AnonymousRN

Hi. I was taught in nursing school that you should never sign out a med until it has been administered. However, certain hospitals have policies in place that you can sign out a med prior to it being given (i.e. immediately prior to your entering the patients room with the med) and then circle your initials if the patient refuses it or if certain parameters (i.e. hr/bp too low) preclude administration. You then document in your nurses note why the medication wasn't given. Always check your hospitals policy on medication administration first. The reason that certain hospitals have this policy in place is that by initialling the medex prior to administration it ensures that the med was put into the cup to be given to the pt. This is helpful when pts have multiple meds. If you wait until after your meds are given to sign off, you could have missed a certain med (it never got into the cup) yet not realize it, go back to your medex after medicating your pt, then just go down the list and sign off all the "open" spots. My hospital does not allow signing off prior to administration. Therefore, what I like to do is put a little check mark in each slot after I've put a med in the cup, then after admin, I go back and sign off. Believe me, it's very helpful. When I was in school I thought I'd never miss a med, but it happens, even to "very careful" nurses. I've gone back to the medex and not seen the check mark and then realized that for whatever reason my eyes just passed over that particular med, and I'm a nurse that triple checks everything! At that point, you just go back in and administer it and med error averted. Hope this helps.