Chapter Five Principles of Medication Administration



Home Care Association of New Hampshire

LNA Medication-Certified

Principles of Medication Administration

As a Licensed Nursing Assistant (LNA), you are the eyes and ears for the nurse. You are always observing your patient for changes in their physical appearance, appetite, behavior, mentation (mental activity)/cognition and overall well-being. The nurse or therapist relies on your observations in order to have a complete picture of the patient and in order to plan and revise the patient’s plan of care (POC) as needed.

As a Licensed Nursing Assistant Medication-Certified (LNA-MC) there are a number of things that must be done when facilitating medication administration for the patient:

• Consult the patient’s plan of care to ensure that you are aware of all nursing instructions noted. If you are unsure or unclear about anything on the care plan in regard to medication administration, contact the primary nurse or a supervisor immediately in accordance with agency policies and procedures.

• Note any special instructions related to the medication facilitation for each patient.

• Ensure the Six (6) Rights: right patient, right medications, right dose, right route, right time, right documentation.

• Observe the patient for any possible side effects and adverse reactions as appropriate to your role and report to the nurse per agency policy.

• Document the medication administration assistance, any observed reactions and specific information as requested in the plan of care (POC) according to agency policy and procedure.

• Give only routine medications. Any medication ordered on an as-needed (PRN) basis must be directly delegated by the nurse.

Preparing to Assist with MedicationAdministration

Use the following steps to ensure safe medication administration:

• Wash your hands

• Know the patient’s allergies

• Prepare only the medications you are going to facilitate now. If medications are in a pill planner, be certain you have the correct day and time of day. If medications are in individual containers, verify the patient name, name of medication, dose, time to be given, and route on the POC. Show the medications to the patient and verify that the patient recognizes all of the medications.

IF YOU HAVE ANY CONCERNS ABOUT THE MEDICATIONS, CONSULT THE PRIMARY NURSE OR A SUPERVISOR IMMEDIATELY AND DO NOT PROCEED WITH MEDICATION FACILITATION.

• Prepare medications in a quiet area so you are not interrupted.

• Before assisting the patient with his/her medications, verify that you have the correct patient.

• If the patient is in bed, position him/her properly to reduce risk of choking or aspiration.

• Explain to the patient what you are doing.

• Have the necessary water or juice available to assist with swallowing the medications.

• Make sure the patient sees the medication or liquid. Stop immediately is the patient does not recognize the medication and do not proceed with facilitation of medication administration.

• Stay with the patient while he/she takes his/her pills, make sure all pills are swallowed.

• Properly dispose of supplies. Never leave medications at the bedside or on a table.

• Store medications or pill planners in the location agreed upon by the patient/ family.

• Wash your hands.

• Document assisting the patient with taking his/her medication(s) per agency protocol.

Tips to Avoid Med Errors

• Avoid being distracted when preparing the medication.

• Avoid conversations.

• Facilitate only administer drugs that you have prepared.

• Utilize only medications from containers labeled correctly.

• Do not transfer drugs from one container to another.

• Do not place medications directly into your hand.

• Note expiration date and do not give if medication has expired.

• Do not assist with administration of medications that are discolored, have sediment or are cloudy.

• Do not leave medications at the bedside or with visitors.

• Keep medications in clear sight.

• Do not assist with administration of a medication if the patient says it doesn’t look like what he/she usually takes.

• Never give food or beverages with medications unless the patient’s care plan indicates that it is safe to give with food or beverages.

Proper Disposal of Medications

Follow your agency’s policy on how to dispose of medications. It is your responsibility to know what the policy is and follow it accordingly.

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