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The nurse literally plays the role of a lifeguard in medication administration. She often provides the last opportunity for the health-care team to identify and correct errors in prescribing and distributing medication. Although the physician prescribes the medication and the pharmacist fills the prescription, the nurse usually administers the medication. She is the last link in medication administration and a safeguard against error.
The Physician's Order
The medication administration record (MAR) is based on the physician's order and provides the information the nurse needs to administer medication. The MAR contains the name of the patient, the name and dosage of the medication to be administered, frequency/time of administration, and the method of introducing the drug into the patient's body (route of administration).
Prior to administering medication, the nurse verifies the patient's identity. The "Journal of Continuing Education in Nursing" reports that "patient misidentification continues to be the root cause of many errors." To prevent errors, the nurse uses two sources of identification and checks for matching information. She compares the patient's wristband identification with a written document such as a MAR or physician's order. Alternately, the nurse may ask the patient to state his name and birthdate and match the information to the patient's wristband.
In safely treating the patient, the nurse observes six patient rights, ensuring that she administers the right medication, in the right dosage, to the right patient, at the right time, via the right route, in accordance with the physician's orders. She completes the process with the right documentation. In addition, before a nurse administers medication, she references the action and expected effect of the drug. She monitors the patient and reports any adverse reactions to the medication.
Health-care providers prescribe and administer medication according to a medication distribution system. The health-care team works together to identify and prevent errors in the system. The nurse verifies medical calculations with a colleague and consults the prescribing physician or her nursing supervisor if she suspects that a prescribed dosage of medication is unsafe. The nurse also identifies prescribed medications, over-the-counter drugs, and client allergies that can interfere with the physician's recommended drug therapy. She gathers data pertaining to the patient's medical history and compares it to the MAR to identify incompatible drug combinations or possible allergic reactions to medication.
Medical facility guidelines also ensure six rights of the nurse. The nurse has the right to legible, clearly written medication orders that specify the dosage, route, and time for medication administration. The nurse also has the right to receive the correct form of the drug from the pharmacist and to access information about the drug. She has the right to report problems in the medication system, to halt the administration process if she identifies an unsafe condition, and she has the right to work in a medical facility that provides guidelines and policies for safe administration of medication.
- Medications and Mathematics for the Nurse; Jane Rice; 2002
- "Journal of Continuing Education in Nursing"; Is This the Right Patient?; Deene' L. Mollon, et al.; 2009
- Instructional Technology Development Center; Long Beach City College; Six Rights of Medication Administration;
- American Journal of Critical Care; "Strategies Used by Critical Care Nurses..."; Elizabeth Henneman, et al.; 2010