Chapter 4 Medication Administration Elsevier items and derived items © 2006 by Saunders, an imprint of Elsevier Inc.

Know The Law!!!! Know: Job Description Institutional Policies State Law Professional Practice Standards

Objective 1 Describe the role of the Surgical Technologist in medication administration. Circulator First scrub (STSR)

Objective 1. Circulator Obtain medications. Identify medications. Deliver medications.

Objective 1. Circulator Maintain asepsis during delivery to sterile field. Document medications.

Objective 1. STSR Accept medications. Identify medications.

Objective 1. STSR Label medications immediately.

Objective 1. STSR Pass medications. Say the name of drug clearly when passing it to surgeon.

Explain the 6 “Rights” of medication administration. Objective 2 Explain the 6 “Rights” of medication administration.

Objective 2. Right drug Read preference card and medication label carefully. (From Morris DG: Calculate with Confidence, 3rd ed, St. Louis, Mosby, 2002)

Objective 2. Right drug Say drug name when handing to surgeon. Keep vials in room.

Objective 2. Right drug CAUTION: Some drugs sound alike or are spelled alike. For example: Pitocin/pitressin Epinephrine/ephedrine

Objective 2. Right dose Correct amount (volume) 30 ml Correct strength (concentration) 1%, 2%, 0.5% The right dose is the amount multiplied by the strength.

Objective 2. Right dose Vital when mixing medications on back table Vital when multiple strengths of the same medication are on back table Label each medication carefully.

Objective 2. Right route Surgeon administers medications at the surgical site. Surgeon determines route. STSR role in right route Correct formulation of drug

Objective 2. Right route For example, epinephrine Strength for topical is 1:1000 Strength for injectable is 1:100,000 Both are clear solutions.

Route/CAUTION! You must know the route and purpose for different epinephrine strengths. A mix-up can cause patient death.

Objective 2. Right patient Identify patient. Verify surgeon and procedure. Check preference card.

Objective 2. Right time Per verbal order Surgeon administers medications at the surgical site at the intended time.

Describe the steps of medication identification. Objective 3 Describe the steps of medication identification.

Objective 3.Med ID steps Read label when obtaining drug. Check integrity of container. Circulator reads label to STSR.

Objective 3.Med ID steps Circulator shows label to STSR.

Objective 3.Med ID steps STSR repeats information. Medication is delivered to field. Medication is labeled.

Objective 3. Med ID steps Warning: Do NOT accept any medication onto your back table without reading the label first.

Objective 4 Discuss aseptic techniques for delivery of medications to the sterile field.

Objective 4. Asepsis/delivery Vials: Do NOT touch rubber stopper. Do NOT touch syringe plunger.

Objective 4. Asepsis/delivery Vials: pouring Remove stopper without touching lip of vial.

Objective 4. Asepsis/delivery Vials: pouring Pour away from area where stopper removed.

Objective 4. Asepsis/delivery Vials: pouring, vial decanter

Objective 4. Asepsis/delivery Vials: pouring Or hold vial inverted (away from table) for STSR to draw up.

Objective 4. Asepsis/delivery Ampules Protect hands when breaking ampule.

Objective 4. Asepsis/delivery Pour bottles Cap up and off Empty all contents at once. Do NOT recap.

Objective 4. Asepsis/delivery Circulator should NOT lean over sterile back table to deliver medications. STSR should hold medication container out away from back table for circulator.

State the procedure for labeling drugs on the sterile back table. Objective 5 State the procedure for labeling drugs on the sterile back table.

Objective 5. Labeling All medications must be labeled immediately after accepting from the circulator!

Objective 5. Labeling Label intermediate container Med cup, pitcher, basin Label administration item Syringe

Labeling options Preprinted labels Write drug name, expiration date, and strength with skin marking pen on Blank label Skin adhesive strips

Objective 5. Labeling NOTE: Failing to label all medications on the sterile back table is unacceptable practice and probable negligence.

Identify supplies used in medication administration in surgery. Objective 6 Identify supplies used in medication administration in surgery.

Objective 6. Supplies Intermediate containers Pitchers, basins Med cups Petri dishes

Objective 6. Supplies Administration items Syringes Parts of a syringe Sizes and tips Types of syringes

Objective 6. Supplies Administration items Hypodermic needles Parts of a needle Gauge and length

In summary The surgical technologist’s role in medication administration in surgery is VITAL!

In summary The ST All must be correct. Identifies medications Labels medications Passes medications All must be correct.