Pre‐procedure

ActionRationale

1. 1.Show
   Introduce yourself to the patient, explain and discuss the procedure with them, and gain their consent to proceed.
   To ensure that the patient feels at ease, understands the procedure and gives their valid consent (NMC [257], C).
2. 2.Show
   Wash hands with bactericidal soap and water or an alcohol‐based handrub.
   To minimize the risk of cross‐infection (DH [64], C; Fraise and Bradley [98], E).
3. 3.Show
   Before administering any prescribed drug, check that it is due and has not already been given. Carry out any required assessments, such as pulse, blood pressure and respiration. Check that the information contained in the prescription chart is complete, correct and legible.
   To protect the patient from harm (DH [61], C; NMC [257], C).

   Assessments are required to ensure the patient is fit enough to receive medication, for example blood pressure check before antihypertensives (Chernecky et al. [39], E).
4. 4.Show
   Before administering any prescribed drug, look at the patient's prescription chart and check the following:

   1. the correct patient is being given the drug
   2. drug
   3. dose
   4. date and time of administration
   5. route and method of administration
   6. diluent as appropriate
   7. validity of prescription
   8. signature of prescriber
   9. the prescription is legible.
   To ensure that the correct patient is given the correct drug in the prescribed dose using the appropriate diluent and by the correct route (DH [61], C; RPS [317], C).

   To protect the patient from harm (DH [61], C; NMC [257], C).
   If any of these pieces of information are missing, unclear or illegible, do not proceed with the administration. Consult with the prescriber.
   To prevent any errors occurring. E

Procedure

1. 5.Show
   Select the required medication and check the expiry date.
   Treatment with medication that is outside the expiry date is dangerous. Drugs deteriorate with storage. The expiry date indicates when a particular drug is no longer pharmacologically efficacious (DH [61], C; RPS [317] C).
2. 6.Show
   Empty the required dose into a medicine container. Avoid touching the preparation.
   To minimize the risk of cross‐infection. To minimize the risk of harm to the nurse (DH [64], C; Fraise and Bradley [98], E).
3. 7.Show
   Take the medication and the prescription chart to the patient. Check the patient's identity by asking them to state their full name and date of birth. If the patient is unable to confirm these details, then check the patient identity band against the prescription chart. If an electronic identity check system for the patient and/or medicine identification is in place, then use it in accordance with hospital policy and procedures. Check the patient's allergy status by asking them or by checking the name band.
   To ensure that the medication is administered to the correct patient and prevent any errors related to drug allergies (NPSA [262], C).
4. 8.Show
   Evaluate the patient's knowledge of the medication being offered by asking them to tell you what the medication is for and what side‐effects to expect. If this knowledge appears to be faulty or incorrect, offer an explanation of the use, action, dose and potential side‐effects of the drug or drugs involved.
   Patients have a right to information about treatment (NMC [257], C).

   To ensure that the patient understands the procedure and gives their valid consent (Griffith and Jordan [110], E; NMC [257], C).
5. 9.Show
   Assist the patient into a sitting position where possible. A side‐lying position may also be used if the patient is unable to sit.
   To ease swallowing and prevent aspiration (Chernecky et al. [39], E).
6. 10.Show
   Administer the drug as prescribed.
   To meet legal requirements and adhere to hospital policy (DH [61], C; NMC [257], C; RPS [317], C).
7. 11.Show
   Offer a glass of water, if allowed, assisting the patient where necessary.
   To facilitate swallowing of the medication (Chernecky et al. [39], E; Jordan et al. [149], E).
8. 12.Show
   Stay with the patient until they have swallowed all the medication.
   To ensure that the medication is taken on time (Chernecky et al. [39], E).

Post‐procedure

1. 13.Show
   Record the dose given and sign the prescription chart. Also sign in any other place made necessary by legal requirement or hospital policy.
   To meet legal requirements and adhere to hospital policy (DH [61], C; NMC [257], C; RPS [317] C).