Nothing replaces the “six rights” that nursing students learn as part of medication administration techniques—the right patient, drug, dose, route, time and documentation, plus the correct reason for its delivery. These checks are done before administering any medication to prevent potentially lethal drug errors. While the nurse’s clinical reasoning remains critical, technology also plays a role in safety today.
A major thrust of The Joint Commission National Patient Safety Goals of 2007 includes the mandate for hospitals to implement a plan for executing a bar-code technology and medication delivery system. This “point of care” solution helps to automate medication administration including validation of the six rights of medication administration. Hospitals have invested in medication dispensing cabinets which store not only the day’s medication for a patient but also the prescriber’s orders and related drug information such as allergies that have an impact on patient safety.
The Learning Resource Center (LRC) at the College of Nursing has invested in patient safety as well, purchasing five medication dispensing cabinets for its clinical simulation labs. Students who are learning about drug administration, or are soon to start their clinical practica in acute care settings, benefit from hands-on practice with this technology. “Because medication safety procedures are critical to overall patient safety goals, the integration of these advanced medication systems allow faculty to provide more realistic and effective medication administration experiences in the clinical simulation lab,” says LRC Director Colleen Meakim, MSN, RN.
Each mobile workstation has a 15” touch screen with a Windows based operating system, barcode scanner and 24 drawers for medications, plus a cabinet for bulks supplies such as those required for intravenous therapy. It also includes a supply of Demo-Dose medications, prepackaged simulation drugs with accurate labels and barcodes just as the students would see in the clinical setting.
Students learn the principles of safe medication administration in the sophomore year followed by a more detailed experience in administering multiple types of medications and use of various routes of administration starting in the junior year. Student Jessica Lee used the new technology early in the semester before starting her medical-surgical clinical practicum at an area hospital. “Practicing on the med carts in lab helped me to think critically while in clinical,” says the junior from Albany, N.Y. She and her clinical group, guided by faculty, participated in medication administration simulation scenarios where the nursing students read their patient’s history and current status and check their patient’s orders for the shift. They log into the workstation, select their patient and the drug to be given, run through a series of checks and scan the drug barcode before administering the drug. The system alerts them to potential problems, such as allergies or an incorrect drug selection, thereby protecting the patient.