This document outlines the responsibilities of nurses in safely administering medications to patients. It discusses ensuring the right patient, medication, dose, route and time of administration. Interruptions during medication administration increase error risk, so other nurses should prevent interruptions. All nurses must prioritize patient safety. The document also provides details on medication administration policies and procedures, including valid orders, nurse-initiated medications, intravenous doses, and regular medication administration requirements.

1. Uses and Responsibilities

2. Clients depend on educated Registered and
Enrolled Nurses to safely administer the right
medication at the:
• Right time
• In the right dose, and
• Via the right route
After all, this together with many other
responsibilities is what we are accountable for
and the rationale behind remuneration.

3. • It is clear from evidence found that increased
interruptions experienced by nurses
administering medications will significantly
increase the risk of errors in medications.
• Nurses not responsible for administering
medications need to take on a role of making
sure that the nurse doing the medication
administration is not interrupted.
• All nurses need to be prepared to meet the
needs of the patients and ensure that safety is
an integral part of their practice.

4. Nursing Caregiver Responsibility for the
checking and administration of
Medications
• All Medications must be checked and/or
administered as per hospital policy 030
• The overall administration of medications is
the responsibility of the RN/RM/EN
• The Nurse must always check against a valid
order

5. Valid Oder
• The following details must be checked by a nurse against
a valid order:
• Patients name and UR number
• Allergies
• Name of medication
• Dosage of medication
• Frequency of dosage
• Route of administration
• Expiry of medication
• Condition of medication

6. Where to find the information?
• Patients name and UR number

7. • Allergies The Alert Section incorporates the ability to record food
and other alerts as well as drugs.

8. • Once Only Medication: Medication will be
ordered here by the Physician when requiring
the medication to be given as a once off.
• Can you think of examples?

9. • Short term telephone orders: This is where
the RN must document telephone/verbal
orders as per policy 032.
• Can you tell me the requirements for this?
• Who can listen?
• How long are these orders valid?

10. • Nurse Initiated Medication: This is where the
RN will document the Nurse Initiated
Medication as per policy 044.
• Subsequent administration must be evaluated
by the RN prior to another dose being given to
the patient.

11. Nurse Initiated Medication cont..
• If therapy is to be ongoing – over 48 hours the
Medical Practitioner must be informed of the
need to review the patients medications and
prescribe the necessary medication as
deemed appropriate.
• Where will you find the list of medications
that the RN can nurse initiate?

12. • Intravenous Incremental doses: This is where
the Doctor will order IV doses that will require
daily reviewing and charting.
• Can you think of some examples of
medications that would be ordered in this
section of the medication chart?

13. • Variable dose medication: This section will be
used for the Medical Practitioner to order
variable dose medication.
• Can you think of some examples of
medication that would be ordered here?

14. • Regular medication:
• Regular medication orders have a prompt for medical practitioners to
enter “times of administration” at the time of prescribing to assist in the
clarification of the frequency of orders and reduce the likelihood of error.
• A box has been added to the regular orders for pharmacists or medical
practitioners to tick if the medication is slow release to alert nursing staff
that these medications cannot be crushed.

15. Regular Medication cont….
• There is a section above the date on the administration section on each
page for the clinical pharmacist to initial the days they have completed
their pharmaceutical review.
• The nurse must sign the medication chart immediately after they have
witnessed the administration of the medication to the patient.
• The RN/EN is legally obliged to question a medication order if it is believed
to be an error.
• What must you check prior to medication administration?
• Which policy must you check to ensure the safe administration of
medications to all patients at St John of God Hospital, Subiaco?

16. • Dose Code: all codes used must be circled to
prevent them from being mistaken for a
nurse’s initials.
• These are the only codes to be used on the
medication chart.

17. • PRN Medication: A separate PRN section with space for 5 medications has been
included to highlight and separate these orders from regular medication orders.
This separation allows for the following:
a) the maximum dose to be administered in 24 hours and
b) an indication to be specified
• There are bigger administration time boxes to facilitate easier documentation of
the time, dose and the administering nurse initials.
• In addition, a “clinical pharmacist review” box is available to be initialled on the
day of each pharmaceutical review.