1. Medication Administration (Adults)
Presented by:
Educator Group Two

2. Topics
Oral (PO)Administration
Subcutaneous (SQ)
Intravenous (IV)

3. Objectives At the end of the unit, students will be able to
Outline the Principles of medication administration in general.
Administration, and the documentation required for
medications administered.
Describe how to properly administer medications via
PO, SQ and IV routes of administration.

4. Nursing Assessments SAFETY is Key! It is the nurse’s responsibility
Check the order – scheduled or PRN, route of administration and dose ?
Assess for patient’s medication allergy
When was the medication given last if PRN and patient’s response?
If PO, can the patient swallow the medication?
If IV , does the patient has a working IV access?

5. Principles Be Knowledgeable about the medication:
Know the name of medication
Drug action
Drug interactions
Dosing and dosages
Route and rate of administration
Side effects
Adverse effects to report
Contraindications
Accurate calculation, preparation, and administration of medications

6. National Patient Safety Goals for Medication Safety
Improve the accuracy of patient identification at least
two identifiers
Improve effectiveness of communication among caregivers
Record and read back complete orders and test results
Standardize abbreviations, acronyms, symbols and dose designations
Identify look alike/sound alike medications

7. National Patient Safety Goals Cont.
Reconcile medications across the care continuum
Avoid the use of unnecessary decimal points
Write out the word “microgram” mistaken for milligram.
Do not abbreviate microgram as “μg”.
Always use a leading zero (0) for doses less than 1 mg.
Example: 0.1 mg vs .1mg

8. Five RIGHTS OF MEDICATION ADMINISTRATION (+2)
Right Patient
Right medication
Right dose
Right time
Right route
Additional “rights”
Right documentation
Right reason/rational

9. BEFORE ADMINISTERING ANY Medication:
Wash hands!!!
Assess patient for medication administration
Identify patient using two identifiers per hospital policy
Check or Scan armband and compare with identifiers
Facility policy determines two identifiers to be used:
(name / birth date or last 4 social security numbers)
Ask patient to verbalize name or required identifiers
Patient teaching

10. Oral medication Administration
Forms
solids
enteric coated
Liquids
PILL

11. Oral Medication cont. Oral or nasogastric tube
It is safe, convenient, and more economical.
Has slower rate of onset of action
Not used if patient:
Is vomiting
At risk for aspiration
Unconscious
Can not swallow

12. Oral Medication Cont. Review medication orders
check for drug allergies.
Wash hands.
Identify patient per hospital policy.
Assess patient for alertness and ability to swallow.
Place patient in sitting or fowler position.

13. Oral Medication Cont.
Remove unit-dose from packaging at bedside, place in a medication cup.
Give patient medication cup and a glass of water for swallowing (may offer other liquids -milk or juice if not contraindicated).
Remain with patient until medications are all swallowed.
DO NOT LEAVE MEDICATIONS AT BEDSIDE!!!!!!!!

14. Oral medication cont. Sublingual: Do all the above checks
Place sublingual tablet under tongue
Instruct patient not to chew or swallow tablet.

15. Oral Medication Cont.

16. Intravenous Injection (IV)
Has rapid onset of action
Injections require skill and special care
to prevent infection and adverse reactions
Review medication orders, and check
for drug allergies.
Verify compatibility of drug to be
admixed with primary IV solution.
Wash hands and wipe injection
port on IV bag with alcohol swab,

17. Intravenous Injection (IV)
Inject medication through the port.
Gently rotate IV bag to mix solution.
Inspect solution for any precipitate
( discard if precipitate )
Visibly Label- date, time, medication, and dosage of additive .
Prime IV tubing, removing air
Administer as ordered

18. Administering IV Bolus
Review medication orders and drug allergies.
Verify compatibility with primary solution.
Wash hands.
Identify patient by Hospital policy
Assess IV site and for patency.
Clean Y-site injection port (closest port to infusion site) with alcohol swab
Pinch off IV tubing above Y-site injection port.
Insert needle into port, and inject medication over specified time interval.

19. IV Bolus or Push Technique

20. Injection through IV Heplock
Assess IV site and for patency.
Cleanse injection port with alcohol swab.
Flush with normal saline to assess patency.
Insert needle into port, and inject medication over specified time interval.
Flush with normal saline or Heparin flush per hospital policy).

21. IV medication

22. IV medication

23. Subcutaneous (SQ)
Review medication orders, and check for drug allergies.
Wash hands, and put on gloves.
Identify patient per policy.
Use cc syringe and gauge, 1/2 - 5/8 inch needle.
Maximum amount of fluid to administer SQ is 1 cc.

24. Subcutaneous (SQ) Cont.
Sites: abdomen, lateral and anterior aspects of upper arm or thigh, scapular area of back, or upper ventrodorsal gluteal area.
Wipe with alcohol in a circular motion to cleanse. Allow to dry.
Pinch skin between finger and thumb , spread skin if obese
Insert needle at 45° or 90° angle : 90° if obese; 45° if average weight, if patient is very thin, pinch skin and administer at 90° angle.
Inject medication slowly, remove needle quickly, and gently massage site with alcohol swab. (No massage after heparin)

25. SQ Injection

26. Subcutaneous medication

27. Mixing Insulin

28. Required Documentations
THE RIGHT DOCUMENTATION MUST INCLUDE:
Medication name
Dosage
Route
Time
Nurse signature
Site of injection
Other information
Omitted drugs
Reason
Notify MD
Refused drugs

29. References
Food & Drug Administration. (2009). Medication Errors. Retrieved 7/8/09 from
Institute of medicine. (2006). Preventing Medication Errors. Retrieved 7/8/09 from
Wilson, B.A., Shannon, M., & Stang, C. (2003). Drug Guide Retrieved 7/18/09 from
Wilson, B.A., Shannon, M., & Stang, C. (2003). Medication Administration Techniques. Retrieved 7/18/09 from