You have known Miss Kelly for over three years, as you have been caring for her and her sister. The two of you have a special connection, so it is particularly distressing to you when you watch her slowly, over time, deteriorate because of her arthritis and heart condition. Show
You have always aided with bathing, meal preparation, and light chores, but she has taken care of her own medications. You know she takes a few pills in the morning, and you have been careful during her bath not to dislodge the medication patch she wears for her heart condition. It seems that lately Miss Kelly has gotten much weaker, and she struggles to get her medication bottles open and then break the tablets in two. She confides that she isn’t always sure that she’s opening the right medication bottle because her vision is blurrier than it used to be. Most worrisome is that fact that she occasionally has trouble swallowing her pills, and even gets choked sometimes. Additionally, she has a new diagnosis of asthma and now uses an inhaler. You report your observations to your supervisor, and changes are made in the care plan to include medication self-administration assistance. You haven’t helped Miss Kelly with her medications before, and you aren’t sure exactly of what “assisting” with her medications really means. Questions flood your mind:
If the answers to these questions are unclear, rest assured that you are not alone in your confusion. There is a lot to know when assisting with self-administration of medications! Your AbilitiesBefore you can assist with the self-administration of medications, there are specific abilities that you must be able to perform. These abilities include:
In addition, you must be aware of and follow scope of practice guidelines and organizational policies and procedures. Be mindful of the fact that practice guidelines and regulations do vary from state to state and from organization to organization. Be sure you understand how state laws govern your practice, and check with your supervisor for clarification if you have questions. Before You BeginBefore assisting someone with taking their medications, you must remember to:
Other ConsiderationsBecause some medications can cause problems with constipation and dehydration, providing adequate amounts of fluid is often essential. Be sure to check the manufacturer’s guidelines for recommendations for fluid intake with certain medications and follow them. The same is true when giving medications that must be taken with food. Remember that everyone has the right to privacy. It is your responsibility to make sure that all medications are administered in a private environment. For example, before giving a medication in front of another person, make sure the individual taking the medication is comfortable with this. You may need to ask visitors to leave the room or take the individual to a private location before assisting with the self-administration of medications. Remember, those who are not able to communicate or have mental or cognitive impairments should also have their privacy and dignity protected. Other considerations include:
Be MindfulThere are many things you must be mindful of as you assist individuals with self-administration of medications. They include abilities and knowledge that you must demonstrate before assisting with self-administration of medication, strategies you should use during the process, and things to watch for and report. Always be aware of and stay within your scope of practice, job description, and capabilities to ensure the safety of the people you care for. Medication Training for CaregiversIf members of your organization are worried about providing medication to those you care for, consider providing additional training to your staff. According to a 2017 study, “Medication errors occur frequently in home care and can threaten the safety of patients.” Ways to prevent errors in medication administration include:
Curriculum Designer, ReliasJennifer W. Burks has over 25 years of clinical and teaching experience, and her areas of expertise are critical care and home health. She earned her Bachelor of Science in Nursing from The University of Virginia in 1993 and her Master of Science in Nursing from The University of North Carolina, Greensboro, in 1996. Her professional practice in education is guided by a philosophy borrowed from Florence Nightingale’s Notes on Nursing, “I do not pretend to teach her how, I ask her to teach herself, and for this purpose, I venture to give her some hints.” What does the nurse correctly administer ophthalmic medication?Ask the patient to lie flat or with their head tilted back. Administer a drop of the medication onto the closed eyelid in the nasal corner. Ask the patient to open the eye and close it gently once the drug has entered it.
What are the nursing responsibilities when administering medications?Nurses' responsibility for medication administration includes ensuring that the right medication is properly drawn up in the correct dose, and administered at the right time through the right route to the right patient. To limit or reduce the risk of administration errors, many hospitals employ a single-dose system.
When applying ophthalmic ointments the nurse should?Administering eye ointment follows the same procedure as administering eye drops, except that instead of drops, ½ inch of ointment is placed in the lower conjunctival sac. When applying the ointment, the nurse should start at the inner canthus and move outward.
What medications should two nurses check?3. Double-checking is a risk management strategy where intravenous, subcutaneous, epidural, intrathecal, and Schedule 8 medications are double checked prior to administration.
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