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Class notes NRSG1301
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Lecture notes of 10 pages for the course NRSG1301 at RRC (Med Admin guide)
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Medication Administration 2Medication Legislation and Standards: FEDERAL LEVEL
Health Products and Food Branch (HPFB) of the federal government
Regulates the manufacture and sale of all health products and drugs
within Canada
Assess the safety, efficacy and quality of a drug and authorizes its sale
within Canada
Licenses most drug production sites and conducts regular inspections as a
condition for licensing
Conducts market surveillance, monitors adverse reaction reports,
investigates complaints and problem reports, and manages recalls, should
the necessity arise
Food and Drug Act
Regulates prescribing standards of composition, strength, potency, purity,
quality or other property of an article of food, drug, cosmetic or device
Covers all drugs includes herbs, and other natural health products
Directorate under HFPB Natural and Non-prescription Health Products
Mandate = oversight of nonprescription, disinfectant drugs, and
natural health products
Medication Legislation and Standards: PROVINCIAL LEVEL
College of Registered Nurses of Manitoba (CRNM)
Establishes regulations that guide nursing practice related to safe
medication administration
Standards include med administration
Negligence or malpractice (what nurses are mostly sued for)
Carelessness = not checking armband which results in admin of
med to wrong pt
Entry-level Competencies for RNs (2019)
Applies knowledge of pharmacology and principles of safe medication
practice
Scope of Practice for RNs (2019)
Competencies for the RN (Authorized Prescriber) (2018)
Medication Legislation and Standards: SITE LEVEL
Healthcare institutions establish policies for drug control, and administration
that conform to federal/provincial regulation
More restrictive than government controls
I.e., auto stop for a/b after certain number of days to prevent drug
sensitivity or toxicity
BE AWARE of site’s policy on high-risk meds
Students cannot prepare or administer high-risk meds
, I.e., IV Heparin for Acute Coronary Syndrome (ACS) or
DVT/PE or IV insulin)
ACS = umbrella term for situations where the blood supplied
to the heart muscle is suddenly blocked causing ischemia i.e.,
heart attack, unstable angina
Hospital policy and procedure manuals outline hospital approved protocols for
completing procedures
Many policy and procedure manuals are accessible through an institutions
intranet
Legal Aspects of Medication Administration
Med administration is regulated
Know site policy and procedure, and recognize limits of own knowledge and skill
Nurses are responsible for their own practice even if the written order was
incorrect
Important to question orders that are incomplete or do not make sense
Cannot delegate med admin in most healthcare settings
Just because there is an order does not mean it is safe to administer
(e.g., Lasix when SBP <90)
Standards of practice
Student nurses are held to the same standard as an RN
o Student nurses are held accountable for med errors
Promotion of a “just” culture patient safety institute is an important part in safe
medication preparation and administration practices.
Nurses’ Responsibilities:
o Interpretation of orders
o Transcription/ reconciliation (students cannot transcribe orders)
o Administration
o Monitoring
o Reporting
To identify system flaws and recognize that system failures impact
number of errors.
Ex:
o Flaws in hospital policy and procedure.
o Large amount of noise and getting interrupted during med
admin some places state “do not disturb” slogan taped
on the floor that anyone is not allowed to step into if
someone is preparing meds.
Medication Errors
Any preventable event that could cause or lead to a client either receiving inappropriate
med therapy or failing to receive an appropriate medication therapy
Safe medication preparation and administration requires nurses critical thinking and
focus; thus, it is important for interruptions to be stopped and med errors to be reported
for client safety.
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