in which medications should be administered. As a general rule, medications can be given 30 minutes before and 30 minutes after the scheduled time and still be considered “on-time”. Additionally, PRN medications do not have a specific administration time and it is the nurse’s duty to make sure doses are not given too close together.
The route refers to the physical method of administering medications. Medications may be given orally, parenterally, topically, enterally, by inhalation, or by intermuscular injection. Many medications have different versions that can be administered in several different ways depending on the needs and specifications of the patients. The nurse should ensure they understand how the medication should to be administered along with whether or not it is the best option for the patient.