The Value of Responsible Medication Administration
By Kim Maryniak, RNC, MSN
With the volume and acuity of patients in healthcare today, it can often feel like there is not enough time for nurses to get everything done. It may appear that administering medications is just another “task” on a long to-do list, but it is much more important than that. An estimated 1.5 million preventable adverse drug events occur each year (IOM, 2006). Of these, the Agency for Healthcare Research and Quality found that up to 60% result from the administration of medication.
There are many strategies nurses can employ to help reduce the potential for adverse drug events. The main principle includes going back to the basics of responsibly administering medications to patients. Common errors include wrong dose, wrong drug, wrong time, and wrong rate. Contributing factors include miscommunication, name confusion, labeling, human factors (such as a lack of knowledge), and inappropriate package or device (AHRQ, 2008).
Extra time must be taken with high risk or high alert medications, which are identified by the Institute for Safe Medication Practices (ISMP). In fact, many facilities require a second nurse to double check high alert medications prior to administration. These medications include adrenergic agonists and antagonists, anesthetic agents, antiarrhythmics, chemotherapy, dialysis agents, hypertonic dextrose or sodium infusions, epidurals, inotropics, insulin, sedation agents, narcotics, contrast, and parenteral nutrition. For a full list of high risk medications, refer to the ISMP website.
Involving patients and families in the administration of medications, including reasons, risks, and side effects, is another nursing priority (IOM, 2006). A nurse needs to have appropriate knowledge and be able to communicate in a manner that is both effective and acceptable to the patient.
Administering medication is not just a task, but has many essential components that can affect patient safety (AHRQ, 2008). Nurses are encouraged to take time with medication administration to ensure that the proper steps are done, with a focus, as always, on safe practices.
RN.com offers several courses on medication safety, including Hazards of Heparin and High-Alert Medications: Safe Practices. View a comprehensive list of Medication Safety and Administration courses.
Agency for Healthcare Research and Quality (AHRQ). (2008). Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Agency for Healthcare Research and Quality, Rockville, MD. Retrieved from: http://www.ahrq.gov/qual/nurseshdbk/
Institute of Medicine (IOM). (2006). Preventing Medication Errors: Quality Chasm Series. Report brief. Retrieved from: http://www.iom.edu/~/media/Files/Report%20Files/2006/Preventing-Medication-Errors-Quality-Chasm-Series/medicationerrorsnew.pdf
Institute for Safe Medication Practices. (2012). ISMP’s List of High-Alert Medications. Retrieved from: https://www.ismp.org/tools/highalertmedications.pdf
© 2012. AMN Healthcare, Inc. All Rights Reserved.
Kim Maryniak, RNC, MSN, is currently a Clinical Director with AMN Healthcare. She has more than 22 years of nursing experience, including med/surg, psychiatry, pediatrics, neonatal intensive care, education, and management.