Provide an alternative route A less painful alternative
AMOUNT Variable INTRAVENOUS
SITE Peripheral IV access
Central lines Vascular access/ implantable infusion port NEEDLE SIZES STEPS IN GIVING PARENTERAL MEDICINES Check the medication card against DOS and MTR for accuracy and validity Identify the patient Explain the procedure Wash hands Prepare prescribed dose of the drug Have the NUM/ANUM/CN/CP counterchecked prepared drugs Identify the patieny Select the correct site STEPS IN GIVING PARENTERAL MEDICINES Select site of injection and disinfect Inject needle quickly (correct angle) Aspirate the blood if necessary Inject the drug (slowly) Withdraw the needle (quickly) Massage the area firmly if necessary Dispose the needle properly(sharp collector) Chart promptly and correctly Document on the MTR and Nurse’s notes NURSING RESPONSIBLITIES NURSING RESPONSIBILITIES Observe Handwashing Honor the “ Three- time check” in preparing medications Administer only the drug that you prepare. Administer no drug without an order. Be familiar with the medication to be administered to your patient (e.g. general purpose, side effects, average dose, safety precautions). NURSING RESPONSIBILITIES Identify drug and amount in each dose unit. Be certain that the name of the medicine ordered is spelled precisely as that on the label—if in doubt. Evaluate client's condition and medication compatibility. Do not administer until the question is resolved. Do not use outdated medicines. NURSING RESPONSIBILITIES If drug appears unusual due to discoloration or precipitation, do not use. Administer medicine at the time specified or as close to that time as possible—if there is a delay, document it. Identify patient. Use Aseptic technique when delivering and administering client's medication. Do not leave medication at bedside NURSING RESPONSIBILITIES Permit patient to self-administer medicines only if permitted by physician's written order Unless authorized by physician, do not use drugs patient brought to hospital If an alert patient questions the drug's identity or appropriateness for use, recheck the identity of the patient and the drug If patient refuses medication, document this on chart and notify the physician responsible for the care of the patient at that time. MEDICATION SAFETY MEDICATION SAFETY "Pharmacists should actively participate in the medication-use process, including, at a minimum, being available for consultation with prescribers on medication ordering, interpretation and review of medication orders, preparation of medications, dispensing of medications, and administration and monitoring of medications." —National Quality Forum RECONSTITUTING POWDERED MEDICATIONS Injectable medications that may be unstable in solution, are packaged in powder form. All package or label directions must be followed exactly. In a multi-dose vial, it is essential that the nurse mark on the container the date and time of preparation, the strength of the resulting solution, the expiration of potency, storage directions and his/ her initials. RECONSTITUTING POWDERED MEDICATIONS
Keep the vial, upright, on the counter top.
Push the needle of the syringe on the vial & inject the air from the syringe to the vial. RECONSTITUTING POWDERED MEDICATIONS Some package directions list several preparation methods to yield different strengths of medication. Select the strength closest to the ordered dose .
The patient age, body weight and build and
injection site for administration must all be considered when reconstituting powdered medications. PREVENT INJURIES needles should not be recapped by hand, purposely bent or broken by hand, removed from disposable syringes, or otherwise manipulated by hand.
After they are used,
disposable syringes and needles, scalpel blades, and other sharp items should be placed in puncture-resistant containers for disposal PREVENT INJURIES
Recap the needle by slipping it into
the cap with your hand away from the rim of the cap. RESPONSIBILITY Immediately report all exposures Don't wait. After disinfecting the area, promptly report your exposure.
Comply with post-exposure follow-up The difficult
period following exposure requires frequent blood testing, safer sex practices, and carrying the burden of uncertainty about your health.
Support your peers We must offer support to nurses
who are potentially exposed. The uncertainty of being exposed to HIV or hepatitis can have a devastating effect on personal lives. NON-COMPLIANCE Patients who do not take prescribed drugs because they did not understand the instructions Patients who do not take the recommended drugs because they do not trust the physician. Patients who do not take the prescribed drugs because they make them feel bad. RESPONSIBILITY Health Teachings