Chapter 15: Medicines optimization: ensuring quality and safety
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15.9 Medication: nasal drop administration
Essential equipment
- Personal protective equipment
- Recording sheet or book as required by law or hospital policy
- Patient's prescription chart, to check dose, route, etc.
- Electronic identity check equipment, where relevant
- Tissues
Optional equipment*****
- Cotton bud
Medicinal product
- Nasal spray, drops, ointment or cream
Pre‐procedure
ActionRationale
- 1.
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.Wash hands with bactericidal soap and water or an alcohol‐based handrub.
- 3.Before administering any prescribed drug, look at the patient's prescription chart and check the following:
- the correct patient is being given the drug
- drug
- dose
- date and time of administration
- route and method of administration
- diluent as appropriate
- validity of prescription
- signature of prescriber
- 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).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 - 4.Have paper tissues available.To wipe away secretions and/or medication. E
Procedure
- 5.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).
- 6.Ask the patient to blow their nose to clear the nasal passages, if appropriate.To ensure maximum penetration of the medication (Chernecky et al. [39], E).
- 7.Assist the patient into a supine position and hyperextend the neck (unless clinically contraindicated, e.g. due to cervical spondylosis).To obtain the safest optimum position for insertion of the medication. E
- 8.Wash hands and put on gloves.
- 9.With the non‐dominant hand, gently push upward on the end of the patient's nose.To aid in opening the nostrils. E
- 10.Avoid touching the external nares with the dropper and instil the drops just inside the nostril of the affected side.To prevent the patient from sneezing. E
- 11.Ask the patient to sniff any liquid into the back of the nose or to maintain their position for 2–3 minutes.To ensure full absorption of the medication. E
- 12.Discard any remaining medication in the dropper into a sink before returning the dropper to the container.
- 13.Instruct the patient not to blow their nose for several minutes.To keep the medication in contact with the nasal passages. E
- 14.Each patient should have their own medication and dropper.
Post‐procedure
- 15.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).