Author: Kimberly Silver Dunker, DNP, RN
Title: Assistant Professor of Nursing
Institution: UMASS Graduate School of Nursing Worcester
After viewing this medication safety video vignette the students and faculty will be able to minimize risk of harm to patients and providers through both system effectiveness and individual performance.
Describe how to safely administer medications in a clinical setting to understand causes of error and allocation of responsibility and accountability improve the quality and safety of nursing care.
Participate appropriately in a medication administration role-play in the lab prior to attending clinical.
Identify their role in communicating essential information to patients about their medications during the administration process.
Demonstrate comprehensive understanding of the multiple dimensions of patient centered care utilizing the five rights to medication administration pass.
Video Link: Click Here
This vignette was designed for both faculty and students to learn how to administer medications safely in clinical settings. The vignette demonstrates to nursing faculty how to manage more than one student in clinical and how to manage a medication administration pass for a student while in clinical. This vignette also is designed to explicate teaching strategies for student and faculty when the student isn’t quite prepared or ready to administer medications. This vignette also reviews how to question a student prior to approaching the patient at the bedside and then demonstrates how to empower the students while working with their patients at the bedside. The student demonstrates how to administer the medications safely and ensures the five rights during the process.
Prior to engaging in clinical experiences, the students and or clinical faculty will view the vignette in the nursing lab. Then the students will discuss the aspects of safe medication administration and the five rights of medication administration. The students will be given a MAR (Medication Administration Record) to look up medications (see example). While in the nursing skills lab, the students will prepare the medications and administer medications to their patients. They will utilize drug guide resources and other e-tools to gather important information about their patients. They will also discuss the right situation for these medications, medication reconciliation, and patient data to connect essential patient information. This activity will help the students to learn how to safely administer medications to their patients prior to going live in the clinical setting.
Patient Centered Care
Students will gather information of the medications they are to prepare for their patients in clinical. (Knowledge)
Students will value their knowledge and how dissemination of essential information about their patients’ current medications create a more patient-centered environment. (Knowledge, Attitudes)
Students will utilize drug guides and other e-tools, learn how gather essential information about their medications and be confident when communicating with their clinical instructors about their patients and their medications. (Knowledge, Attitudes)
Students will demonstrate the five rights of medication administration while administering medications in clinical. (Skill)
Students will value own role in providing safe medication administration while in clinical. (Attitude)
This activity was used in the lab as a strategy to teach novice nursing students how to safely administer medications while in clinical. Concurrently, the novice adjunct clinical faculty were also taught how to safely perform a medication administration pass while in clinical for the first time. The faculty were taught how students should be questioned on medications prior to administering them to their patients at the bedside. Ultimately by viewing the video vignette, both the faculty and student were on the same page on the ultimate expectations for medication administration while in clinical. This activity helped to create an empowering environment for medication administration.
This assignment was utilized with pre-licensure nursing students. These students were in a skills course and had not yet gone to their first clinical. Medication administration is part of the safety competency. The students were to view this video vignette to teach them how to administer medications safely in clinical and learn about patient needs during medication administration.
Secondly, both faculty and students who participated in this activity were clear of the objectives for medication administration and ensure safety, and focus on patient centered care while in clinical.
Feedback from both the clinical faculty and the students was positive. Faculty reported greater critical thinking skills in clinical as evidence by two medication transcription errors were identified during a medication administration pass while at clinical. This generated a great discussion around safety and medications.
This exercise has bridged the clinical practice environment with theory. As a result, clinical nursing faculty have reported feeling they were competent in giving medications with students prior to going to clinical. This increased knowledge empowered both the faculty and students during this important nursing responsibility in clinical settings. Ultimately no medication errors occur with the clinical faculty during the semester after implementation of this activity, thus increasing safety in clinical practice.