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Helping Your Family Member Adjust to Nursing Home Living-Tip #28

To ensure an accurate and proper “med pass,” the nurse must adhere to the Ten Rights of Medication Administration. The second right, the right drug requires an alert nurse to perform this responsibility error free. When a physician writes an order for a medication, the nurse transcribes the order on the Medication Administration Record (MAR) and some facilities require a second nurse to double check the order against the MAR. If abbreviations are used, it is mandatory that they be accurately transcribed; some facilities discourage this due to the increased risk of errors. The pharmacy usually receives a faxed copy of the order, where the medication is dispensed and delivered to the nursing home. The pharmacy is also responsible for recognizing drug factors when reviewing the physician medication orders. The locked med cart often contains most/all of the medications for many residents. Before the medication is administered, the nurse must check the pharmacy label of the medication to the MAR as it is removed from the med cart. The prescription label is then checked against the order before placing it in the med cup. Finally, the medication is then checked against the MAR after it is placed in the med cup. The nurse must understand the uses, actions, adverse side effects, contraindications and what the resident needs to know about the drug before giving any medication. The expiration date also needs to be confirmed. The medication is then taken by the resident in the presence of the nurse. It is risky for a nurse to administer meds that were prepared by others. Caution is required when medications have sound alike names. These steps must be followed to ensure safe administration of the right drug. This is basic training, usually taught to nursing students before they ever actually pass medication to residents. If there is any doubt about a medication that a nurse gives to your loved one, ask the nurse to confirm if it is the correct medication and/or if it was actually ordered.