nursing medication administration sheets

38+ Free Printable Medication Administration Record Sheets – PDF, DOC

Medication Administration Record Sheet is an essential tool for healthcare workers who need to ensure accuracy and efficiency when providing medication to their patients. Having an easy-to-use, digitally interactive record sheet can streamline the process while giving healthcare staff peace of mind when it comes to managing difficult and complicated medication regimens.

Table of Contents

With easy-to-follow instructions and prompts, healthcare professionals can stay organized by keeping a comprehensive list of all the drugs their patient is taking, as well as tracking important information such as the dosage and duration. By having all of this pertinent information recorded in one comprehensive document, critical medical mistakes can be avoided that may otherwise put patient safety at risk.

Download Free Printable Medication Administration Record Sheets

What is a Medication Administration Record?

A medication administration record (MAR) provides a comprehensive record of medications that have been prescribed and administered to a patient. The MAR serves many purposes, including providing an exact history of the patient’s care and reducing the ambiguity of handwritten orders or verbal information from doctors.

Additionally, it can ensure that prescribed dosages are precise, that doctors consider possible adverse reactions before prescribing, and that medications do not interact negatively with one another. Furthermore, it allows for easier tracking of patient outcomes and better patient monitoring by providing an accurate record of medications given to them over time. In short, MAR is an invaluable tool in ensuring patient compliance with their treatment plans and improving their overall outcome.

Types of Medication Administration Records

Medication administration records (MARs) are essential for providing safe, effective, and accurate care for patients. MARs provide a detailed record of the patient’s medication history, which allows medical professionals to track changes in medications and use this information to make treatment decisions. Here are some different types of MARs and how they are used.

Electronic MARs (eMARs)

An electronic MAR, or eMAR, is an electronic version of a paper-based MAR that is stored on a computer. They allow healthcare providers to quickly access detailed records and enter new information accurately and efficiently. Electronic MARs also provide real-time data analysis so that medical professionals can easily monitor patient responses to medications. Additionally, electronic MARs help facilitate communication between healthcare providers as well as health IT systems so that all parties have access to up-to-date information about the patient.

Paper-Based MARs

Paper-based MARs are traditional records kept by hand on paper forms. While these types of records are still widely used in many healthcare settings, there is increasing pressure from healthcare organizations to move away from paper-based systems towards more efficient eMAR systems. Paper-based records can be difficult to update quickly and accurately when changes occur in the patient’s medication regimen or health status.

Computerized Provider Order Entry (CPOE) System

Computerized provider order entry (CPOE) systems are another type of electronic system designed specifically for ordering medications electronically instead of manually entering them into paper forms or electronic databases. CPOE systems allow medical professionals to quickly order medications online with fewer errors than manual methods and reduce potential drug interactions by alerting providers when orders may conflict with current medication regimens or underlying conditions. CPOE systems also help simplify billing processes by instantly transmitting orders directly to pharmacies and insurance companies while eliminating time-consuming paperwork associated with manual ordering processes.

Benefits of a Medication Administration Record

A Medication Administration Record can be a useful tool for medical professionals to stay organized and informed. Not only does this record provide an accurate account of the medications being taken by patients, but it also serves to prevent medication errors, and attempt to reduce the risk of adverse drug events. This record allows medical professionals to track the exact date, time, and content of each medication prescribed and helps them to easily compare dosages, strengths, and other details about all the medications a patient is taking at any given time.

MARs provides real-time access to complete patient information which may prove invaluable during urgent situations when a patient’s current condition must be rapidly assessed in order for them to receive timely care. For delivering quality care in an efficient manner, Medication Administration Records are essential components of modern healthcare systems.

Medication Administration Record Training and Education

Medication Administration Record (MAR) training and education are essential for healthcare staff in any healthcare setting. MARs detail a patient’s dose, instructions, the time the medication was taken, and any abnormalities associated with it, all of which are important for providing quality care at all times. The training required to correctly understand this process provides healthcare professionals with the skills to determine appropriate doses of medications and identify signs that may indicate adverse drug reactions or interactions.

Furthermore, effective MAR training includes interventions that staff can use when a medication issue arises and steps they should take to prevent similar issues from happening in the future. With these trained skillsets, healthcare personnel is able to make informed decisions that lead to safer, improved patient outcomes.

Medication Administration Record Audit and Review

Medication Administration Record (MAR) audit and review are an essential part of patient safety. These processes in the healthcare industry provide a structured way to examine and assess how medications are being prescribed and administered. By evaluating each prescription, its administration, and patient response, healthcare professionals can ensure that the medications that patients are taking are safe.

MAR audit and review could help decrease medication errors, meaning fewer avoidable injuries or illnesses due to medication mistakes. Even more importantly, it can safeguard patient health by promoting accurate prescribing, dosing, and monitoring of medications which will all result in improved quality of care and satisfaction among patients. With MAR audits and reviews in place, patients can be confident they are receiving the safest and most appropriate care possible.

Creating a Medication Administration Record Sheet for Your Facility

A Medication Administration Record (MAR) sheet is an important document that healthcare facilities must have in order to effectively track the administration of medications. It’s essential for patient safety and should be created with care and accuracy.

Gather the Necessary Information

The first step in creating a Medication Administration Record (MAR) sheet is to gather all the necessary information from your facility. This includes patient information, such as name and date of birth, as well as the type of medication being administered, the dosage amounts, the route of administration, and when it was administered. Additionally, make sure you have any special instructions that may apply to administering this medication.

Enter Patient Information

Once you have gathered all the necessary information, you can begin to enter it into your MAR sheet. Start by entering the patient’s name and date of birth on the top line of your form. Additionally, if you are using an electronic system such as an EHR (Electronic Health Record), make sure you include any relevant identifiers such as medical record numbers or insurance carrier codes.

Input Medication Information

After entering the patient information, move on to entering the medication details into your MAR sheet. Make sure you include all pertinent information regarding this medication including its name, dosage amount, route of administration (i.e., orally or intravenously), indication for use (the reason why it is being prescribed), and any special instructions for its administration. In some cases, you may also need to include additional information such as frequency or duration of use for certain medications.

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StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.

StatPearls [Internet].

Nursing rights of medication administration.

Angela Hanson ; Lisa M. Haddad .

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Last Update: September 4, 2023 .

• Definition/Introduction

Nurses have a unique role and responsibility in medication administration, in that they are frequently the final person to check to see that the medication is correctly prescribed and dispensed before administration. [1] It is standard during nursing education to receive instruction on a guide to clinical medication administration and upholding patient safety known as the ‘five rights’ or ‘five R’s’ of medication administration. These ‘rights’ came into being during an era in medicine in which the precedent was that an error committed by a provider was that provider’s sole responsibility and patients did not have as much involvement in their own care. [2]

The five traditional rights in the traditional sequence include:

‘Right patient’ – ascertaining that a patient being treated is, in fact, the correct recipient for whom medication was prescribed. This is best practiced by nurses directly asking a patient to provide his or her full name aloud, checking medical wristbands if appropriate for matching name and ID number as on a chart. It is advisable not to address patients by first name or surname alone, in the event, there are two or more patients with identical or similar names in a unit. Depending on the unit that a patient may be in, some patients, such as psychiatric patients, may not wear wristbands or may have altered mentation to the point where they are unable to identify themselves correctly. In these instances, nurses are advised to confirm a patient’s identity through alternative means with appropriate due diligence. [1]

‘Right drug’ – ensuring that the medication to be administered is identical to the drug name that was prescribed. Some brand names or generic names may have very similar spelling or sound very similar due to prefix, suffix, or starting with the same first letter. For example, beta-blocker medications all end in ‘-lol’ to aid in suggesting their mechanism of action. It is important to discern between two similarly named medications since the two drugs in question may have drastically different mechanisms of action or indications for prescribing. Except for nurse practitioners who have the qualifications to prescribe some medications in limited situations, nurses cannot legally prescribe drugs. Recent evidence-based studies support the practice of prescribers writing out full generic names as opposed to brand names of medications along with the indication for prescribing when writing orders to help minimize confusion. Poor handwriting and abbreviations account for many medical errors due to misreading letters or numerals that appear differently to different individuals. For example, brand names, if written poorly, could easily confuse a recipient of an order leading to the administration of medication with a different indication than intended. [1] When checking to ensure the correct medication name is printed on the product to be given to the patient, nursing staff need to remember also to check other critical information on packaging such as the expiration date. [3]

After affirming the name and expiratory date of the intended drug, nursing providers should also develop a routine habit of explicitly asking patients about known allergies or history of an allergic response to a drug they are about to administer. A potential barrier that nurses may face is a patient's misunderstanding of what qualifies as a hypersensitivity reaction, versus a negative symptom which they perceived as a negative experience. Patients may need the education to aid in discerning whether they have had an allergic response, ranging from a skin rash to anaphylaxis, versus an expected side effect, such as nausea or diarrhea.

‘Right Route’ – Medications can be given to patients in many different ways, all of which vary in the time it takes to absorb the chemical, time it takes for the drug to act, and potential side-effects based on the mode of administration. Some common routes include oral, intramuscular, intravenous, topical, or subcutaneous injection. In modern medicine, medication administration has become more complex with the development of drugs that can be given via newer routes, including but not limited to central venous catheters, patient-controlled analgesia (PCA), epidural infusions, and intrathecal administration. [1]

It is crucial that nurses remain educated and up to date on newer medications or less commonly administered medications to learn how they are safely delivered to patients before being asked to do so in clinical practice. Additionally, nurses must have at least a minimal basic understanding of the physiology influencing drug absorption rates and time of drug onset, as these principles relate to medication administration. For example, medications that are to be delivered intravenously will likely have a higher bioavailability and faster onset of action as they are introduced directly into venous circulation for distribution, as opposed to an oral medication that must first undergo digestion, absorption, and filtration through hepatic circulation.  

‘Right time’ – administering medications at a time that was intended by the prescriber. Often, certain drugs have specific intervals or window periods during which another dose should be given to maintain a therapeutic effect or level. A guiding principle of this ‘right’ is that medications should be prescribed as closely to the time as possible, and nurses should not deviate from this time by more than half an hour to avoid consequences such as altering bioavailability or other chemical mechanisms. [1] Similarly, it is crucial that medications that are given by an infusion, such as intravenous medications, are administered at the correct rate. Failure to deliver a drug at the correct rate may lead to devastating consequences for a patient. For example, vancomycin requires administration by slow intravenous infusion to avoid a complication known as vancomycin flushing syndrome,  a hypersensitivity reaction that is managed by further slowing the infusion rate of vancomycin or discontinuing the agent altogether. [1]

‘Right dose’ – Incorrect dosage, conversion of units, and incorrect substance concentration are prevalent modalities of medication administration error. This error type stems from nurses giving a patient an incorrect dose of medications, even if it is the correct medication and the patient’s identity is verified, without first checking to ensure it is the correct strength for the patient. This may be due to misplaced decimals, errors in arithmetic, or incorrect conversion between two units. For example, a misplaced decimal point can impact the dose of medication by 10-fold, just as micrograms and milligrams may easily be mistaken with a quick, incorrect glance at unit abbreviations like mcg versus mg. [1] Studies that have emphasized observing positive behaviors nurses have adapted to help reduce medical errors include consulting with pharmacy personnel, using calculators to assist in arithmetic, or in some cases, cross-consulting with patients or their families about usual doses they administer at home. [3]

• Issues of Concern

The traditional framework used in teaching the rights has remained largely unchanged, but there has been no significant reduction in error rates reported in the literature since their introduction. [3] Sole reliance on the ‘five rights,’ the necessity of adding additional rights, and the lack of consideration for the role of the patient are a few of the points of contention named in the medical literature concerning the traditional ‘five rights.’ [2]

An increasing number of recent studies have identified inadequacies of the ‘ five rights’ in significantly reducing errors due to factors that induce workplace strains on nursing staff members, frequently listing workload, being under-staffed, or interruptions as limitations that make the five R’s difficult to comply with all of the time. [3] Nurses encounter many types of pharmaceutical labeling and packaging on a given shift, where it is expected that nurses with more clinical experience have more familiarity with how to find information on packaging efficiently. Nurses with less experience may feel less confident in their ability to find where specific warnings may be located, especially in poorly lit environments. [3] Experience aside, it is not uncommon for pharmaceutical manufactures to update their packaging to change how information appears, therefore creating a potential for more experienced nurses to become accustomed to outdated packaging instead of actively seeking important drug warnings. Disregard for the time to read labeling fosters overconfidence in administering medications. For example, negative labels such as ‘not for oral use’ can easily be misinterpreted as the opposite, posing a direct negative consequence if not corrected. [1] Although the packaging is not a modifiable factor on the level of nursing staff, it is a responsibility that ultimately falls on pharmaceutical manufacturers and governing and regulation organizations to ensure that new products are as user-friendly as possible. [1]

Some other specific critiques of the five rights listed in medical literature surround the realities of modern nursing care. Consideration for the five reasons typically occurs right at the exact time of medication administration; however, a variety of factors impact patient care well before this step, including checking medication orders, follow up with the pharmacy on missing medications, assessing the patient, and preparing drugs to be administered. [2] The focus of most recent literature lies not on research advocating that nurses disregard or do not utilize the five rights, but instead focus on problems, deficits, and diversions in attention that result from the workplace environment. [3]

Literature also states that the rights are not just the responsibility of nurses but a responsibility of the whole health care organization to have functionality. [4] Medical errors have an interprofessional nature to them, requiring that all healthcare workers uphold their unique responsibilities to ensuring mediation administration safety and adherence to the five rights. [5] Additionally, nurses should not merely follow prescriber orders “blindly.” They should always seek answers from either pharmacy or the prescriber if there are any questions related to the interpretation of the order, the mediation itself, or the dose. [1] Nurses have a responsibility to protect patients, which is best achieved by providing professionals with adequate time and resources, which are not always possible without multiple workplace interruptions. [2]

It has been proposed that adding additional ‘rights’ to the globally accepted five may augment the functioning of a linear model for guiding medication administration. [2] Various studies name anywhere from 5 up to 12 unique rights under consideration as new solutions towards addressing the inadequacies identified within the traditional ‘five rights’ framework. [3] Elliot et al. recommend four additional rights, including right documentation, right indication for prescription, right patient response, and right form of administration within a given route. Cook et al. have proposed rights such as the right to have legible orders, correct drug dispensing, timely access to information, procedures in place to support medication administration, and problems addressed in the medication administration system. [2] Such proposals identify a significant limitation of the rights framework, referring to the drastic inconsistency in the framework.

Inconsistencies in which rights are taught or practiced have been noted as a hindrance to their suitability for modern practice due to a lack of local, national, or international accord regarding how many rights should be utilized and accepted. [3] Organizations, including the Institute for Safe Medication Practices, have documented the shortcomings of simply adding more ‘rights’ to the existing model, claiming that even solely following the guidelines laid out by the rights will not in itself prevent medical errors. Examples of this point might be scanning a patient’s wristband that does not belong to the patient, although the patient is wearing a wristband, or selecting a medication with an incorrect label. [2]

The medical literature states that the value of nurses’ critical thinking, the role of patient advocacy, and clinical judgment are not accounted for by the five rights framework that is commonly observed in modern practice to deliver patient-centered care. [3]  Research has shown a clear benefit in the value of nursing experience as it relates to decision-making capability; however, it states that further studies are necessary to achieve an improved understanding of how nurses apply intuition, the context of the situation, and interpretation. [6] [7]  Roughly 36% of patients believe and expect that decision-making regarding care and treatments to be a shared responsibility, while an estimated 50% of patients believe they have the primary responsibility for decisions, according to a 2002 survey. [2] This survey illustrates the ever-growing importance of the decision-making capacity of patients, which provides a new component of a “checks and balances” system that has the potential to improve patient safety during medication administration. [2]

Nurses have accomplished this inclusion of patients by educating patients about their medications and the importance of their involvement during medication administration enabling trust and respect. [2] Many studies emphasize the value of nurses’ clinical reasoning skills, defined as the ability to reason about a clinical situation as it unfolds, as well as about the patient and family concerns and context. [8] Safe medication administration is said to require much more than the five rights and medication management to avoid costly errors. Literature is gradually showing more evidence that new efforts to maintain safety should also highlight the emergence of nurses’ clinical reasoning as the element that shapes nurses to become highly competent in their profession. [8] Competency is measurable in a nurse’s display of clinical and pharmacological knowledge, clinical experience, and the ability to perform comprehensive, situational assessments of the patient before medication administration. [8]

Medication safety requires the integrity and functionality of several complex, interrelated steps and the cooperation of medical personnel to prevent such adverse drug events (ADE). [2]  Most medication-related errors occur in hospital settings where nurses administer the majority of medications, totaling about 5% to 10% of all errors in hospital settings. [6]  Medical literature states that about one-third of all medical errors causing harm to hospitalized patients occur during the medication preparation and administration phase, predominately nursing activity. [4]  One study suggested more specifically that the majority of medication-related errors occur at the points of ordering medications (39%) and administering medications (38%). [2] Therefore, nurses need to be proficient in considering how to manage the environment in which they work to facilitate a reduction in medication errors. [1]

Medical errors are a reality that will inevitably occur, as nurses, patients, and medical personnel are human and, therefore, prone to error. Examples of human error are lack of medical knowledge, lack of attention to detail or care, failing to verify information in an effort to save time, disorganization of workplace or supplies, and miscommunication among healthcare professionals or with a patient. While human nature does account for the majority of circumstances that may incite potential for medication administration errors, administrative or environment-related errors may also explain ADEs, such as lack of labeling or inadequate labeling systems or overwhelming workload with limited staffing. [3] Errors are usually multifaceted and can occur at any point within the complex process of medication administration.

• Clinical Significance

The 'five rights' first have important clinical significance by their integration into the methodologies used for instructing nursing students about the applications of the 'rights' framework in clinical practice. Traditionally, nurses learn to administer medications in a laboratory setting before working with patients in clinical settings. [5] It is in the laboratory that students are first introduced to applying the 'rights' of medication administration; although, it is stated that this lacks many realistic aspects of clinical practice that complicate medication administration, such as understanding how to read and interpret a medication administration record (MAR). [5] To build the most robust foundation for future nurses, it has been formally recommended in medical literature to structure nursing coursework to present the theory and practical components of nursing so that they directly relate to one another, emphasize the practice of mathematical skills, and incorporating more exclusive supervision from clinical professors. [5]

The nursing instructor's role of providing students with clinical scenarios that force nursing trainees to make decisions in unclear clinical situations, function as a competent member of an interprofessional team, and practice with advanced types of medication administrations has been stated as a pivotal role in teaching future nurses about the rights of medication administration. [5]

In practice, the innovation of modern technologies has contributed to helping nurses clinically apply the five rights in everyday practice. An example of modern technology is barcode medication administration (BCMA), which allows nurses to verify the five rights of medication administration by electronically scanning a patient's wristband to confirm the information and crossmatch with a patient's electronic medical chart. [9] Barcode administration has been shown to decrease the incidence of medication administration errors ranging from 23% to 56% of the time in observational studies, although little evidence exists regarding the severity of medical errors with barcode administration. [9] In one observational study conducted by Marcias et al., the authors observed a statistically significant reduction in specific types of errors with the implementation of the barcode administration, including wrong medication, administration omission, wrong dose, and wrong order of administration.

Computerized provider order entry (CPOE) with clinical decision support (CDS) also aid healthcare providers with prescribing. [10] Such systems automatically alert providers to potential errors and hazards such as drug-drug interactions, although this has subsequently led to the modern concern of "alert fatigue." [10] Alert fatigue is referred to in the literature as too many or repetitive alert warnings that are voluntarily disregarded, thus leading to a potential error if important medication information is overlooked. [10] This example demonstrates that, in some cases, regularly adding additional steps to administering medications may create a habitual, automatic mindset for medication providers that leads to mistakes and chronic fatigue. Additionally, these mistakes are costly to the healthcare system.

Estimates are that in 2014 approximately 5.5 million medication-related alerts were inappropriately overridden, resulting in approximately 196,600 adverse drug events nationally, costing between $871 million and $1763 million. [10] This data illustrates the role of automated assistance in augmenting a traditional problem-solving method in nursing practice.

• Nursing, Allied Health, and Interprofessional Team Interventions

Patient safety and quality of care are essential components of nursing practice and priorities that demand consideration to enable the delivery of high-quality, patient-centered care, and overall well-being. Medical errors are unfortunately very common in clinical practice, and in addition to compromising a patient’s personal safety, they can also be extremely costly for hospitals. ADEs qualify as unintended injuries or insults directly related to medical interventions involving a drug resulting in disability at discharge, death, or extended hospital stay that is the result of health care management rather than by the patient’s underlying disease process. [5]

In a recent 2018 study, ADEs reportedly result in more than 770,000 injuries or deaths in US hospitals each year and are responsible for an estimated hospital expense of $1.56 to $5.6 billion annually. Moreover, patients experience an additional individual cost between $2,852 and $8,116 per ADE incidence relative to increased length of hospital stay and prolonged treatment. [10] Alternatively, patients may suffer a potentially life-threatening ADE.

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Disclosure: Angela Hanson declares no relevant financial relationships with ineligible companies.

Disclosure: Lisa Haddad declares no relevant financial relationships with ineligible companies.

This book is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) ( http://creativecommons.org/licenses/by-nc-nd/4.0/ ), which permits others to distribute the work, provided that the article is not altered or used commercially. You are not required to obtain permission to distribute this article, provided that you credit the author and journal.

• Cite this Page Hanson A, Haddad LM. Nursing Rights of Medication Administration. [Updated 2023 Sep 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.

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15.4 Checklist for Oral Medication Administration

Open Resources for Nursing (Open RN)

Use the checklist below to review the steps for completion of “Oral Medication Administration.” [1]  

Disclaimer: Always review and follow agency policy regarding this specific skill.

Special Considerations:

• Plan medication administration to avoid disruption.
• Dispense medication in a quiet area.
• Avoid conversation with others.
• Follow agency’s no-interruption zone policy.
• Perform hand hygiene prior to medication preparation.
• Prepare medications for ONE patient at a time.
• Gather supplies: MAR/eMAR.
• Know the actions, special nursing considerations, safe dose ranges, purpose of administration, and potential adverse effects of the medications to be administered. Consider the appropriateness of the medication for this patient at this time.
• The right patient: Check that you have the correct patient using two patient identifiers (e.g., name and date of birth).
• The right medication (drug): Check that you have the correct medication and that it is appropriate for the patient in the current context.
• The right dose: Check that the dose is safe for the age, size, and condition of the patient. Different dosages may be indicated for different conditions.
• The right route: Check that the route is appropriate for the patient’s current condition.
• The right time: Adhere to the prescribed dose and schedule.
• The right documentation: Always verify any unclear or inaccurate documentation prior to administering medications.
• When the medication is taken out of the drawer.
• When the medication is being prepared.
• At the bedside, prior to medication administration to the patient.
• Unit dose packages: Do not open the wrapper until you are at the patient’s bedside. Keep opioids and medications that require special nursing assessments separate from other medication packages.
• Multi-dose containers: When removing tablets or capsules from a multi-dose bottle, pour the necessary number into the bottle cap and then place the tablets or capsules in a medication cup. Cut scored tablets, if necessary, to obtain the proper dosage. If it is necessary to touch the tablets, wear gloves.
• Liquid medication in a multi-dose bottle: When pouring liquid medications out of a multi-dose bottle, hold the bottle so the label is against the palm to avoid dripping on the label. Use an appropriate measuring device when pouring liquids, and read the amount of medication at the bottom of the meniscus at eye level. Wipe the lip of the bottle with a paper towel.
• Depending on agency policy, the third check of the label may occur at this point. If so, after all medications for one patient have been prepared, recheck the medication labels against the eMAR/MAR before taking the medications to the patient. However, many agencies require the third check to be performed at the bedside after obtaining two patient identifiers and scanning the barcode of the patient.
• Replace any multi-dose containers in the patient’s drawer or medication supply system. Lock the medication supply system before leaving it.
• Transport the medications to the patient’s bedside carefully, and keep the medications in sight at all times.
• Perform hand hygiene.
• Check the room for transmission-based precautions.
• Introduce yourself, your role, the purpose of your visit, and an estimate of the time it will take.
• Confirm patient ID using two patient identifiers (e.g., name and date of birth).
• Explain the process to the patient and ask if they have any questions.
• Be organized and systematic.
• Use appropriate listening and questioning skills.
• Listen and attend to patient cues.
• Ensure the patient’s privacy and dignity.
• Assess ABCs.
• Check the name on the patient’s identification band.
• Check the identification number on the patient’s identification band.
• Check the birth date on the patient’s identification band.
• Ask the patient to state his or her name and birth date, based on facility policy.
• If a patient is unable to verbalize their name and date of birth and patient identification bands are not used, use alternative methods of identification such as a second staff member and/or a patient picture in the MAR.
• Complete all necessary assessments before administering the medications. Check the patient’s allergy bracelet or ask the patient about allergies. Explain the purpose and action of each medication to the patient.
• Based on facility policy, the third check of the medication label typically occurs at this point. If so, recheck the label with the eMAR/MAR before administering the medications to the patient. Scan the patient’s bar code on the identification band, if bar scanning is used. If an error occurs during bar code scanning, obtain assistance before administering the medication.  Most error messages are intended to warn the nurse of a potential medication error.
• Offer water or other permitted fluids with pills, capsules, tablets, and some liquid medications.
• Ask if the patient prefers to take the medications by hand or in a cup and if they prefer all medications at once or individually.
• Note: If the patient is confused or has been known to hoard pills, have the patient open their mouth and check under the tongue.
• Assist the patient to a comfortable position, ask if they have any questions, and thank them for their time.
• CALL LIGHT: Within reach
• BED: Low and locked (in lowest position and brakes on)
• SIDE RAILS: Secured
• TABLE: Within reach
• ROOM: Risk-free for falls (scan room and clear any obstacles)
• Document medication administration and related assessment findings. Report any concerns according to agency policy.
• Evaluate the patient’s response to the medication within the appropriate time frame. Note: Most sublingual medications act in 15 minutes, and most oral medications act in 30 minutes. If patient presents with any adverse effects:
• Withhold further doses.
• Assess vital signs.
• Notify prescriber.
• Notify pharmacy.
• Document as per agency policy.
• This work is a derivative of Clinical Procedures for Safer Patient Care by British Columbia Institute of Technology and is licensed under CC BY 4.0 ↵

Nursing Skills Copyright © 2021 by Open Resources for Nursing (Open RN) is licensed under a Creative Commons Attribution 4.0 International License , except where otherwise noted.

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Nasn releases toolkit on administering meds in schools, by nasn inc posted 01-31-2022 15:22.

NASN’s School Nursing Evidence-based Clinical Practice Guideline: Medication Administration in Schools Toolkit provides a uniform guideline for the administration of medication in schools, including evidence-based recommendations for the safe care of Pre-K-12 students who receive medications during the day. The Toolkit is designed to help implement the recommendations in the Guideline.

School Nursing Evidence-based Clinical Guideline: Medication Administration in Schools Implementation Toolkit

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A Nurse’s Ultimate Guide to Accurate Drug Dosage Calculations

Doing math in nursing and nursing school is a lot harder and more critical than you think. One wrong interpretation and calculation can compromise your patients’ safety and health.

Despite that, however, pharmacology for nurses shouldn’t make you feel scared or overwhelmed. Here’s an in-depth yet easy-to-understand guide to help you out.

Abbreviations used in drug preparation and administration

Abbreviations rule the medical world. It is important to know the recognized abbreviations in clinical setting so you will not be lost when preparing medications for your patient. Here are the most commonly used abbreviations when preparing drugs:

IM – Intramuscular IO – Intraosseous IV – Intravenous IVP – Intravenous Push ID – Intradermal IN – Intranasal IP – Intraperitoneal IT – Intrathecal IVPB – Intravenous piggyback p.o – By mouth SC / SubQ – Subcutaneous SL – Sublingual top. – Topical vag . – Vaginally

Measurements

Kg – kilogram gm – gram mg – milligram mcg – microgram mEq- milliequivalent L – liter mL – milliliter µg – microgram gtt – drop µgtt – micro drop tbsp – tablespoon tsp – teaspoon mg/dL – milligrams per deciliter

Conversions

Before mastering drug dosage formula, you should first learn how to convert the commonly used units of measurements in drug preparation. It is essential so you will not get lost between drug calculations as physicians commonly order a medication available in a different preparation.

The most common conversion factors you will use for drug dosage calculations are the following:

Solid Conversions

gr 1 = 60 mg gr 15 = 1 g 2.54 cm = 1 in 2.2 lb = 1 kg

Liquid Conversions

30 mL = 1 oz 1 tsp = 5 mL 1 standard measuring cup = 240 mL

mcg ← mg ← g ← kg ( x by 1,000 ) mcg → mg → g → kg ( ÷ by 1,000 ) lb ← kg ( x by 2.2 ) lb → kg ( ÷ by 2.2 )

mcL ← mL ← L ← kL ( x by 1,000 ) mcL → mL → L → kL ( ÷ by 1,000 )

min ← hr ( x by 60 ) min → hr ( ÷ by 60 )

• Convert 0.008 kg to mg

mcg ← mg ← g ← kg     ( x by 1,000 )

0.008 L x 1,000 = 8 mg

8 mg x 1,000 = 8,000 mg

• Convert 1,000 mcL to mL

mcL → mL → L → kL    ( ÷ by 1,000 )

1,000 L ÷ 1,000 = 1 mL

• Convert 480 minutes to hour

min → hr     ( ÷ by 60 )

480 ÷ 60 = 8 hr

Drug Calculation Formulas

Below are the four most important calculation formulas that you should know in preparing medications and drips.

Calculating Tablet Dosages

In calculating tablet dosages, the following formula is useful:

Desired dosage ÷ stock strength = number of tablets

The desired dosage is the ordered dosage of the physician while the stock strength is the amount of drug present in each tablet. Stock strength is also known as stock dose.

• The physician orders 1,500 mg of calcium carbonate for the patient. The drug is available in 250 mg tablets.  How many tablets should be given to the patient?

1,500 mg ÷ 250 mg = 6 tablets

• The patient is ordered to have 2 g of potassium chloride. The drug is available in 500 mg tablets. How many tablets should be given?

Convert 2 g to mg = 2 x 1,000 = 2,000 mg

2,000 mg ÷ 500 mg = 4 tablets

Calculating Mixtures and Solutions

The following formula is useful in calculating mixtures and solutions:

Desired dosage ÷ stock strength x stock volume = amount of solution to be given

The desired dosage is the ordered dosage of the physician. The stock strength is the amount of drug present in the preparation while the stock volume is the amount of the solution where the drug is diluted.

• The physician orders 375 mg of cefuroxime for the patient. The drug is available in 750 mg vial. You plan to dilute it in 10 mL of sterile water. How much should you give to your patient?

[Desired dosage ÷ stock strength] x stock volume = amount of solution to be given

[375 mg ÷ 750 mg] x 10 mL = amount of solution to be given

0.5 mg x 10 mL = 5 mL

• A pediatric patient recovering from accidental fall is about to be given with 130 mg paracetamol syrup. The drug is available in 250 mg per 5 mL preparation. How much should you give to your patient?

[130 mg ÷ 250 mg] x 5 mL = amount of solution to be given

0.52 x 5 mL = 2.6 mL

Calculate IV Rate – mL per hour and minute

It is easy to calculate the running rate of IV fluids in terms of mL per hour or mL per minute:

Total IV volume ÷ time (hour or minute) = mL per hour or minute

The total IV volume is the amount of fluid to be infused while the time is the number of running hours or minutes.

• Start venoclysis with D5 0.9 NaCl 1 L to be infused for 16 hours. How many mL of the IV fluid should you infuse per hour?

Total IV volume ÷ time (hour or minute) = mL per hour

1 L ÷ 16 hours = mL per hour

[1 L x 1,000] ÷ 16 hours = mL per hour

1,000 mL ÷ 16 hours = 62.5 mL per hour

• You are going to start IV infusion with Plain Lactated Ringer’s Solution 1 L. By regulating it for 11 hours, how much fluid are you going to infuse per minute?

Total IV volume ÷ time (hour or minute) = mL per minute

1 L ÷ 11 hours = mL per minute

[1 L x 1,000] ÷ [11 hours x 60] = mL per minute

1,000 mL÷ [11 hours x 60] = mL per minute

1,000 mL ÷ 660 = 1.5 mL per minute

Calculate IV Rate – drops per minute

Calculating for drops per minute is simple with the following formula:

[Total IV volume ÷ time (minute)] x drop factor = drops per minute

The total IV volume is the amount of IV fluid to be infused while time is the duration of how long the IV fluid should be infused in terms of minutes.

The drop factor is the “drops per milliliter” delivered to the patient and it depends on the macrodrip used for the infusion. The common drop factors used in different hospitals are 10, 15 and 20.

• The physician orders to start venoclysis with D5 0.3 NaCl 1 L solution. The IV fluid will be infused for 14 hours and the drop factor of the macrodrip used is 20. It should be regulated to how many drops per minute?

[Total IV volume ÷ time (minute) ] x drop factor = drops per minute

[1 L ÷ 14 hours] x 20 = drops per minute

[{1 L x 1,000} ÷ {14 hours x 60} ] x 20 = drops per minute

[1,000 mL ÷ 840 minutes] x 20 = drops per minute

1.19 x 20 = 23 to 24 drops per minute

• You are going to regulate D5 0.9 NaCl 500 mL solution for 7 hours. The macrodrip used has 15 drop factor. You should regulate the IV fluid for how many drops per minute?

[500 mL ÷ 7 hours] x 15 = drops per minute

[500 mL ÷ {7 hours x 60}] x 15 = drops per minute

[500 ÷ 420] x 15 = drops per minute

1.19 x 15 = 17 to 18 drops per minute

Calculate IV Rate – Remaining Time of Infusion

Calculating for the remaining time of infusion for a certain IV fluid is possible with the following formula:

[Volume remaining (in mL) ÷ drops per minute] x drop factor = minutes remaining

The volume remaining is the amount of IV fluid remaining for the infusion while the drops per minute is the regulation of the IV infusion. The drop factor can be determined in the macrodrip used in the hospital.

• You see that your patient has D5 0.9 NaCl IV infusion at 400 mL level. It is regulated to run for 22 drops per minute using a macrodrip set with drop factor 20. How many minutes are remaining before you are due to change the IV fluid?

[400 mL ÷ 22] x 20 = minutes remaining

18.18 x 20 = 363 minutes or 6 hours

• A patient has 350 mL of Plain 0.9 NaCl solution as IV infusion regulated at 20 drops per minute. Drop factor 10 was used for the patient’s macrodrip set. Considering the IV fluid level of the patient, for how many minutes will it run?

[350 mL ÷ 20] x 10 = minutes remaining

17.5 x 10 = 175 minutes or 3 hours

Helpful Videos to Watch

Here are some of the most popular videos about drug calculations. It is easy to understand and practice the formulas presented above using these audio-visual learning tools:

Infusion Rates

Dosage calculations for nurses – drug math made easy!

Dosage Calculation – Everything you need to know!

Additional Tips:

As long as you know the basic formulas of drug calculations, you will never be lost in finding the desired dosage for your patient.

The trick in mastering drug calculations is to know unit conversions by heart. Once you are regularly working in a clinical setting, you will get used to the common formulas used in determining desired dosages or IV regulations for the patient.

It takes a lot of practice to master drug calculations and you don’t need to memorize it. Answer practice questions at home and in a short period of time, nursing pharmacology will just be a piece of cake for you.

Recommended Articles:

Nursing Pharmacology Mnemonics & Tricks – Learn nursing pharmacologythe fun way using these easy-to-memorize mnemonics and useful study guides.

Top 10 Best Online Drug Guides for Nurses – Say goodbye to bulky nursing drug handbooks. This article features the ten of the best free drug guides for nurses online that you must consider.

The nurse’s quick guide to I.V. drug calculations – This article will provide a simple and concise method for accurate computation using basic calculations.

Dimensional analysis: Calculate dosages the easy way – This article introduces the DA method of performing dosage calculations to practicing nurses.

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Nursing Pharmacology Cheat Sheet

Explore the Nursing Pharmacology Cheat Sheet for streamlined medication management. Enhance care with Carepatron's software solutions.

By RJ Gumban on Jul 15, 2024.

Fact Checked by Ericka Pingol.

The importance of pharmacology in nursing

Pharmacology is a critical component of nursing care, integral to ensuring patient safety and effective treatment outcomes. For nurses, understanding pharmacology is not just about knowing a list of drugs; it's about comprehending how these medications interact with the human body, how they produce therapeutic effects, and what side effects or complications might arise. This knowledge is essential for:

• Safe medication administration : Nurses are often the last defense against medication errors. A deep understanding of pharmacology helps them to administer medications safely and accurately.
• Patient education : Nurses are crucial in educating patients about their medications. Knowledge of pharmacology enables them to explain the purpose, potential side effects, and the importance of adherence to prescribed treatments.
• Clinical decision-making : In their daily practice, nurses make numerous decisions related to medication management. A solid grasp of pharmacology supports these decisions, ensuring they are made in the patient's best interest.

Pharmacology knowledge empowers nurses to provide high-quality, patient-centered care, making it an indispensable part of nursing education and practice.

Nursing Pharmacology Cheat Sheet Template

Nursing pharmacology cheat sheet example, what is a nursing pharmacology cheat sheet.

A Nursing Pharmacology PDF Cheat Sheet is an invaluable tool for nurses, offering a quick and comprehensive reference to essential medication information. This digital guide is meticulously organized to include drug classifications, providing an overview of medications based on their therapeutic effects and mechanisms of action. It lists common medications, detailing their generic and brand names and primary uses, which is crucial for nurses in various clinical settings.

The cheat sheet also provides standard dosage information for these medications, which is critical for safe and effective administration. Understanding the common side effects associated with different drug classes is essential for monitoring patient responses and managing potential adverse reactions, and this cheat sheet makes this information readily accessible.

Additionally, it includes special considerations for each medication, such as specific monitoring requirements and patient education points, which are vital for holistic patient care.

Designed to the needs of nursing professionals, this cheat sheet is particularly beneficial for those in fast-paced environments or those new to the field. It serves as a practical guide for daily nursing tasks and as a resource for enhancing pharmacological knowledge and improving patient care outcomes.

Therefore, the Nursing Pharmacology PDF Cheat Sheet is more than just a reference document; it's a support tool that empowers nurses to deliver high-quality care with confidence and precision.

What does this cheat sheet include?

The Nursing Pharmacology Cheat Sheet is a comprehensive resource that includes essential information for nurses administering medications. Key elements of the cheat sheet are:

• Drug classifications : It categorizes medications into their respective classes, such as analgesics, antibiotics, anticoagulants, and more, providing a structured overview of different types of drugs.
• Medication names : Both generic and brand names of common medications are listed, aiding recognition and understanding.
• Common uses : This section outlines the primary indications for each medication, helping nurses understand why a drug is prescribed.
• Typical dosage : Standard dosage information for each medication is included, which is crucial for safe administration and dosage adjustments.
• Common side effects : The cheat sheet highlights the potential adverse effects of each medication, preparing nurses to monitor and manage these effects.
• Special nursing considerations : This vital section includes specific nursing actions, monitoring parameters, and patient education points relevant to each medication.

Overall, this cheat sheet serves as a quick reference guide, ensuring that nurses have immediate access to critical pharmacological information, enhancing patient care and safety.

How does this template work?

Using the Nursing Pharmacology Cheat Sheet is a straightforward process that can be broken down into simple steps:

Access the cheat sheet

First, open and save the cheat sheet in a user-friendly PDF format on any digital device for easy access.

Identify the medication class

Start by locating the specific class of medication you need information on, such as antihypertensives or antidepressants.

Find the medication

Within the class, look for the specific medication prescribed to your patient. Both generic and brand names are listed for ease of identification.

Review key information

Review each medication's common uses, typical dosage, common side effects, and special nursing considerations. This comprehensive information aids in safe medication administration and patient education.

Apply in clinical practice

Utilize the information in your daily nursing practice, whether administering medication, educating patients, or monitoring for side effects.

Keep the cheat sheet updated

Regularly update your cheat sheet with new medications or changes in practice guidelines to ensure that the information remains current and relevant.

This step-by-step guide ensures that nurses can effectively utilize the Nursing Pharmacology Cheat Sheet for optimal patient care and medication management.

The benefits of using this cheat sheet

The Nursing Pharmacology Cheat Sheet offers numerous advantages in clinical practice:

Quick access to information

It provides immediate access to essential medication information, saving time and enhancing efficiency in fast-paced healthcare settings.

Enhanced patient safety

By offering detailed information on dosages, side effects, and nursing considerations, the cheat sheet helps reduce medication errors and improve patient safety.

Improved patient education

The cheat sheet serves as a resource for nurses to educate patients about their medications, including how to take them, potential side effects, and the importance of adherence, leading to better patient outcomes.

Supports clinical decision-making

It aids nurses in making informed decisions about medication administration and adjustments, ensuring that patient care is based on accurate and up-to-date information.

Convenience and ease of use

The cheat sheet's concise, user-friendly format makes it easy for nurses of all experience levels to use, whether new graduates or seasoned professionals.

Research and evidence

The development and utilization of nursing pharmacology cheat sheets are supported by research emphasizing their role in enhancing medication management and decision-making in nursing care. Studies have shown that these tools can significantly contribute to more effective, patient-centered, and evidence-based medication management.

For instance, Ghamari Zare and Adib-Hajbaghery (2016) highlighted the importance of clinical nurse educators in teaching pharmacology and medication management, underscoring the need for tools to optimize medication use.

Similarly, Mouazer et al. (2022) discussed the ABiMed research project, which aims to develop an innovative clinical decision support system for medication reviews, demonstrating the potential of digital tools in monitoring and analyzing medication practices.

He et al. (2022) emphasized the need for decision support in administering high-alert medications among pediatric nurses, indicating the critical role of accessible knowledge resources in ensuring safe medication practices.

Additionally, Dodson and Layman (2022) reported on the interdisciplinary collaboration in creating a pharmacogenetics clinical decision support tool, showcasing the successful integration of nursing and computer science to enhance medication management.

These studies collectively indicate that nursing pharmacology assessment cheat sheets, as part of broader clinical decision support systems, can significantly improve the accuracy and safety of medication administration in nursing practice.

Dodson, C., & Layman, L. (2022). Interdisciplinary Collaboration Among Nursing and Computer Science to Refine a Pharmacogenetics Clinical Decision Support Tool Via Mobile Application. CIN: Computers, Informatics, Nursing. https://dx.doi.org/10.1097/CIN.0000000000000960

Ghamari Zare, Z., & Adib-Hajbaghery, M. (2016). Performance of Clinical Nurse Educators in Teaching Pharmacology and Medication Management: Nursing Students' Perceptions. Nursing and Midwifery Studies. https://dx.doi.org/10.17795/nmsjournal29913

He, M., Huang, Q., Lu, H., et al. (2022). Call for Decision Support for High-Alert Medication Administration Among Pediatric Nurses: Findings From a Large, Multicenter, Cross-Sectional Survey in China—frontiers in Pharmacology. https://dx.doi.org/10.3389/fphar.2022.860438

Mouazer, A., Leguillon, R., Leroy, B., et al. (2022). ABiMed: Towards an Innovative Clinical Decision Support System for Medication Reviews and Polypharmacy Management. https://dx.doi.org/10.3233/shti210859

Commonly asked questions

Yes, Carepatron's software is versatile and customizable, making it suitable for various nursing specialties, from general practice to specialized care.

Absolutely, Carepatron enhances patient education through its online patient portal, facilitating easy access to health information and resources, thus improving patient understanding and engagement.

Carepatron prioritizes data security by adhering to healthcare regulations and employing advanced security measures to protect patient information, ensuring confidentiality and compliance.

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This resource from ONS clinical staff provides information through a nursing lens and includes the drug’s indication, side-effect profile, nursing considerations, patient education talking points, and more.  

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Nursing Pharmacology

Explore our simplified study guides for nursing pharmacology, designed to help nurses understand various drugs and medicines used in the healthcare setting. These resources are perfect for NCLEX review, providing useful tips and detailed explanations to enhance your pharmacological knowledge.

Key features include:

• Simplified Study Guides for Easy Understanding
• Comprehensive Coverage of Different Drugs and Medicines
• Useful Tips for Remembering Drug Information
• Perfect Companion for NCLEX Review
• Sample Test Bank Questions for Each Study Guide
• Detailed Explanations and Practical Applications
• Key Nursing Considerations and Responsibilities

Enhance your pharmacology knowledge and boost your exam readiness with our expertly curated content. Dive into our study guides to master the essentials of nursing pharmacology and excel in your nursing career.

IV Fluids and Solutions Guide & Cheat Sheet

Get to know the different types of intravenous solutions or IV fluids in this guide. Differentiate isotonic, hypertonic, and hypotonic IV solutions and the nursing interventions and management for each.

Diuretics are drugs that primarily increase the excretion of sodium. Learn about thiazide, loop, potassium-sparing, osmotic diuretics, and carbonic anhydrase inhibitors.

Antihypertensive Drugs

Nursing pharmacology study guide for antihypertensive agents includes ACE Inhibitors, Angiotensin II Receptor Blockers, Calcium-Channel Blockers, Vasodilators.

Antiarrhythmic Drugs

Antiarrhythmics address arrhythmia by altering cells’ automaticity and conductivity. Includes Class IA, IB, IC, II, III, and IV.

Antianginal Drugs

Learn about antianginal drugs, nitrates, beta-blockers, and calcium channel blockers in this simplified guide for nursing pharmacology.

Antihyperlipidemic Drugs

Antihyperlipidemic Drugs lower serum levels of cholesterol and various lipids.

Cardiotonic-Inotropic Drugs

Cardiotonic agents are drugs used to increase the contractility of the heart. Included below is a pharmacology guide for nurses on the various effects of cardiotonic-inotropic agents.

Drugs Affecting Coagulation (Anticoagulants, Antiplatelets, Thrombolytics)

Simplified study guide for nursing pharmacology which includes antiplatelet drugs, anticoagulants, thrombolytic agents, anticoagulant adjunctive therapy and more.

Bronchodilators and Antiasthmatics

Bronchodilators, or antiasthmatics are medications used to facilitate respiration by dilating the airways. They are helpful in symptomatic relief or prevention of bronchial asthma and for bronchospasm associated with COPD.

Expectorants and Mucolytics

Learn about the uses and nursing care plan considerations needed for patients taking expectorants and mucolytics in this nursing pharmacology guide.

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