Pediatric Informatics: Computer Applications in Child Health (Health ...

Chapter 28
Medication Administration
and Information Technology
Catherine Garger, Carol Matlin, George R. Kim and Robert E. Miller
Objectives
To present a framework for thinking about medication administration and errors
To discuss healthcare information technology interventions in the context of the
model
To focus on pediatric-specific issues
28.1 Introduction
Medication administration is the final step in the medication delivery cycle before a
prescribed drug reaches a patient. In ambulatory settings, the patient, or in the case
of children, the parent or guardian is responsible for accepting prescribed medications
from the pharmacist and following directions regarding direct administration of
drug doses. In inpatient settings, it is principally the bedside nurse who administers
prescribed medications. A study of inpatient settings suggests that interventions by
pediatric clinical pharmacists, while effective for intercepting prescribing errors,
may be ineffective in intercepting harmful administration errors. 1
28.2 The Steps of Medication Administration
The steps of the inpatient administration process assure the “5 Rights” of medication
safety (Right patient, Right medication, Right dose, Right time, Right route)
in delivering a drug dose to a patient. These steps include:
1. Medication reconciliation: the development and maintenance of shared knowledge
of a patient’s prescribed medications by the entire health team and what is actually
being given. Development of this shared knowledge begins when a patient
is admitted to an inpatient unit and current drug regimen is checked, corrected,
and recorded as part of the care process. The principal prescriber should have
this information in the patient record where it is available to nursing and other
C.U. Lehmann et al. (eds.), Pediatric Informatics: Computer Applications 357
in Child Health, Health Informatics,
© Springer Science + Business Media, LLC 2009