Protocols

Protocol 100: Medication Administration

1. FIRST, DO NO HARM:   Medication errors are the most common AVOIDABLE error that causes patients direct harm.  When in doubt, contact ON DUTY MEDICAL CONTROL for any questions concerning dosage.

2.  VERIFY “5 RIGHTS”:

               - right patient

           - right drug

           - right dose

           - right route (IV, IO, IM, SC, etc)

           - right time (including rate of administration)

3.  DOCUMENTATION: document accurately all medications administered, any reaction to medication, repeat vital signs after administration, and any adverse events.

4. MEDICATION ERRORS: Any error in medication administration should be documented and reported immediately through the CQI process to the Medical Director / Liaison for review.  The goal of CQI review is to determine and minimize systemic contributions to causality of errors, not to take punitive action.

5.  PEDIATRICS:  Errors in pediatric medication dosing occur more often due to poor estimates of weight or infrequent use of pediatric doses.  Every effort must be made to obtain accurate weight estimates, accurate calculation of dose, and appropriate monitoring of patient response.  When in doubt, contact MEDICAL CONTROL for verification of dosage.  Standardized tools to determine dosing in critical situations, such as a ‘pedi-wheel’ or Broslow tape, are encouraged.

               *****When calculating pediatric doses, NEVER ROUND UP*****