1. Pharmacology
Dose Over Have

2. Safe Dose
• Legal responsibilities
• Six rights
• Nursing process
• Components of medication prescription
• Minimize medication errors
• Atraumatic care to pedicatrics
• Risk for adverse medication reactions

3. DOH: Safe Dose
• Responsibilities:
• Preparing
• Administering
• Evaluating client response
• Developing and maintaining an up-to-date knowledge
base
• Skill competency
• Knowledge of acceptable practice
• Accuracy of med orders
• Reporting all medication errors
• Safeguarding and storing medications

4. DOH: Safe Dose
• 6 rights
• Client
• Med
• Route
• Time
• Dose
• Documentation

5. DOH: Safe Dose
• Types of Medication Prescriptions:
• Routine
• Standard
• Single
• One time
• PRN
• Stat

6. DOH: Safe Dose
• Types of Medication Prescriptions:
• May or may not have termination date
• Without a specified termination date, the
order will be in effect until it’s discontinued or
client discharged
• opioids, and antibiotics must be reordered
within a specified amount of time or will
automatically be discontinued

7. DOH: Safe Dose
• Components of Medication Prescription:
• Client name
• Date of order
• Time of order
• Name of medication
• Dosage
• Route
• Time and frequency
• Signature of prescribing provider

8. DOH: Safe Dose
• Medication errors:
• Wrong medication or IV fluid
• Incorrect dose or IV rate
• Wrong client, route, or time
• Administration of known allergic medication
• Omission of dose
• Incorrect discontinuation of medication or IV
fluid

9. DOH: Safe Dose
• Nursing Process: Assessment
• Client’s condition relevant to med administration
• Preadmission HR, BP etc.
• Omit or delay doses as indicated by condition
• Identify allergies
• Determine if the medication prescription is
complete
• Interpret medication prescription accurately
• Question provider if the prescription is unclear or
seems inappropriate for the client’s condition

10. DOH: Safe Dose
• Nursing Process: Planning
• Calculate & measure doses accurately
• Be sure the medication is the correct strength
• Verify high alert medication with a colleague
• Avoid distractions during medication
preparation

11. DOH: Safe Dose
• Nursing Process: Implementation
• 6 right
• Only administer what YOU have prepared
• Follow correct procedure for all routs
• Use verbal orders for only emergencies
• Follow agency policy for telephone orders
• Follow laws & regulations when administering
controlled substances
• Omit or delay a dose if client question size of
dose or appearance of medication

12. DOH: Safe Dose
• Errors:
• Assess client for any signs of an adverse reaction
• Notify the client’s provider and the supervisor
• Document the event, along with the action taken
in response to the event to treat or prevent
adverse reactions
• Document the event on an incident report
according to agency policy
• Evaluate the cause of the error in order to
prevent a reoccurrence

13. DOH: Safe Dose
• Nursing Process: Evaluation
• Client response
• Document and report appropriately
• Side & adverse effects; document and report
appropriately
• Report all errors & take corrective measures
immediately

14. DOH: Safe Dose
• Tools for Safe Practices
• Abbreviation (error prone)
• Tall Man Letters
• High Alert Medication List
• Universal guideline: always use leading zeros
before a decimal, but never trailing

15. DOH: Safe Dose
• Atraumatic Care:
• Therapeutic care in setting and thru the use of
interventions that eliminates or minimizes the
psychological and physical distress
experienced by children and their families

16. DOH: Safe Dose
• Atraumatic Care: Preventing Physical Stressors
• Educate on environment, diagnosis, treatments
• Use non-threatening models (dolls)
• Make environment less threatening “safe areas”
• Keep a neutral thermal environment
• Explain all noises, including alarms
• Close doors to room when possible to allow privacy
• Allow rest periods between invasive procedures
• Allow transitional items at bedside (blankets, dolls, etc.)