PRACTICAL PROCEDURES

Administration of
oral medication
AUTHOR Andy Ferguson, RN, is The prescription should be
registered nurse, emergency care, legible and unambiguous and
Birmingham Children’s Hospital. should be signed and dated by
the prescribing practitioner.
Administration of medication is The prescription chart should be
more than a task to be done in labelled with the patient’s name,
compliance with a prescription date of birth and hospital
(NMC, 2004). It requires nurses to identification number. It should
understand the prescription and also clearly state whether the
to have knowledge of common patient has any known allergies. Fig 1. Check the information on the prescription
indications, dosages and side- Good practice states that the
effects of the medications. patient’s weight be recorded on
Should any error occur during the prescription sheet for any
the procedure the practitioner has weight-related dosages, such as
a professional responsibility to therapeutic doses for low
report this in accordance with molecular weight heparin or for
local risk management procedures. medicines for children.
Ultimately, the practitioner is
responsible for ensuring the Checking the medication
correct patient, dose, drug, time Policies regarding the appropriate
and route. practitioner and number of
practitioners needed to check oral
Preparing to administer medication may vary. Exceptions
All equipment required to to this include controlled drugs
administer the medication should and medicines for children, both
be gathered before the procedure. of which need to be checked by
This may include: two registered nurses.
● Any necessary keys; The nurse should check, as
Fig 2. Select the medication and check the expiry date
● Prescription charts; a minimum:
● Clean dispensing pots; ● The generic name of the drug;
● Drug reference books. ● The dose required;
Gathering equipment prior to ● The time for administration;
the procedure reduces ● That the drug has not already
interruptions and the risk of error been given (or taken by
associated with these. the patient);
Thorough handwashing should ● That the prescription is legible,
be performed. Hands should be signed and dated;
cleansed between patients to ● The expiry date of the drug;
reduce the risk of cross-infection. ● That the patient does not have
any known allergy or sensitivity
The prescription to the drug.
Local policies vary slightly on the
requirements for legitimate Patient identity
prescription. As a minimum the The practitioner must verify that
prescription should include: the patient receiving the medicine
● The generic name of the drug is the patient for whom it is
(not the trade name); prescribed. The most common Fig 3. Check the patient’s identity using their hospital name band
● The dose to be given; and convenient way to do this is
● The time for administration; to check that the details on the
SPL

● The route of administration. patient’s hospital identification

24 NT 8 November 2005 Vol 101 No 45 www.nursingtimes.net

 KEYWORDS ■ Medication ■ Drug administration ■ Risk management

band match those on the REFERENCES

prescription chart.
If the patient does not have an Morris, H. (2005) Administering
identification band, or for patients drugs to patients with swallowing
in areas such as A&E, it is difficulties. Nursing Times;
necessary to verbally confirm the 101: 39, 28–29.
identity of patients by asking
them to state their name and Nursing and Midwifery Council
date of birth. (2004) Guidelines for the
Administration of Medicines.
London: NMC.
Administration
Medicines should be dispensed
into a clean, dry and preferably
disposable container.
Where liquid preparations are
used, these should be measured
using syringes specifically
Fig 4. To avoid touching the medication, empty the prescribed dose into the designed for this purpose.
lid of the bottle then into a clean dispensing container Informed consent should be
sought and this will involve
assessing the patient’s knowledge
of the medication and providing
information where necessary.
Patients have the right to refuse
medication. If this occurs it should
be correctly documented and
reported to the prescribing health
care professional.
The patient should be helped
into a comfortable position and
assisted if necessary.
If the patient is not present
when the medication is due or
does not wish to take it then, the
practitioner should return later.
Medicines should never be left out
Fig 5. Liquid medication should be measured in a specialist oral syringe and
administered immediately for the patient to take later.
Medication must be given in
the prescribed manner and
tablets should not be crushed
(Morris, 2005).

Documentation
The practitioner should sign the PROFESSIONAL
prescription to verify that the RESPONSIBILITIES
medication has been administered. All nurses who administer
Only when the patient has taken medication must have
the medication should the chart be undertaken a programme of
signed. It is not acceptable to sign education and demonstrated
the chart when the medication is competence under supervision.
placed into the container. The practitioner is responsible
The effectiveness of the for ensuring that her or his
medication should be documented. practice is compliant with the
Following the procedure, the NMC guidelines (NMC, 2004).
Fig 6. Document that the medication has been given on the prescription practitioner should ensure that all The practitioner should also
chart, according to local policy equipment is replaced and that all ensure that she or he is familiar
medicines are stored in with local trust policies.
compliance with local policy. ■

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