Running Head: MEDICATION ADMINISTRATION IN NURSING HOMES

Medication Administration in Nursing Homes

Angela N. Hulme

Anderson University
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In evaluating the various medication administration processes, a lot of the nursing homes

currently use the paper medication administration record. When a physician orders a medication,

the order is written on paper and put into the patient’s chart. It is the responsibility of the nurse to

make sure that the order is transferred over to the paper medication administration record. In the

event, that the nurse fails to write the new order on the paper medication administration record,

the patient misses that dose or change in medication. The nurses use a rolling cart to go to each

patient’s room to administer medications. The rolling cart with the paper medication

administration record is kept on the rolling cart. The nurse interacts with the patients and their

families during the administration of medication. In the event, the physician changes an order

during medication administration, it is very easy for the nurse to get distracted by the patient or

patient’s family. When a physician calls an order by telephone, it is the nurse’s responsibility to

make sure the order is written on an order form for the chart, and written in the paper medication

administration record. During administration of medication, the patients are identified by their

room number and/or another staff member confirming their identity. There are some patients that

are able to verify their name and date of birth; however, there are several patients with dementia

that are not oriented to person. The majority of the patients have a roommate that lives in the

room with them. When the nursing home hires new nurses, this can be challenging during the

medication administration.

An improvement process plan that would increase patient safety during medication

administration would include an updated computerized system. In addressing the benefits of

electronic medication administration, the long care facilities would benefit in advance

technologies due to the patients being older, having numerous chronic conditions, and numerous

medications (Bhuyan, Chandak, Powell, Kim, Shiyanbola, Zhu & Shiyanbola, 2015). In using a
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computerized system, the physician could put the order directly into the computer so that the

order is not missed or forgotten by the nurse.

The second improvement would include having an area designated for nurses that would

allow them to prepare medications without any distractions. During studies performed on

interruptions, the frequency and characteristics of distractions show that nurses have little

uninterrupted time to focus on medication (Flynn, 2016). The nurses would be able to utilize this

area to gather everything they need to begin their administration of medications.

The third improvement in the process plan would involve having the patients have a

bracelet, necklace, or a sticker form of identification. If a patient refuses to wear a bracelet or

necklace with an identification barcode on it, the facility could have stickers with the barcode on

them for the patient’s to wear on their clothing. In using barcode technology, it has been

identified as a way of improving medication administration through confirming a patient’s

medication at the bedside to ensure the 5 rights which consist of the correct drug, dose, time,

route and patient (Truitt, Thompson, Blazey-Martin, Nisai & Salem, 2016).

In using the benefits of advanced technology, the administration of medications would

improve patient safety. When administering medication to patients with impaired cognitive

abilities, it is very easy to make a medication error. When using the paper medication

administration record, the verbal dictation of physicians to nurse’s can easily be

miscommunicated or forgotten. In order to improve the process of administering medications, the

computerized medication management helps to decrease the amount of medication errors.

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References

Bhuyan, S. S., Chandak, A., Powell, M. P., Kim, J., Shiyanbola, O., Zhu, H., & Shiyanbola, O.

(2015). Use of information technology for medication management in residential care

facilities: correlates of facility characteristics. Journal of Medical Systems, 39(6), 70.

doi:10.1007/s10916-015-0252-0

Flynn, F. (2016). Progressive Care Nurses Improving Patient Safety by Limiting Interruptions

During Medication Administration. Critical Care Nurse, 36(4), 19-35.

Truitt, E., Thompson, R., Blazey-Martin, D., NiSai, D., & Salem, D. (2016). Effect of the

Implementation of Barcode Technology and an Electronic Medication Administration

Record on Adverse Drug Events. Hospital Pharmacy, 51(6), 474-483.

doi:10.1310/hpj5106-474