Medication Administration Practicum: Study Notes for Nursing Students

Medication Administration Practicum

Introduction

This guide summarizes the essential steps and safety checks for administering medications orally and parenterally, as practiced in clinical nursing education. It covers patient identification, medication verification, administration techniques, and post-administration evaluation, following best practices for safe and effective patient care.

Oral Medication Administration

Preparation and Verification

• Review the Medication Administration Record (MAR): Determine which medications are due for administration based on the schedule provided by the instructor.

• Medication Information: For each drug, identify the trade name, generic name, adverse effects, appropriate dosage range, and any interactions.

Safety Checks and Patient Rights

• 3 Checks:

  1. When pulling medication from the cart, check with MAR.

  2. Before pouring or preparing medication, check with MAR.

  3. At the bedside, before administering, verify with MAR.

• 11 Patient Rights: Right patient, medication, dosage, route, time, reason, documentation, assessment, refusal, education, response.

Patient Interaction and Safety

• Hand Hygiene: Perform before patient contact.

• Patient Introduction: Introduce yourself and your role.

• Patient Identification: Use two accepted identifiers (e.g., name and date of birth).

• Allergy Check: Ask the patient about any drug allergies.

Administration Process

• Assessment: Complete necessary assessments prior to administration (e.g., check pulse before giving digoxin).

• Patient Positioning: Assist the patient to an upright or lateral position for safe swallowing.

• Medication Administration: Remain with the patient until the medication is swallowed; offer water as needed.

• Documentation: Record administration immediately after giving the medication.

• Evaluation: Assess and document the patient's response to the medication.

Parenteral Medication Administration

Preparation and Verification

• Type of Injection: Determine the appropriate injection type and medication order.

• Medication Information: Review trade and generic names, adverse effects, dosage range, and interactions.

Safety Checks and Patient Rights

• 3 Checks:

  1. When pulling medication from the cart, check with MAR.

  2. When about to draw medication, hold against MAR.

  3. Before administering at bedside, verify with MAR.

  • After completing checks, sign the bottom of the paper in black or blue ink with your name and credentials.

• 11 Patient Rights: As above (right patient, medication, dosage, etc.).

Patient Interaction and Safety

• Hand Hygiene: Perform before patient contact.

• Patient Introduction: State your name and role.

• Patient Identification: Use two accepted identifiers.

• Allergy Check: Ask about allergies.

• Patient Privacy: Ensure privacy during the procedure.

Injection Technique: Intradermal Example

• Sites: Inner forearm, upper back, upper scapula.

• Needle Gauge: 25–27 gauge.

• Needle Length: 1/2 inch.

• Dose: Less than 0.5 mL.

• Technique:

  • Pull skin taut to create a wheel.

  • Scrub the hub.

  • Remove cap and place on side.

  • Hold vial on table, push air in, then pull back medication.

  • Scoop method to recap needle.

  • Second check with MAR.

  • Prep patient's skin in a circular motion.

Summary Table: Key Steps in Medication Administration

Step	Oral Administration	Parenteral Administration
Preparation	Review MAR, gather info, assess patient	Review MAR, gather info, assess patient
Safety Checks	3 checks with MAR, 11 rights	3 checks with MAR, 11 rights
Patient Interaction	Hand hygiene, introduction, ID, allergy check	Hand hygiene, introduction, ID, allergy check, privacy
Administration	Assist position, give med, ensure swallowing	Prepare injection, select site, administer
Documentation	Immediately after administration	Immediately after administration
Evaluation	Assess response, note adverse effects	Assess response, note adverse effects

Key Terms and Definitions

• MAR (Medication Administration Record): A legal record of drugs administered to a patient by a healthcare professional.

• Parenteral: Administration of medication by injection (e.g., intradermal, subcutaneous, intramuscular, intravenous).

• Intradermal Injection: Injection into the dermis, just below the epidermis.

• Adverse Effect: An undesired harmful effect resulting from a medication.

Additional info:

• While this guide is focused on nursing practice, the principles of safe medication administration are foundational for all healthcare professionals and are relevant to clinical pharmacology and patient safety in Anatomy & Physiology contexts.