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syringe with the name and strength of the medicine, the patient name and the time it was prepared. Labelling is unecessary if the preparation and administration is one uninterrupted process and the labelled syringe does not leave the hands of the person who prepared it. Only one unlabelled syringe should be handled at any one time (NPSA 2007d).

Figure 13.7 Oral syringe (compliant with NPSA guidance).

Specific patient preparations

Before administering oral medication, the nurses should assess for:

the patient’s ability to understand the purpose of the medication being administered

any medication allergies and hypersensitivities

nil by mouth status

the patient’s ability to swallow the form of medication

the patient’s cough and gag reflexes

any contraindications to oral medications including nausea and vomiting, absence of bowel sounds/reduced peristalsis, nasogastric suctioning or any circumstance affecting bowel motility or absorption of medication, for example general anaesthesia, GI surgery, inflammatory bowel disease

any possibility of drug–drug or drug–food interactions

any preadministration assessment for specific medications, for example pulse or blood pressure.

(Chernecky et al. 2002, Snyder 2007)

Procedure guideline 13.3 Medication: oral drug administration

See also Table 13.9

Essential equipment

Drugs to be administered

Recording sheet or book as required by law or hospital policy

Patient’s prescription chart, to check dose, route and so on

Glass of water

Any protective clothing required by hospital policy for specified drugs, such as antibiotics or cytotoxic drugs, for example gloves

Medicine container (disposable if possible)

Preprocedure

Action Rationale

1 Wash hands with bactericidal soap and water or bactericidal alcohol handrub. To minimize the risk of cross-infection (DH 2007, C; Fraise and Bradley 2009, E).

2 Before administering any prescribed drug, check that it is due and has not already been given. Check that the information contained in the prescription chart is complete, correct and legible. To protect the patient from harm (DH 2003b, C; NMC 2008a, C).

3 Before administering any prescribed drug, consult the patient’s prescription chart and ascertain the following:

(a) Drug

(b) Dose

(c) Date and time of administration

(d) Route and method of administration

(e) Diluent as appropriate

(f) Validity of prescription

(g) Signature of prescriber

(h) The prescription is legible.

To ensure that the patient is given the correct drug in the prescribed dose using the appropriate diluent and by the correct route (DH 2003b, C; NMC 2008a, C). To protect the patient from harm (DH 2003b, C; NMC 2008a, C).

Procedure

4 Select the required medication and check the expiry date. Treatment with medication that is outside the expiry date is dangerous. Drugs deteriorate with storage. The expiry date indicates when a particular drug is no longer pharmacologically efficacious (DH 2003b, C; NMC 2008a, C).

5 Empty the required dose into a medicine container. Avoid touching the preparation. To minimize the risk of cross-infection. To minimize the risk of harm to the nurse (DH 2007, C; Fraise and Bradley 2009, E).

6 Take the medication and the prescription chart to the patient. Check the patient’s identity by asking the patient to state their full name and date of birth. If the patient is unable to confirm details then check patient identity band against prescription chart. To ensure that the medication is administered to the correct patient (NPSA 2005, C).

7 Evaluate the patient’s knowledge of the medication being offered. If this knowledge appears to be faulty or incorrect, offer an explanation of the use, action, dose and potential side-effects of the drug or drugs involved. A patient has a right to information about treatment (NMC 2008a, C; NMC 2008b, C).

8 Assist the patient to a sitting position where possible. A side-lying position may also be used if the patient is unable to sit. To ease swallowing and prevent aspiration (Chernecky et al. 2002, E).

9 Make any required assessments