The intended use of medications is meant to improve a person’ health, it is very important the individual administering medication or self-medicating use the drugs correctly, by following the doctors’ instruction for the medication prescribed. Medication is given to diagnose, treat, and prevent illness. Medication can be very dangerous, which can potentially cause harm or even deaf if it’s not used properly. Administering medication requires the understanding of how the medication is to enter the body such as orally, transdermal, or intravenous. It also requires the knowledge of when the medication needs to be administered, the possible side effects, and its toxicity. Doctors, nurses, and a few other professionals are trained and licensed to safely give medication and it is imperative they do it without harm. Training for professionals also includes proper storage, handling, and disposal of the drugs. Nursing responsibilities for drug administration includes the Three Checks and the Rights of Medication Administration. The nurse also has the responsibility of the medication to be given. Before administering any medication, rather the medication is known or unfamiliar it is the issuer responsibility to know about or why the medication is to be given. Knowing the mode of action will ensure that the medication given is appropriate for the patient’s diagnosis.
It’s also the nurse responsibility to know the side effects of and the contraindications for the medication, as well as the antagonist, safe dosage range, interaction, with other drugs, precautions to take before administering, and the proper administration techniques. The Three Checks states that the label on the medication package or container to be given should be checked three times during the preparation and administration. First check, read the label when reaching for the medication. Second, after retrieving medication from the drawer and compare it to the CMAR. And thirdly, read the label when replacing the medication or before giving the unit dose medication to the patient. Medication error is due to the wrong drug, the wrong timing, the wrong dose, and the wrong route. According to the Food and Drug Administration (FDA 2009), the wrong route of administrating medication accounts for 1.3 million injuries each year.
An article published in September issue of the Journal of Patient Safety estimates there are between 210,000 and 400,000 deaths per year associated with medical errors. This makes medical errors the third leading cause of deaths in the United States, behind that comes heart disease and cancer. To prevent medical errors always follow the Three Checks and most importantly the Rights of Medication Administration. The “Rights of Medication Administration” helps to ensure accuracy when administering medication to a patient. When administering medication the administer should ensure they have the Right Medication, Right Patient, Right Dosage, Right Route, Right Time, Right Route, Right Reason, and Right Documentation. Also remember the patient has the right to refuse, assess patient for pain, and always assess the patient for signs of effects.
Medication administration is not just giving medicine to a patient; it also involves observation of how the patient responds to the drug after administration. As a nurse or health professional we’re trained to know medication effects. Knowing how medication move through the body and what effects the medication has or what adverse effects may occur is most important when preventing medication errors. Medication mishaps can occur anywhere in the distribution system such as monitoring, administering, dispensing, repacking, or prescribing. The most common cause of errors occur when administering a drug happens when there is poor communication, problems reading directions, medical abbreviations or hand writing misunderstood, poor procedures or teachings, job stress (most common), and lack of product knowledge.
It is difficult to reduce or eliminate medication errors completely when information is absent, inaccurate, contradictory, or simply not reported. It is not exact that every medication error will cause harm, but think about the undetected errors that will. The undetected errors administering medication makes assessing the effectiveness of medications errors challenging and hard to prevent. Any nurse that has made a drug error knows how stressful the situation can be. The increasing demands and the amount of patients during work load can increase the chances to drug errors. Being overworked can affect concentration and competence, which can be exacerbated by erratic working hours and stress, while complacency can also lead to mistakes. While nurse fatigue is commonly cited caused of drug errors, others include illegible physicians’ handwriting. Drug errors also miscalculations, over-dosing and under-dosing. Checking calculations and identifying any shortfall in your knowledge is a qualified ensures to keep from making a mistake.
In 1995, the FDA established the black box warning system which alert the prescribers to drugs or drug products with increased or serious adverse reactions or potential safety hazards, or those that may cause serious harm or death. It appears on the prescription drug label to call attention to the seriousness or life-threatening risks of the drugs being used. Before a drug can be used in the United States, the drug manufacturers and other research organization that develops a drug must show the FDA results of testing of the drug developed before it used by patients. The Barcode Medication Administration system (BCMA) is an electronic program used by the nursing department.
The nurse is able to validate and document the administration of medications by using a computer and barcode scanner, which is linked by a wireless network to the electronic MARS. BCMA is an integral part of the health record; all information is documented with a time stamp for improved accuracy of clinical information. An alert is sent if the scanned medication does not match the medication order for the patient. Another method used is automatic medication dispensing system, which are computerized systems that allow nurses to access client medication by using a password to enter the system. The computer controls and manages the distribution of drugs.
1. Comprehensive Nursing Care, Revised 2nd Edition. (2012). Ramont, Reberta P.; Niedringhaus, Dolores M.; Towle, Mary A. 2. Medication Error Reports. (2009). Food and Drug Administration. Retrieved May 19, 2013, from www. Fda.gov/Drug Safety/Medication Errors 3. Medication errors, handoff process and information quality. Chiru, Alina M; Baxter, Ryan. Business Process Management Journal 19.2, (2003): 2011-2016