Hello Everyone and Welcome to My blog for this week Module 4

            For this week’s blog, I will take a closer look into the steps I take as a nurse during the medication administration process. It is quite surprising that daily I administer medication to my patients but never take an in-depth look into the process and steps until now. Administering medication has become apart of my daily routine as a nurse; second nature, so it is vital that I examine if I am following the right steps in medication administration.

            According to the College of Nurses of Ontario [CNO], 2019), the medication practice standard describes nurses ‘accountabilities when engaging in medication practices, such as administration, dispensing, medication storage, inventory management and disposal (p.3). Authority, Competence, and Safety are three principles outlined by the CNO, which promotes public safety (CNO, 2019).

Nurses: 

• ensure their medication practices are evidence-informed
• assess the appropriateness of the medication practice by considering the client, the medication and the environment
• know the limits of their knowledge, skill, and judgment, and get help as needed
• do not perform medication practices that they are not competent to perform.

(CNO, 2019, p.4).

            Currently, I work on the Complex Continuing Care and the Slow Stream Rehab unit. Medication administration time normally range from 08:00am, 10:00am, 12:00, 13:00 hours 1600 hours, 1800, 2100 hours. If the patient has a new order by the physician, the chart is flag with a label called Md order, but for safety, it is the nurse’s responsibility to check the patient chart. On a given day, my patient workload is 4-5 patient on day shift and 6-7 on evening shift/or twelve-hour shift.  Once it has been determined there is no new order; I will complete my first rounds to ensure my patients are safe, breathing, and obtain their vital signs and blood sugar reading if needed. I then proceed with my medication administration. For some medication, it requires taking the patient pulse or blood pressure before administering the medication. If the patient reading is not within the range specified by the MD, I will hold the medication and document and monitor the patient.

            The medication cart each has the patient room number, no names on the cart for confidentiality reasons. Each nurse has a code to get into the medication cart and another code for the narcotics. The treatment cart with prescribed creams or dressing if the patient has an ulcer is different. Currently, my place of employment use electronic mar sheet; the patient picture is shown on the patient mar sheet. Administering medication requires the nurse to be focus and ensuring the rights of medication administration are being followed., I read an interesting article which I wanted to share regarding medication administration. A research was conducted and showed (87.5 %) of the medications have documentation error, followed by technique error 263 (73.1 %) and time error 193 (53.6 %) (Fathi et al., 2017). Significantly associated with medication administration error include nurses between the ages of 18–25 years (Fathi, 2017).  I have created a medication flow chart. Please see below.  

Reference

College of Nurses of Ontario. (2009). Medication.  Retrieved from https://www.cno.org/globalassets/docs/prac/41007_medication.pdf

Fathi, A., Hajizadeh, M., Moradi, K., Zandian, H., Dezhkameh, M., Kazemzadeh, S., & Rezaei, S. (2017). Medication errors among nurses in teaching hospitals in the west of Iran: what we need to know about prevalence, types, and barriers to reporting. Epidemiology and health, 39, e2017022. doi:10.4178/epih.e2017022