Administering Oral Medications

Goal: The patient will swallow the prescribed medication at the proper time.

1. Gather equipment. Check each medication order against the original in the medical record, according to facility policy. Clarify any inconsistencies. Check the patient’s chart for allergies.

2. Know the actions, special nursing considerations, safe dose ranges, purpose of administration, and adverse effects of the medications to be administered. Consider the appropriateness of the medication for this patient.

3. Perform hand hygiene.

4. Move the medication cart to the outside of the patient’s room or prepare for administration in the medication area.

5. Unlock the medication cart or drawer. Enter pass code into the computer and scan employee identification, if required.

6. Prepare medications for one patient at a time.

7. Read the CMAR/MAR and select the proper medication from the patient’s medication drawer or unit stock.

8. Compare the label with the CMAR/MAR. Check expiration dates and perform calculations, if necessary.Scan the bar code on the package, if required.

9. Prepare the required medications:

a. Unit dose packages: Place unit dose-packaged medications in a disposable cup. Do not open the wrapper until at the bedside. Keep narcotics and medications that require special nursing assessments in a separate container.
b. Multidose containers: When removing tablets or capsules from a multidose bottle, pour the necessary number into the bottle cap and then place the tablets or capsules in a medication cup. Break only scored tablets, if necessary, to obtain the proper dosage. Do not touch tablets or capsules with hands.
c. Liquid medication in multidose bottle: When pouring liquid medications out of a multidose bottle, hold the bottle so the label is against the palm. Use the appropriate measuring device when pouring liquids, and read the amount of medication at the bottom of the meniscus at eye level. Wipe the lip of the bottle with a paper towel.

10. When all medications for one patient have been prepared, recheck the labels with the CMAR/MAR before taking the medications to the patient. Replace any multidose
containers in the patient’s drawer or unit stock. Lock the medication cart before leaving it.

11. Transport medications to the patient’s bedside carefully, and keep the medications in sight at all times.

12. Ensure that the patient receives the medications at the correct time.

13. Perform hand hygiene and put on PPE, if indicated.

14. Identify the patient. Usually, the patient should be identified using two methods. Compare the information with the CMAR/MAR.
a. Check the name and identification number on the patient’s identification band.
b. Ask the patient to state his or her name and birth date, based on facility policy.
c. If the patient cannot identify him- or herself, verify the patient’s identification with a staff member who knows the patient, for the second source.

15. Scan the patient’s bar code on the identification band, if required.

16. Complete necessary assessments before administering medications. Check the patient’s allergy bracelet or ask the patient about allergies. Explain the purpose and action of each medication to the patient.

17. Assist the patient to an upright or lateral position.

18. Administer medications:
a. Offer water or other permitted fluids with pills, capsules, tablets, and some liquid medications.
b. Ask whether the patient prefers to take the medications by hand or in a cup.

19. Remain with the patient until each medication is swallowed. Never leave medication at the patient’s bedside.

20. Assist the patient to a comfortable position. Remove PPE, if used. Perform hand hygiene.

21. Document the administration of the medication immediately after administration.

22. Evaluate the patient’s response to medication within appropriate time frame.