Current Status of Administration of Medicine
Shane, R. (March 1, 2009). American Journal of Health-System Pharmacy, 66:5 Supplement 3, s42–s48; doi: 10.2146/ajhp0606/
http://www.ajhp.org/content/66/5_Supplement_3/s42.full
Abstract
On an international basis, the domain of administration of medications is primarily the responsibility of nurses, although nurse technicians are used in countries such as Brazil. Medication administration is often referred to as the “sharp edge” in the medication-use process because errors introduced at the prescribing, dispensing, or transcribing step, if not intercepted, will result in the patient receiving the medication in error.
The administration of medications consists of a series of complex, problem-prone processes. In a study of the origin of errors, 38% of preventable medication errors occurred at the administration step. It has been claimed that nurses spend up to 40% of their time administering medications. The frequency of administration errors ranges from 2.4% to 47.5%, depending on the drug distribution system in place. In the United Kingdom, a recent report by the National Patient Safety Agency (NPSA) indicated that 56.5% of reported errors associated with severe harm or death occurred at the administration step.
Medication orders require the drug, dose, rate, route, frequency, and, when appropriate, duration to be explicit and specific to the needs of the patient in order to achieve the desired outcome. In effect, medication orders are sentences where an error or lack of precision in any of the elements of the order can result in unintended consequences. Administration of the wrong medication, dose, dosage form, route, rate, or frequency are examples of consequences due to misinterpretation, ambiguity, or lack of knowledge or understanding of elements of the medication order sentence.