One of the most critical aspects of nursing education is ensuring that your nursing students learn to administer medications safely. As educators, we understand that mastering medication administration requires knowledge, hands-on practice, and clinical judgment. With patient safety at stake, assessing whether students are truly prepared to manage medications effectively in real-world healthcare settings is essential. Let’s explore critical indicators that your students are developing the skills and competencies to pass medications safely.
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We can all agree that removing medications from an automated dispensing unit (ADU) and administering them at the patient's bedside using an electronic medication administration record (eMAR) is a crucial practice for nurses to acquire, whether working in an acute care or long-term/skilled nursing care facility. How do we know this? Well, here are some reasons that are based on current research and best practice protocols:
Reduction of Medication Errors
ADUs and eMARs help minimize medication errors. Research shows that errors often occur during medication preparation and administration, especially when doses are manually prepared. The medication is pre-measured using unit doses, reducing the risk of dosage errors. Coupled with eMAR, which provides real-time patient data and medication orders, nurses are less likely to administer the wrong medication or dose, ensuring higher accuracy.
Enhanced Patient Safety
Administering medications at the bedside with eMAR enables real-time verification, such as barcode scanning of both patient wristbands and medications. This ensures that the “rights" of medication administration are adhered to. A 2017 study indicated that integrating barcode technology with eMAR reduced bedside medication errors by as much as 50%.
Improved Workflow Efficiency
Unit dose dispensing cabinets streamline medication retrieval, saving time by organizing medications by the patient and limiting access to only those medications prescribed for the specific patient. With eMAR, synchronized with the patient’s medical record, this reduces the need for manual record-keeping and allows nurses to focus more on patient care rather than administrative tasks.
eMAR enables real-time documentation of medication administration, which helps maintain accurate records for compliance with hospital policies and legal regulations. This immediate documentation improves communication between healthcare teams and ensures that critical medication data is not missed or delayed.
Unit dose dispensing cabinets limit access to controlled substances and other high-risk medications. Each nurse has to authenticate access, which creates an audit trail. This, combined with real-time tracking through eMAR, reduces the risk of drug diversion or misuse, improving security and accountability in medication handling.
Research has consistently shown that combining unit dose dispensing and bedside administration using eMAR systems leads to better patient outcomes. These systems reduce adverse drug events and contribute to faster recovery times by ensuring that medications are administered accurately and on time, directly improving patient safety.
Even with the advent of technologies like ADUs and eMAR software, the nurse must perform critical manual checks competently and consistently during every medication administration. The first two happen in the med room, and the third is at the bedside. These three checks are essential for all nurses to integrate into their practice.
The nurse first checks that the medication entered in the ADU matches the medication order in the eMAR. This starts by verifying the correct drug, dose, and form (e.g., tablet, liquid) by comparing the eMAR information with the order on the AUD screen.
The nurse then checks that the medication retrieved from the ADU matches the medication order in the eMAR. This includes verifying the correct drug, dose, and form (e.g., tablet, liquid) by comparing the eMAR information with the medication label retrieved from the ADU.
These first two critical checks ensure that the nurse is retrieving and preparing the exact medication prescribed for the patient. Any mismatch between the eMAR and the ADU’s dispensed medication could lead to errors such as administering the wrong drug or incorrect dosage.
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At the bedside, the nurse ensures that the medication dispensed from the ADU is intended for the correct patient. This includes not only having the patient identify themselves, when possible but also scanning the patient’s wristband barcode and the medication barcode and confirming that the medication order matches the patient’s prescription on the eMAR. This step is the final stopgap that prevents the nurse from administering the medication to the wrong patient, a leading cause of medication errors.
So, if we have advanced technologies and manual checks, where do the “Rights of Medication Administration” fit into this picture? The primary goal of “rights” is to protect patients from harm. By verifying each right, nurses minimize the risk of potentially life-threatening medication errors such as administering the wrong drug, incorrect dosage, or at the wrong time. This is particularly important when dealing with high-risk medications like anticoagulants, insulin, or opioids.
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Medication errors can lead to adverse drug reactions, patient harm, extended hospital stays, or even fatalities. Research has shown that medication errors significantly cause preventable harm in healthcare. By following the rights of medication administration, nurses have a systematic process that helps catch potential errors before they occur. This process allows nurses to meet their legal and ethical responsibilities, protecting the patient and themselves. The table below can serve as a great teaching tool or resource for your nursing students:
And, of course, nurses can’t dispense and administer medication without documentation…closing the loop on this critical aspect of patient care. Medication administration records are vital for ensuring clear communication between healthcare providers. Other care team members rely on accurate records to make informed decisions about a patient’s ongoing treatment. If the documentation is inaccurate, it can lead to confusion, delays, or inappropriate care. Documenting medication administration accurately helps your students develop accountability and attention to detail. It also provides a record you can review to assess your students’ understanding and identify areas for improvement.
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