Meds Check-Off---Advice????

JB2007, ASN, RN · Sep 22, 2010

This is the most important thing that I can suggest take a deep breath and RELAX. Getting all worked up over this will cause you to make mistakes that you would not normally. Follow your instructors directions and you will be fine. Good luck and study hard.

netglow, ASN, RN · Sep 22, 2010

Just remember to assess first (vitals, skin, etc.) Also check ID/MAR/ask pt. if allergies.

cecilsgirl · Sep 22, 2010

and may I add, in the middle of all this , do not forget the 5 rights!!!! after 20 years I still know how important that is.

April, RN, BSN, RN · Sep 22, 2010

After you dispense your meds, double check the order in the MAR before administering. Also, don't forget to sign off the med once given!

cecilsgirl · Sep 22, 2010

PS ............and I may add, after 21 years as a Nurse, I have made a few med errors, but they were all because I was in a hurry, I forgot the 5 rights of med administration .. all stupid, but sooo human, ... and I never forgot them !! or made the same mistake 2 times. Good Luck !!

BabyLady, BSN, RN · Sep 22, 2010

I'm a first semester Nursing student and we have our Medication Check-Off next week and ALL of us are soooooo nervous and scared about passing this check-off! We were told there would be three different types of medication (i.e. tablet, patch, inhaler, liquid, drops, etc.) and we will need to properly read the patient's chart and correctly administer the medication. I know that we need to observe the three label checks and the patient's rights, but is there ANY other advice that some of you seasoned Nurses and later-semester students could give us to help us pass this MOST important check-off? We have been practicing, but there just seems like there is sooooo much to remember and only ONE little slip-up and we will fail. PLEASE send me some study/practice suggestions for this if you guys can! It would be very much appreciated!!!! Thanks!

My tips:

1. Remember that you never rub transdermal patches.

2. Stick with that you know...I'll be honest..tons of other nurses try to tell me other ways to do my med calculations, but the way I was taught in school, that short of a mathematical error, it almost made making a mistake impossible. So I do what I have always done and I won't change b/c it works for me.

3. Just relax...I always did very well on my tests but the first time I gave a med to a real patient I was shaking in my boots.

Forever Sunshine, ASN, RN · Sep 22, 2010

First off verify your MAR agaisnt the doctors orders.(In LTC we don't do this as its too time consuming for the number of patients we have per med pass.

Set up the cart.. pudding, applesauce, juice, water, cups, spoons, straws, syringes and insulin(if you have to do that too), tissues, gloves and hand sanitizer.

Wash your hands.

Introduce yourself to the patient. Verify that you have the right patient by name/picture/medical recard number/birthdate. Get any vital signs/blood sugars if the meds have certain parameters.

Wash your hands again.

Find the patients MARs in the MAR book. Turn to the first page. I like to go through to have an idea of what I have to give.

Pay close attention to the times. My facility uses 8:30am/4:30pm. Some places use 0830/1630pm.

Pull the first med that you have to give. Triple check patient, med, dose, route, and time. Do this again after putting it in the cup.

Repeat this over and over until you have gotten through the whole mar. Get clips and put a clip on the side of the page you need to sign and go back and sign after you have given the med.

When you go to give the med, verify the right patient, with their armband, and MAR.

Do not leave the patient until all meds have been swallowed.

After the patient has taken the meds, wash your hands and go sign the mar.. or if they refused. put that they refused it. Don't forget to document if you took any vitals. Theres usually a space on the MAR for that.

For digoxin- Apical pulse one minute.

Do not touch any pills. If it comes in a bottle, use the cap to pour the correct amount of pills in.

If its a capsule and the patient needs to take in pudding/applesauce. My facility has us put on gloves. open capsule into pudding/applesauce. take off gloves. and performing hand hygiene before and after putting on gloves.

For narcotics. Sign out med before popping into the cup. Any wastes must be done with an RN.

Patches- Wear gloves, treat it as a med.. 5 rights, Remove old patch and dispose of correctly. Put the date, time and your initals on the new patch and apply to clean, dry, skin. Chest or back... even upper arm is acceptable sometimes.

Don't forget to relax and breathe.

Bec717 · Sep 22, 2010

Great adivce above- I wear gloves when I open the package-- a few patients have mentioned they appreciate it, as they have seen others touch their pills & don't forget your patient education- the drug name, is this a home medication for you,what the meidcation is given for, any questions, any common side effects or call the RN if..............

BabyLady, BSN, RN · Sep 22, 2010

Great adivce above- I wear gloves when I open the package-- a few patients have mentioned they appreciate it, as they have seen others touch their pills & don't forget your patient education- the drug name, is this a home medication for you,what the meidcation is given for, any questions, any common side effects or call the RN if..............

This is also a good tip and I think was an NCLEX question when I was studying for my boards.

It is for the protection of the patient as well as to prevent the nurse from absorbing minute amounts of the medication.

April, RN, BSN, RN · Sep 22, 2010

First off verify your MAR agaisnt the doctors orders.(In LTC we don't do this as its too time consuming for the number of patients we have per med pass.
Set up the cart.. pudding, applesauce, juice, water, cups, spoons, straws, syringes and insulin(if you have to do that too), tissues, gloves and hand sanitizer.
Wash your hands.
Introduce yourself to the patient. Verify that you have the right patient by name/picture/medical recard number/birthdate. Get any vital signs/blood sugars if the meds have certain parameters.
Wash your hands again.
Find the patients MARs in the MAR book. Turn to the first page. I like to go through to have an idea of what I have to give.
Pay close attention to the times. My facility uses 8:30am/4:30pm. Some places use 0830/1630pm.
Pull the first med that you have to give. Triple check patient, med, dose, route, and time. Do this again after putting it in the cup.
Repeat this over and over until you have gotten through the whole mar. Get clips and put a clip on the side of the page you need to sign and go back and sign after you have given the med.
When you go to give the med, verify the right patient, with their armband, and MAR.
Do not leave the patient until all meds have been swallowed.
After the patient has taken the meds, wash your hands and go sign the mar.. or if they refused. put that they refused it. Don't forget to document if you took any vitals. Theres usually a space on the MAR for that.
For digoxin- Apical pulse one minute.
Do not touch any pills. If it comes in a bottle, use the cap to pour the correct amount of pills in.
If its a capsule and the patient needs to take in pudding/applesauce. My facility has us put on gloves. open capsule into pudding/applesauce. take off gloves. and performing hand hygiene before and after putting on gloves.
For narcotics. Sign out med before popping into the cup. Any wastes must be done with an RN.
Patches- Wear gloves, treat it as a med.. 5 rights, Remove old patch and dispose of correctly. Put the date, time and your initals on the new patch and apply to clean, dry, skin. Chest or back... even upper arm is acceptable sometimes.
Don't forget to relax and breathe.

Reading this just brought back those feelings of anxiety from nursing school! It's a wonder that we all didn't end up with stress ulcers by the time we graduated! :eek:

Forever Sunshine, ASN, RN · Sep 23, 2010

Reading this just brought back those feelings of anxiety from nursing school! It's a wonder that we all didn't end up with stress ulcers by the time we graduated!

I just tried to remember what my nursing instructors and inservices said about med passes.

I did one in med-surg clinical, but my instructor walked me through parts of it.