TITLE: MEDICATION SYSTEM D. E. F.

POLICY #M-03

Check allergies on Medical Care Plan/Allergy List. Select appropriate medication from designated drawer. Carefully check the labels on the medications with the entries on the Meds Due List: correct drug, dose, correct time, route. G. Medications may be given one hour before or after schedule dose.

5.

To Administer the ordered medications: A. Open strip package and places tablets or capsules in medication cup. If patient is not able to handle the medications, the nurse places them into his/her mouth or feeds from cup. Gloves should be worn when there is potential for contact with oral secretions. Break open seals of liquid medications and hand them to patient. Administer injectable and intravenous meds, ointments, drops, as ordered. Flush nasogastric or gastrostomy tubes with 20 cc H20 before and after medication administration. Placement and patency of tube checked prior to administration of drugs by auscultating abdomen while injecting air.

B. C. D.

6. 7.

Initials may be charted on the Scheduled Meds Due List before moving on to the next patient. After administering the medications for that hour, immediately chart in the MIS System all medications as GIVEN or NOT GIVEN. Any meds not documented via MIS within 3 hours of scheduled time will generate on Unreported Scheduled Meds list at 3 A.M. daily.

8.

OBTAINING AMD RETURNING MEDICATIONS: 1. 2. The Pharmacy is open 24 hours a day for obtaining medications. Reorder of drugs - If sufficient drugs are not in the medication cart, use the MIS System to reorder under Pharmacy request.

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TITLE: MEDICATION SYSTEM 2.

POLICY #M-03

Apical Pulse - If below 60, withhold drugs listed below and notify attending physician unless otherwise noted in the order. Digoxin Disopyramide Procainamide Quinidine

If apical rate is above 120, withhold the drugs listed below and inform the physician unless otherwise noted in the order. Atropine Sulfate Adrenalin Isuprel Epinephrine

Blood Pressure - Blood Pressure is to be checked prior to giving the following: Captopril Methyldopa Prazosin Nicardipine Enalapril Nifedipine Terazosin Nimodipine Hydralazine Nitroprusside Isradipine

Blood Pressure and Apical Rate are to be checked prior to giving the following: Clonidine Diltiazem 3. Metoprolol Propanolol Betaxolol Verapamil

Insulin - When a diabetic patient who has insulin coverage is ordered NPO or on clear liquids for tests or O.R., the insulin order must be clarified with the physician.

DOCUMENTATION: Scheduled medications are documented in MIS as given or not given. PRN medications are documented in MIS when they are administered. Administered topical agents are documented in progress notes in medical record by physical therapists or physical therapist assistants. Transcription errors require an incident report to be completed. INFECTION CONTROL: 1. Aseptic technique in administration. 2. Keep medication cart clean; contact Environmental Services for "steam-cleaning" as needed. 3. Maintain Universal Precautions and handwashing. 132a