It’s been said that hospitals
are one of the most dangerous places for patients. Although we provide great
care, we can also do great harm – especially when administering medications. We
all know the 5 rights, but even if we comply, mistakes are made. Potassium is given to a patient with a
level of 5.5mEq or Dilantin is given to a patient with an existing level of
30mcg/ml (normal is 10-20). By not doing our due diligence prior to
administration, we put our patients at risk.
Making sure you give the
right drug to the right patient isn’t enough. We have to truly understand how
every drug we give will affect the individual patient. Mastering that is
quintessential way we can provide “great care” to patients.
When giving a drug, answer
these questions to administer them safely:
1. Why is this
patient on this medication?
It’s
not enough to know the classification of the drug. You need to understand why
YOUR patient is getting it. For example, Neurontin is an anti-convulsive drug.
However, we also give this drug to patients with diabetes who suffer from
neuropathic pain. Understanding why your patient is on the drug helps you to
assess for effectiveness – are you assessing for seizure activity or are you
assessing for pain level? Same drug – different expected result.
2. Is there
anything I need to check prior to giving?
We cause
many iatrogenic disorders by not assessing patients prior to administering
medications. I once cared for a young man with a brain injury that was loaded
with Dilantin. He had received Dilantin 3 days in a row when I took care of
him. Prior to giving, I checked his Dilantin level and found it to be 30mcg/ml!
This was a toxic amount. We held his dose but he had to stay on our unit for 5
extra days to monitor his cardiac rhythm. We caused it by not checking his
levels. When in doubt, check!
3. What do I
expect as a result?
We
should always be thinking about the expected results from the administration of
medications. Do we expect an increase in urine output, a drop in the heart
rate, pain level or blood pressure? How will we know if this medication is
working? What assessments do we need to perform to evaluate.
Following these tips can
help you to continue providing great care and doing no harm.
Thanks for choosing to become a nurse! I'm cheering for your success.
Renee
If you liked this post, you might like this one too on "connecting the dots"
For more great tips, make sure you "like" me on Facebook,"follow" me on Twitter and YouTube and subscribe to my blog. Also, check out my new book on nurse-to-nurse bullying and my new eBook titled, Survive and Thrive: A guide helping new nurses succeed!
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