Incorrect Medication Administration Route?

[Steveo123]

Being in nursing school, I am more than aware that "Right Route" is one of the Patient Rights in regards to medication administration. However, I have noticed through my clinical experiences that there are some orders written to give a medication inappropriately relating to the situation (example: the patient is unable to swallow and the medication should be given through his/her NG tube but the order states PO). Other orders for the patient will specify to give the medications per the correct route, however there always seems to be one that is incorrect and the nurse administers it to the patient in the way it should be. My question: is it appropriate for a nurse to give a medication through the intended route instead of what the order says, or does the nurse HAVE to have the order changed by the physician to state the correct route before the medication can be given legally?

[gmondina]

To be safe, get a correct order. But i it does not make sense like the order says PO and the patient cannot swallow, clarify it with the doctor and get an order what is best for the patient.

Sent from my iPhone using allnurses.com

[Esme12, ASN, BSN, RN]

Here is the deal......NGT is usually a treatment for the acute abdominal patient whether it is a GI bleed of post surgical abdomen. These patients are usually NPO.

They shouldn't have any meds.

Go right ahead an give the meds through the NGT because they "end up in the stomach anyways" is allowing the MD/NP/PA/primary care provider to get away with being lazy and not reconciling the med to their proper route. There are meds that cannot be crushed for example as I have said before "SUSTAINED RELEASE/TIMED RELEASE" meds which rely on the exterior coating for proper administration and effectiveness.

Someone is going to come along and follow the MAR exactly........If there is no clarification and someone comes an gives a non swallowing chronic G tube po meds and they aspartate and die. Or....... give a timed release narcotic and the patient becomes snowed or non responsive and becomes hypoxic....WHO do you think the MD/PA/NP/primary care provider will blame? Themselves? NO....they will blame you.

What is the harm in a phone call?

I have no problem making the "advanced provider" do their job.

[PunkBenRN]

Here is the deal......NGT is usually a treatment for the acute abdominal patient whether it is a GI bleed of post surgical abdomen. These patients are usually NPO.

They shouldn't have any meds. .

Yes, this is one indication for an NGT, however you can have one outside the realm of GI bleed, bowel obstruction, or post-op. In these cases, NPO is moot point because it is usually hooked up to suction. In and right back out

I guess the general consensus is "Just call the Doc", this is always a good way to handle situations like these.

[guest64485]

Some medications which can not be crushed will have a substitute available which can go through the g-tube. In my hospital the pharmacists can change orders to substitute a non crush-able med with the equivalent liquid/crush-able version without having to consult with the doctor. I've called on them a lot for my G-tube patients.

Schools always just seem to say to call the doctor but there are so many other professionals that can be of assistance such as dietitians and pharmacists so be sure to make use of their skills and abilities!