Administration of medication as per the instructions by the treating physician is perhaps the most important step in the treatment process, because any medication error may not just prevent the desired effects but may cause some adverse effects and complications.
This is one of the common mistakes that can take place in the wards and can happen because of multiple factors.
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Safe, error free medication can be ensured by carefully following the protocols:
1. The physician should write the instructions in the case records in a legible hand writing and avoiding any unauthorized abbreviations, as far as possible.
2. Nurse should read and interpret the prescription (name of the medicine, dose, route, frequency, before/after the food) carefully and note it down on the nurse’s treatment book/chart correctly.
3. Nurse following the protocol for Verification of all High Risk Medication Orders (such as in case of chemotherapy, narcotics) to verify the accuracy of the name of drug, dose, frequency and route of administration, from the treating physician, before medication administration.
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4. At the right time, the nurse rechecks the treatment book/chart and takes out the right drug, checking for the right dose, right shelf life, and right condition and then approaches the patient.
5. Nurse correctly identifies the patient by cross checking and confirming at least two patient identifiers (other than the room/bed number) such as the patient’s name, CR number, ID band, age, sex or address.
6. Nurse checking from the case file as well as from the patient, before medication, about history of any allergy to any drug and in particular to the specific drug being administered.
7. In case of any known allergy, keeping the anaphylactic reaction tray ready, nearby.
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8. Testing for any allergic response by subcutaneous administration of a low test dose of the drug, as per the standard protocol, and observing for any allergic response.
9. As a standard precaution, nurse checking from the case file and the patient, if the patient is taking any other drugs on his own, simultaneously.
10. Administering the drug to the patient personally in her presence taking all the standard precautions.
11. Informing the patient/attendants, without unduly alarming them, about the common side effects, after effects and allergic effects of the drug, so that the patient may inform the sister in case any of those effects is felt after the medication.
12. Noting down the action in the treatment chart.
13. Observing the patient and asking the patient for the side effects, if any.
14. Ensuring that the same nurses (in every shift) administer the medication to every patient in all the shifts.
15. A policy on acceptance of any drugs brought by the patient/attendant from outside the hospital.