6.1. Medication administration procedures
A method used during medication administration to safeguard the clients; before administering the medication the QMAP must ask self-six questions – Am I giving the medication to the right client? Am I giving the right medication? Am I giving the right dose? Is this the right route? Is this the right time? Have I done the right documentation?
1. Right Client: – Asking a client his/her name, etc. It is important to identify the right person when administering medications. An example of this might be referring to the photograph inside the record, and/or having the person state his/her name if possible. It is imperative that the “right person” has been identified prior to administering medications. Most common method used for identifying clients before administering medications is photographs of clients in the medication administration record (MAR). Photos should be kept updated and photograph is to have the name of the client on it.
2. Right Time – when the client is ordered to receive the medication. Your agency should have a policy in place that provides a time frame for which it is acceptable to give medications (for example: 60 minutes before or 60 minutes after the scheduled time).
Timing of Medication Administration
- Important to understand timing in relation to administering medications, i.e., insulin and medications ordered to be administered on an empty stomach or in relation to meals
Timing of medications in relation to meals
- Before meals – medication generally administered within 30 minutes prior to the client eating meals;
- With meals – medication generally administered when the client is eating meals or right after finishing meals;
- After meals – medication administered after the client has finished eating meals up to 30 minutes afterward. Clients in the facility during the medication pass should receive their medications within a window of time one hour prior to and one hour after the scheduled administration time on the MAR, except in the case of medications prescribed for administration in relation to meals or medications such as insulin If unsure about giving a medication because it is outside the designated time frame;
- Contact a supervisor or a health care professional regarding the administration of the Client’s medications or to determine if prescribing practitioner should be contacted;
- The medication should not be omitted without contacting a supervisor or a health care professional or prescribing practitioner
Please note: For non-time, specific medications the facility may designate a timeframe or use “am” and “pm” (for the time slots on the MAR) as long as the information is included within their policies and procedures.
3. Right Medicine – the name of the medication ordered by the physician; always use the three checks Giving the right medication to the right person is imperative for safety. Ensure that the medication label coincides with the Medication Administration Record. Cross-check the label on the medication container with the MAR and the physician order three times. Once as the medication is taken off of the shelf, once as the medication is being poured and again when the medication is returned to the storage area.
4. Right Dose– the amount of medication ordered. Read the label on the medication container and compare it to the transcribed order. Pay close attention to the dosage amount.
5. Right Route– the method of medication administration. Read the label on the medication container and compare it to the transcribed order. Pay close attention to the route. Ensure that ear (otic) drops are never given in the eye.
6. Right Documentation– the process of writing down that medication was administered to the resident on the MAR and writing down if a medication ordered was not administered and the reason it was not administered Each medication must be documented when it is given. If a medication has been given, and it has not been documented that it was given, the process for administration is incomplete. This has the potential of causing a serious medication error, (overdosing) if the medicine were to be re-administered. It is very important to remember once the medication has been administered you should initial in the area indicated on the Medication Administration Record. Inaccurate medication counts are also considered as incomplete documentation, which constitutes a medication error.