Goal: The medication is delivered via the transdermal route.
1. Gather equipment. Check medication order against the original order 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 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. When all medications for one patient have been prepared, recheck the label with the CMAR/MAR before taking them to the patient.
10. 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 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. 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.
16. Scan the patient’s bar code on the identification band, if required.
17. Put on gloves.
18. Assess the patient’s skin where patch is to be placed, looking for any signs of irritation or breakdown. Site should be clean, dry, and free of hair. Rotate application sites.
19. Remove any old transdermal patches from the patient’s skin. Fold the old patch in half with the adhesive sides sticking together and discard according to facility policy. Gently wash the area where the old patch was with soap and water.
20. Remove the patch from its protective covering. Initial and write the date and time of administration on the label side of the patch.
21. Remove the covering on the patch without touching the medication surface. Apply the patch to the patient’s skin. Use the palm of your hand to press firmly for about 10 seconds. Do not massage.
22. Remove gloves and additional PPE, if used. Perform hand hygiene.
23. Document the administration of the medication immediately after administration.
24. Evaluate the patient’s response to medication within the appropriate time frame.
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