Edith Cowan University

School of Nursing and Midwifery

Medication
Administration
Edith Cowan University
School of Nursing and Midwifery

Objectives
Reinforce
Direct students to
Importance resources on
Clarify of Patient Medication medical
Scope of Safety calculations and
Calculations
Practice (6Rights + medication safety
MAX)
Edith Cowan University
School of Nursing and Midwifery

ECU undergraduate student nurses are only

permitted to give medications with an RN or RM,
at no stage can you give medications with EN
even if he/she is medication competent

Scope of practice Students are not permitted to give S4 and S8 drugs

which are in Drug register. However, you are
encouraged to observe the process of checking
and administration of these drugs.
Edith Cowan University
School of Nursing and Midwifery
Edith Cowan University
School of Nursing and Midwifery

Think about this

As a stage 3 student on prac, an EN offered to supervise you
to administer paracetamol 1g through the nasogastric tube of
Mr Adams?
Give yourself a go!
Is this within your scope of practice? If yes/no, why?
Edith Cowan University
School of Nursing and Midwifery

Patient Safety

Common General
Types of abbreviations Schedule 4 considerations
medication used in & Schedule 8 when
orders medication medications dispensing
orders medication
orders
Edith Cowan University
School of Nursing and Midwifery

Standing order: Medication administration carried

out for a specific period until discontinued by a
medical order
Single order: Medication administration carried out
for one time only

Types of STAT order: Medications prescribed to be given

immediately

medication orders PRN order: Medication administered as required

by patient
Telephone or verbal order: Orders for medication
carried out through telephone or verbally. This
must be confirmed by a second RN/RM.
Students are not required to confirm these
orders
Edith Cowan University
School of Nursing and Midwifery

Common 1. FREQUENCY MANE: MIDI: MIDDAY NOCTE: NIGHT

abbreviations MORNING DOSE

used in
medication
orders
BD: TWICE A TDS: THREE QID: FOUR PRN: WHEN
DAY TIMES A DAY TIMES A DAY NEEDED
Edith Cowan University
School of Nursing and Midwifery

2. ROUTE

IV: Intravenous

IM: Intramuscular
Common
SC: Subcutaneous injection
abbreviations
used in PO: Oral
medication NEB: Nebuliser
orders cont’d
PR: Per Rectum

TOP: Topical

VAG/PV: Vaginal/Per Vaginal

Edith Cowan University
School of Nursing and Midwifery

Schedule 4 and • Students are not allowed to hold S4 and

S8 drug keys or sign the drug register.
Schedule 8 However, you should take the opportunity
to watch “drug count” and understand the
medications process in checking the drug register
Edith Cowan University
School of Nursing and Midwifery

Patient •“Why do you think that nurses

Safety have a heavy responsibility for
ensuring medication is
(Cont’d) administered safely”
Edith Cowan University
School of Nursing and Midwifery

“6 Rights”
Right Drug
Right Dose
Right Documentation
Right Time
Right Patient
Right Route
Edith Cowan University
School of Nursing and Midwifery

Right Drug (including MAX)

MIMS (Check drug in MIMS for use, contraindications, precautions,
adverse reactions, interactions, dose & availability)

Allergy status (Does the patient have any allergies, will this drug
interact with them?)

eXpiry dates (Also check the expiry dates on the fluids and NaCl –
hold fluid bag to light & check for “floaties”)
Edith Cowan University
School of Nursing and Midwifery

Right Drug cont’d

Question 1: What is the generic name of Dilantin?
Edith Cowan University
School of Nursing and Midwifery

Right Drug cont’d

Question 2: Prochlorperazine mesylate (Stemetil)
12.5mg injection and Promethazine Hydrochloride
50mg are often located next to each other as they are
both antiemetics prescribed for the management of
nausea. What is different about them?
 
Edith Cowan University
School of Nursing and Midwifery

Right Dose
Edith Cowan University
School of Nursing and Midwifery

Right Documentation

Name of
Medication, Medication
Date, Time &
Dose, Route & Action or
Signature
Frequency of Indications
Administration
Edith Cowan University
School of Nursing and Midwifery

Study the medication charts below

Medication chart A (Paracetamol) Medication chart B (Heparin)
Edith Cowan University
School of Nursing and Midwifery

Which medication order has

been correctly completed – A
or B?

Question 3
What documentation is
missing from the medication
order that has not been
completed correctly?
Edith Cowan University
School of Nursing and Midwifery

Right Time
Edith Cowan University
School of Nursing and Midwifery

Study the clocks below

A B

C D
Edith Cowan University
School of Nursing and Midwifery

On a morning shift, Metoprolol 25mg has been

prescribed for 8am. Of the four clocks shown,
when would you NOT notify the Doctor if the
Question 4 administration of a medication has been
delayed? Choose either A, B, C or D.
 
Edith Cowan University
School of Nursing and Midwifery

Right Patient
It’s
me!
Edith Cowan University
School of Nursing and Midwifery

Right Route

TOPICAL – EYE DROPS INHALER INTRAMUSCULAR INJECTION ORAL – SYRUP

TOPICAL – CREAMS ORAL – TABLETS RECTAL SUBCUTANEOUS INJECTION

Edith Cowan University
School of Nursing and Midwifery

Right Route cont’d

Question 5: What is the difference between these two types of syringes and the significance in
the design at the ends of each syringe? The answer to the question is at end of the presentation.
Edith Cowan University
School of Nursing and Midwifery

Medication Calculations
Playing Cards Pack 1

A patient has been

prescribed 1 litre of
normal saline 0.9% to
be infused over 12
hours. If your giving
set delivers 20 drops
per minute what is
the drip rate of the
infusion?
Edith Cowan University
School of Nursing and Midwifery

Medication Calculations
.

A patient is prescribed Paracetamol 1g.

The box of Paracetamol only contains
500mg tablets. How many Paracetamol
tablets would you give to the patient?
Edith Cowan University
School of Nursing and Midwifery

Medication Calculations
..
Edith Cowan University
School of Nursing and Midwifery

Question 6: What is the drop

factor shown on this
intravenous giving-set
packaging? The answer to
this question is at end of
the presentation.
Edith Cowan University
School of Nursing and Midwifery

• In addition to the 6 Rights + MAX, consider the

following;
General • Wash hands before medication
administration
considerations • Take responsibility for your actions
when • Be knowledgeable about medication you
are about to administer, when in doubt, ask
dispensing medical staff + MIMS
• Report if patient vomits soon after oral
medication medication
orders • Do not leave unsecured medications at
bedside
Edith Cowan University
School of Nursing and Midwifery

Resources
Numeracy
Workshops

Med+Safe website using

your credentials
Self-directed Learning Package on
medication safety: NPS
medicineWise
Insert website:
https://learn.nps.org.au/mod/page Royal Perth Hospital
/view.php?id=4277
Medication
Administration Policy
Edith Cowan University
School of Nursing and Midwifery

Summary
Always follow the “6- Always be
Rights” of medication knowledgeable
Always work within administration: about the
your scope of Right Drug medications you are
practice during the Right Dose administering and
administration of Right Documentation NEVER give
medications Right Time medications that you
Right Patient are unsure about its
Right Route action or side effects
Edith Cowan University
School of Nursing and Midwifery

Answers
Question 1: Phenytoin is the generic
name for Dilantin used in the
management of epilepsy, Question
2: Prochlorperazine 12.5mg in 1mL &
Promethazine Hydrochloride 50mg in
2mL are both antiemetics but have
different dosages, Question 3:
Answers to Medication Chart A - Indication for
Paracetamol not documented,
Questions 1 - 6 Question 4: A – You can give
medications half an hour before and
after the time written on the
medication order without notifying the
delay to the Doctor, Question 5: The
purple syringe is for drawing up oral
medications and cannot be connected
to an intravenous leur lock cannula,
Question 6: Drop factor 20
Edith Cowan University
School of Nursing and Midwifery

https://www.safetyandquality.gov.au/wp-content/uploads/
2012/02/NIMC-acute-PDF-82KB.pdf