Safety in Medication Administration

Medication administration is a multifaceted process which involves the application of a prescribed medication to a patient.

As the licensed practical nurse, or LPN, or licensed vocational nurse, or LVN, you are responsible for administering certain medications, which requires the use of critical thinking and clinical judgment to promote patient safety and avoid medication errors, or preventable events that lead to inappropriate medication use or patient harm.

Although numerous protocols exist to promote safe medication administration, as the nurse, you are the patient’s last line of defense against medication errors.

To safely administer medications, you must be familiar with measurement systems, approved medical abbreviations, and methods of dosage calculation.

First, measurement systems used to prescribe medications include the metric system, which uses grams, liters, and meters to calculate doses, and is preferred for medication prescription.

The household system uses drops, teaspoons, tablespoons, and cups to measure doses, and although it’s familiar to patients, it tends to be inaccurate.

Okay, so most facilities have a list of medical abbreviations that shouldn’t be used in order to decrease the risk of medication errors.

For example, some facilities state that health care providers shouldn’t use the letter “u” to denote units since it can be mistaken for the number 0.

Next, nurses must be competent in dosage calculation. Although there are various methods of dosage calculation, dimensional analysis is the preferred method.

Now, the standard practice for medication administration is to use the rights of safe medication administration because they are shown to reduce medication errors.

These principles include: the right medication, right dose, right time, right route, right patient, and right documentation.

These rights must be confirmed at least three times prior to administering a medication to a patient. The first check happens when collecting the medication, the second check occurs during medication preparation, and the third check occurs immediately prior to administering the medication.

Patients also have rights when it comes to medication administration, including the right to know about the medication they are receiving, the right to refuse a medication, the right to have an accurate medication history taken, and the right to safely receive the medication.

So, medication errors can occur at any time during the medication administration process and can be related to system factors or human factors.

System factors refer to errors that result from organizational and policy issues, such as improper prescribing procedures or inaccurate product labeling; whereas human factors occur on an individual level, such as distraction while preparing and administering medications, lack of sleep, or errors in dosage calculation.

There are also different types of medication errors ranging from ones that cause the patient direct harm, like giving an antihypertensive medication to a patient with hypotension; errors that fail to treat the illness, such as missing a dose of a scheduled pain medication; or errors that don’t harm the patient, such as administering saline eye drops earlier than scheduled.

Now, if a medication error occurs, you must prioritize patient safety. Immediate actions should include notifying the registered nurse and health care provider.

If the health care provider prescribes an antidote or orders an intervention to offset the adverse effects of the medication, work in collaboration with the registered nurse to initiate these steps as soon as possible.

Lastly, you should document the medication error and complete an occurrence report, consistent with your facility policy.

Alright, as a quick recap… Medication administration is a multifaceted process which involves the application of a prescribed medication to a patient.

As the nurse, you must prevent medication errors by being familiar with the types of measurement systems, approved medical abbreviations, and dosage calculation methods; as well as always using the rights of safe medication administration.

Medication errors can occur at any time during the medication administration process and can be related to system factors