ATI Skills Modules Checklist for Medication Administration 2

Transcription

1 For faculty use only Educator s name Score Date ATI Skills Modules Checklist for Medication Administration 2 Student s name Date Verify order Patient record Assess for procedure need Identify, gather, and prepare equipment and supplies ophthalmic ointment (MAR, medication, washcloth, facial tissues) ophthalmic drops (MAR, medication, washcloth, facial tissues) otic medications (MAR, medication, cotton-tipped applicator, cotton ball) nasal medications (MAR, medication, facial tissues) oral medications (MAR, medication, medicine cup, cup of water) oral medications buccally (MAR, medication, medicine cup) oral medications sublingually (MAR, medication, medicine cup) liquid medications (MAR, medication, medicine cup) topical medications (MAR, medication, facial tissue, transparent dressing) Using a metered-dose inhaler (MAR, inhaler, spacer, cup of water, emesis basin) Apply principles of aseptic practice Hand hygiene Personal protective equipment Disposal of waste Communicate effectively Privacy Patient identification Patient teaching

2 Provide for a safe environment Body mechanics Equipment placement Patient safety

3 ophthalmic ointment Position patient supine with head slightly hyperextended. Use warm, moist washcloth to remove drainage or crusts from eyelids. Pull down lower eyelid to expose conjunctival sac. Have patient look upward. Instill ointment along inner edge of lower eyelid onto conjunctiva, moving from inner to outer canthus. Have patient blink to distribute medication. Use facial tissue to remove excess medication. ophthalmic drops Position patient supine with head slightly hyperextended. Use warm, moist washcloth to remove drainage or crusts from eyelids. Place facial tissue on patient s cheekbone just below lower eyelid. Pull down lower eyelid to expose conjunctival sac. Have patient look upward. Place prescribed number of drops in center of conjunctival sac. Have patient close eye gently. Use facial tissue to remove excess medication. otic medications Position patient side-lying or sitting with ear to be treated facing up. Warm medication to body temperature. Adults and children >3 years: Pull pinna up and back.

4 otic medications (continued) Infants and children <3 years: Pull pinna down and back. Clear cerumen or drainage with a cottontipped applicator. Instill prescribed number of drops toward side of ear canal. Distribute by gently massaging tragus. Have patient remain in position for 5 to 10 minutes. If prescribed, place cotton in ear canal. nasal medications Have patient gently blow nose. Position patient supine with head position varying with affected sinus. With patient s head supported, instill prescribed number of drops. Instruct patient to breathe through mouth. Have patient remain in position for 5 minutes without blowing nose or sneezing. oral medications Pour stock medication into lid of bottle, then transfer to medication cup. Place unit-dose drugs in medication cup with wrapper intact. Place multiple drugs in same cup unless drug requires patient assessment first. Take medication and MAR to bedside. Give patient cup of water and medications. Stay at bedside until patient swallows all medication. If patient refuses medication, return wrapped medications to storage area; discard if wrapper was removed.

5 oral medications buccally Have patient open mouth. Place medication toward back of mouth against mucous membranes of cheek. Instruct patient not to chew or swallow but keep in place until dissolved. oral medications sublingually Instruct patient to lift tongue. Place medication on mucous membranes under tongue. Instruct patient not to chew or swallow but keep in place until dissolved. liquid medications Gently shake medication. Multi-dose container: Remove lid and place upside down on work surface. Hold bottle with label toward palm. With medication cup at eye level, pour medication, measuring at base of meniscus. Recap container. Unit-dose container: No further preparation required. Take medication and MAR to bedside. Administer the medication. Stay at bedside until patient swallows all medication. If patient refuses medication, discard it.

6 topical medications Squeeze appropriate amount of medication onto gloved finger. Apply medication evenly to skin surface. If not for single use, recap container and store it. Nitroglycerin ointment Remove previous dressing and guide. Wipe skin. Discard waste. Write date and s on tape or label. Place appropriate amount of medication on measuring guide. Apply measuring guide, ointment side facing the skin. Secure with transparent dressing. Apply label to dressing. Transdermal patch Remove previous patch. Wipe skin. Discard waste. Remove patch from wrapper, touching only edges of patch. Apply to hair-free skin area. Press patch firmly with hand for at least 10 seconds.

7 Using a metereddose inhaler Have patient in sitting position. Shake inhaler several times. Remove mouthpiece cover. If new inhaler, prime by pumping into air once or twice. Hold inhaler 1 to 2 inches from mouth. Ask patient to take a deep breath then exhale completely. Ask patient to inhale slowly and deeply through mouth. While patient inhales, depress inhaler completely. Instruct patient to continue breathing slowly for 2 to 3 seconds, then hold breath for 10 seconds. Tell patient to exhale slowly through nose or pursed lips. Using a metereddose inhaler with spacer Have patient in sitting position. Remove cover from mouthpiece of inhaler and mouthpiece of spacer. Insert inhaler into end of spacer. Shake inhaler several times. Place spacer mouthpiece into mouth. Instruct patient to breathe normally through the spacer. Ask patient to breathe slowly and deeply through mouth. While patient inhales, depress inhaler completely. Instruct patient to continue breathing slowly for 2 to 3 seconds, then hold breath for 10 seconds. Tell patient to exhale slowly through nose or pursed lips. If more puffs prescribed, wait 20 to 30 seconds between puffs.

8 Using a metereddose inhaler with spacer (continued) If administering another inhaled medication, wait 2 minutes before giving the next puff. Instruct patient to rinse mouth with water.

9 Documentation Document per facility policy For all medications: Drug name Dose Route Time Any assessment data collected at administration (blood pressure, apical pulse) Your signature or s Any medications withheld and why Patient s response to medication Oral, sublingual, and buccal medications: Appearance of sublingual or buccal area Any problems patient has with swallowing If medication was crushed or mixed with liquid or with food Topical medications: Appearance of skin before applying topical medication Site of application of medication Time medication is to be removed, if it is to be removed If removed, appearance of skin after removal Ophthalmic medications: Appearance of eye(s) (redness, swelling) Any drainage: amount, color, odor If instilled in one eye only (and which one) Any changes in vision Otic medications: Appearance of outer ear and ear canal Any drainage: amount, color, odor If instilled in one ear only (and which one) Any changes in hearing

10 Documentation Document per facility policy Otic irrigations : Appearance of outer ear and ear canal Any drainage: amount, color, odor If instilled in one ear only (and which one) Any changes in hearing Nasal medications: Appearance of inside and outside of nose Any drainage: amount, color, odor Nasogastric tube medications: Method used to confirm placement of nasogastric tube Amount of residual Appearance and ph of gastric contents Total amount of fluid used for administering medication(s) Metered-dose inhaler (MDI): Lungs sounds before and after medication is administered Respiratory rate and rhythm before and after medication is administered Color and consistency of sputum Teaching done for proper use of device Small-volume nebulizer: Lungs sounds before and after treatment Respiratory rate and rhythm before and after treatment Color and consistency of sputum Peak-flow measurement before and after treatment Vaginal medications: Appearance of genitalia and vaginal canal Any discharge: amount, color, odor, consistency Teaching done for self-administration of medication

11 Documentation Document per facility policy Rectal medications: Appearance of anus (redness, swelling, hemorrhoids) Any pain, bleeding, or discharge Teaching done for self-administration of medication