Avoiding Common Administration Errors – Knowledge Is The Key

By Kim Stanton, RN, Gayco Consultant Nurse

Healthcare personnel who administer medications are familiar with the rights of medication administration. There are 6 that are key! Can you remember those?

Right Resident
Right Medication
Right Dose
Right Route
Right Time
Right Documentation

Do you also know that failure to administer the medication according to the manufacturer’s instructions also constitutes a medication error? When we administer medications and do not follow the manufacturer’s recommendation for proper technique, we cannot ensure that the patient receives the correct dose of the medication.

Check out the guidelines below for some quick tips on common medication errors that are related to the manufacturer’s instructions.

COMMON MANUFACTURER’S INSTRUCTION FOR ADMINISTRATION:

Respiratory Inhalers: always shake the meter dose inhaler (MDI) well. The medication is in a suspension inside the canister and shaking well ensures medication is evenly distributed. Don’t shake powdered inhalers. The correct technique for all inhalers is to EXHALE completely, then INHALE deeply with the medication, and then HOLD for 10 seconds. This will ensure the body absorbs the medication effectively. Remember, when inhaling a steroid medication, it is important to rinse the mouth with water and spit it out. This helps prevent Thrush (painful fungal infection). Always check the expiration date.

Two inhalations of the same medication should be spaced at least one minute apart. Two different medications should be spaced at least 5 minutes apart.

Insulin pens: Always check the expiration date prior to use. Always prime the needle with 2 units of insulin before dialing the prescribed number of units. Pinch up the skin to avoid injecting the insulin into muscle. Once you have injected the prescribed amount of insulin you must continue to hold the pen in place for a count of 10 seconds. The pen can continue to be administering insulin for those 10 seconds. Remember to rotate the injection site.

Nasal sprays: Gently shake or mix prior to use. The correct technique is to blow the nose before administration. This clears the nasal passages out to allow for better absorption of the medication. Be sure to wipe the tip of the medication bottle off after each administration.

Eye drops: Remember to wait at least 5 minutes between two different medications. Pull down just below the lower lid and create a pocket to instill the drop in the eye.

Patches: always rotate the site and document where it was placed. Date and initial the patch.

Crush each medication separately. Obtain a physician’s order. Cannot crush timed/delayed-release or enteric-coated. When in doubt check it out!!!!

Don’t mix liquids together.

Bulk Laxatives: give with 4-8 oz of water!!