Best Practices for Administering Medications in Patient Rooms: Ensuring Safety and Infection Control

Introduction

Administering medications to patients, especially those with antibiotic-resistant infections such as C. diff, MRSA, and VRSA, requires careful handling to prevent cross-contamination and ensure patient safety. Incorrect practices can lead to the spread of infections, which is a serious concern in healthcare settings. This article explores the best practices for administering medications and the rationale behind these practices.

Common Practices in Healthcare Facilities

In many healthcare facilities, it is common to bring the medication administration record (MAR) into the patient's room to ensure that the correct medication is administered accurately. This practice, although necessary for verifying the six rights of medication administration (right medication, right dose, right route, right time, right patient, and right documentation), can also pose risks of cross-contamination. This risk is particularly high in patient rooms where infections such as C. diff (Clostridium difficile), MRSA (Methicillin-resistant Staphylococcus aureus), and VRSA (Vancomycin-resistant Staphylococcus aureus) are prevalent.

Risks and Precautions

The use of paper MARs and binders to transport medication administration records into patient rooms can introduce risks of cross-contamination. These records are often difficult to disinfect properly, which can lead to the spread of pathogens. Additionally, the process of manually transferring patient information into the MAR can introduce errors and increase the risk of misadministration. To mitigate these risks, healthcare providers must adhere to strict infection control protocols.

Alternative Methods

Several alternative methods can be employed to ensure the safe administration of medications while minimizing the risks of cross-contamination:

Disposable Cups and Stickers: Medications can be dispensed and handed into a small, disposable cup outside the patient room. A sticker imprinted with the patient's information can be placed on this cup, which can then be brought into the room. After conducting necessary checks against the MAR, the medication can be administered. This method ensures that the cup, which is disposable, is easy to decontaminate and does not pose a risk to other patients. Once the administration is complete, the sticker can be discarded in a sharps container, reducing the risk of contamination. Shredding: Another effective method is to use a small disposable slip of paper with the patient's medical record number and dispense the medications in a disposable cup as well. This paper can be shredded after use, further minimizing the risk of contamination. Electronic MARs: Using electronic MARs can significantly reduce the risks associated with paper records. Electronic records can be accessed from a device that can be sterilized, reducing the risk of contamination. Additionally, electronic records can be updated in real-time, reducing the risk of errors.

Rationale for Innovative Solutions

The practice of bringing unsealed, non-disposable records into patient rooms is outdated and poses significant risks. Modern healthcare methodologies emphasize the importance of infection control and patient safety. The use of disposable cups and stickers, or electronic MARs, ensures that patient safety is prioritized over convenience. Nurses and healthcare providers must critically evaluate every step in the patient care process to ensure that actions are justified and effective.

Conclusion

The safe and effective administration of medications is crucial in preventing the spread of infections in healthcare settings. While bringing the MAR into patient rooms is a necessary practice, it is important to adopt new technologies and innovative methods to minimize cross-contamination. By prioritizing infection control and using modern practices, healthcare providers can ensure that their patients receive the correct medications in a safe environment.

References

Pearson, R., Sundelid, F. (2017). Medical-Surgical Nursing: Diagnosis and Management Across the Continuum. McGraw-Hill. World Health Organization. (2018). Infection Prevention and Control of Antimicrobial-Resistant Microorganisms in Health Care Settings. WHO.