1. Assessment 1st Check: a. Check MAR against physicians orders.
b. Ensure 6 (8) rights- right pt, med, dose, route, time, doc (knowledge & refuse). c. Note pts allergies agaisnt MAR.
d. Look up meds I do not know!
• generic & trade name
• actions, therapeutic effects, side effects, precautions, interactions.
• recommended dosages, route
• Nursing implementations/ assessments monitoring before, during, and after admin. •Admin considerations: can med be
crushed, best injection site, ac or pc
e. assess pt knowledge regarding health and medication.
f. assess pt to see if condition aligns with med admin.
g. assess pt safety precautions (aspiration/ bledding, optimal injection site, mental status).
2. Medication Prep/Planning: • Prepare meds for one pt at a time/one med at at time.
• Prepare meds in med room or on med cart.
• No distractions!
• Wash Hands!
3. Med Prep/Plan 2nd Check: a. check meds against MAR x2 when pulling from drawer and before preparing. b. check
expiration date.
c. Calculate dose. Verify with a second RN when needed or required. d. Wash hands!
4. Med Prep/ Plan Oral meds: a. Place unit dose meds into cup without removing wrapper.
b. Place any meds that require assessment in separate cup.
5. Med Prep/ Plan Parenteral meds: a. Gather all supplies for prep and admin
(gauze pads, alcohol wipes)
• Choose appropriate syringe and needle for medication and calculate dose.
• Clean top of vial vigorously for 30 seconds and let dry.
b. Draw up med accurately.
• Have another nurse check insulin or heparin dosage.
•change needle prn.
c. take med/admin within 30 minutes before or after schedule time.
6. Standard Protocol/Pt Safety~ Implementation: • wash hands!
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