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 (Griffith and Jordan [110], E; 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, 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
   10. the patient's allergy status.
   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; RPS [317], 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. 4.Show
   Put on a plastic apron and assist the patient into the required position.
   To protect the patient from infection and the nurse from the topical agent as well as to allow access to the affected area of skin. E
2. 5.Show
   Close the room door or curtains if appropriate.
   To ensure patient privacy and dignity. E
3. 6.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. 7.Show
   Expose the area that requires the medication and where necessary cover the patient with a towel or sheet.
   To gain access to the affected area and to ensure patient dignity. E
5. 8.Show
   Apply gloves and assess the condition of the skin, using aseptic technique if the skin is broken.
   To prevent local or systemic infection (DH [64], C; Fraise and Bradley [98], E).
6. 9.Show
   If the medication is to be rubbed into the skin, the preparation should be placed on a sterile topical swab.
   To minimize the risk of cross‐infection. To protect the nurse (DH [64], C; Fraise and Bradley [98], E).
7. 10.Show
   If the preparation causes staining, advise the patient of this.
   To ensure that adequate precautions are taken beforehand such as removal of clothing and to prevent stains (NMC [257], C).
8. 11.Show
   Apply the medication.
   To ensure the medication is applied. E
9. 12.Show
   Apply a sterile dressing if required.
   To ensure the ointment remains in place (Chernecky et al. [39], E).

Post‐procedure

1. 13.Show
   Remove gloves and apron and dispose of waste appropriately.
   To ensure safe disposal and prevent reuse of equipment (HWR [137], C; MHRA [201], C).
2. 14.Show
   Record the administration on the appropriate charts.
   To maintain accurate records, provide a point of reference in the event of any queries and prevent any duplication of treatment (RPS [317], C).