MEDICATION ACTIVITY This is a timed medication administration check off. It is worth 6 points. It is divided into 3 points for clinical reasoning, being able to correctly identify which meds should be administered, and 3 points for appropriately administering the medications within a 20 minute time frame. Remember to complete and verbalize the 7 rights of medication administration. Review the SBAR you were given. You will find labs/vs/data associated with the patient SBAR. You do not need to do a new assessment. The assessment data from the information you have been given is accurate. The time is 0745 and you need to administer the 0800 medications. On the form, list the medications you administered and list any medications not administered (if any). If there are medications that you did not administer (based on patient data) please document on the form why the medication was held. In some scenarios there will be no indications to hold any of the medications. For IVPB infusions document your rate using ml/hour. For IV Push medications, document your rate of administration broken down into how many mls you will administer every 15 seconds. You may use your medication book. At the end of the check off, please give this form to the faculty member. Student name: Section: Date: Patient initials: Time began: Time ended: Points: Faculty: Points deducted due to: List Medications Administered Include ml/hr for IVPB and rate for IV Push List Medications (if any) not administered: document rationale for holding medication
Rubric for Medication Activity This is a timed administration check off and is worth 6 points. It is divided into 3 points for clinical reasoning, being able to correctly identify which meds should be administered, and 3 points for appropriately administering the medications within a 20 minute time frame. Clinical Reasoning: 3 points Medication Administration: 3 points To receive the full 3 points student must: To receive the full 3 points student must: Correctly identify which medications should be administered as ordered. Identify if any medications should not be administered and provide appropriate rationale for not administering the medication * Identify appropriate rate of IVPB/ IVP medications if meds administered (Prior to check off, a form will be provided to students to document the above items) Appropriately administer medications, correctly exhibiting the 7 rights of medication administration Includes drawing up/administering correct dose Verbalizing rights out loud Correctly utilize appropriate needle/syringe size if applicable Follow appropriate steps of cleansing skin/iv hub prior to medication administration Administer medication correctly and in appropriate anatomical site (example: subcutaneous injections) Incorrectly identifies which medications should be administered =0 points Identifies incorrect rate of administration for medications = 0 points Fails to complete one of the above criteria =2 points Fails to complete more than one of the above criteria =0 points Timer will be set for 20 minutes. If timer goes off prior to completion of medication administration, no points will be award for the administration component of check off. Student may still receive points for clinical reasoning if criteria in clinical reasoning achieved. * Nurses must have orders from healthcare providers (HCP) to withhold medications unless indications for withholding are written into the order. If you do not administer a medication in this medication check off, faculty will know that communication with the HCP will occur after the check off is completed.
FACULTY GUIDE: For the patient listed SG there are four scenarios- marked as SG- (for SG1) SG- - (for SG2) SG- - - (SG3) and SG - - - - (SG4) Forms for students were marked in this manner to ensure students do not pass information to other students based on initials/numbers. There is a data sheet with VS/Labs and MAR with each SBAR. For setting up SG simulation you will need NS @75 ml/hr per pump and the following medications. SG- meds: Zosyn, Cardizem, Lovenox 1 SG- Hold lovenox Creatinine 2.0. Administer Cardizem and Zosyn 2 SG- - Hold Cardizem SBP 98, Pulse 52. Administer Lovenox and Zosyn 3 SG - - - Hold Lovenox, PLT 49,000 and H 8.2. Administer Cardizem and Zosyn. 4 SG- - - - No indications to hold any med. Administer Zosyn, Cardizem, Lovenox The students will be performing the activity in front of you in a Learning Resource Center room on a mannequin. Medications, syringes, needles, blunts, IV tubing, etc should be available to students in the room. This is timed for 20 minutes. Follow the rubric for grading. Students have previously been given the direction sheet, an example, and rubric on blackboard. They may use a medication or resource book. Print the SBARs, data sheets, MARs and give the appropriate ones for each scenario to the student. Ensure that you have stapled the appropriate SBAR/data sheet/mar together- different actions will be based on VS/labs. Remind the student of the directions on their form: Review the SBAR you were given. You will find labs/vs/data associated with the patient SBAR. You do not need to do a new assessment. The assessment data from the information you have been given is accurate. The time is 0745 and you need to administer the 0800 medications. On the form, list the medications you administered and list any medications not administered (if any). If there are medications that you did not administer (based on patient data) please document on the form why the medication was held. In some scenarios there will be no indications to hold any of the medications. For IVPB infusions document your rate using ml/hour. For IV Push medications, document your rate of administration broken down into how many mls you will administer every 15 seconds. You may use your medication book. At the end of the check off, please give this form to the faculty member. Observe the activity, document on the form, record score and turn in items to faculty leader.
S B SITUATION Initials/Age/Sex SG- 85 Male Admit DR. Smith Room: 333 Last Adm. Dx: UTI Adm. Date: night at 1900 Code Status: Full Code Advanced Directive: Y/N Surgery Date: History of this admission: Admitted from Nursing Home last night at 1900 BACKGROUND Past History: Labs/Procedures/Tests: Allergies: NKA HTN; COPD; current smoker CBC/ CHEM @ 0600 A Activity: Up with assist ASSESSMENT Weight: (kg) GU Voiding: cloudy yellow, adequate UO Adm: 75 kg Foley: Today: I & O: Trends: Urine: Neuro Intact: Alert and oriented Dialysis/access/days: LOC: Grips: Skin Color/Temp/Turgor: Warm/dry/pink MAE: PERRLA: Edema: none Rhythm/Tones: Regular rate and rhythm Braden Scale/Fall Risk: CV Metabolic Blood Glucose: Peripheral Pulses: +2 bilat Attach Strip with interpretation: sinus rhythm Pain Lungs 02/02 Sat: 94% RA Meds: Breath Sounds: CTA Drains/Incisions/Closure Device/Dressings SMI/PEP: encourage Resp Tx: IV Site Insertion Date Hanging Adj/gtt Dsg R GI #1 Right AC Last night Abdomen: Soft, non-tender #2 Bowel Sounds: Positive Last BM: #3 yesterday NG/FT: PICC/Centra Diet/Appetite: General diet l Other Information RECOMMENDATION To Do or Report: Smoking Cessation NS @75 ml/hr
SG- This column: CBC from one month ago Today s am lab Chemistry and CBC 42 2.0 66 99 VS: 1900 2400 0700 ETC Room air Room air Room air
PT: SG - DOB: 8/26/19 TODAY s EMAR Allergies: NKA 0800 DUE 0600 New bag hung 0200 Given 0800 DUE 0800 DUE
S B SITUATION Initials/Age/Sex SG- - 85 Male Admit DR. Smith Room: 333 Last Adm. Dx: UTI Adm. Date: night at 1900 Code Status: Full Code Advanced Directive: Y/N Surgery Date: History of this admission: Admitted from Nursing Home last night at 1900 BACKGROUND Past History: Labs/Procedures/Tests: Allergies: NKA HTN; COPD; current smoker CBC/ CHEM @ 0600 A Activity: Up with assist ASSESSMENT Weight: (kg) GU Voiding: cloudy yellow, adequate UO Adm: 75 kg Foley: Today: I & O: Trends: Urine: Neuro Intact: Alert and oriented Dialysis/access/days: LOC: Grips: Skin Color/Temp/Turgor: Warm/dry/pink MAE: PERRLA: Edema: none Rhythm/Tones: Regular rate and rhythm/sb Braden Scale/Fall Risk: CV Metabolic Blood Glucose: Peripheral Pulses: +2 bilat Attach Strip with interpretation: sinus rhythm Pain Lungs 02/02 Sat: 94% RA Meds: Breath Sounds: CTA Drains/Incisions/Closure Device/Dressings SMI/PEP: encourage Resp Tx: IV Site Insertion Date Hanging Adj/gtt Dsg R GI #1 Right AC Last night Abdomen: Soft, non-tender #2 ETC Bowel Sounds: Positive Last BM: #3 yesterday NG/FT: PICC/Centra Diet/Appetite: General diet l Other Information RECOMMENDATION To Do or Report: Smoking Cessation NS @75 ml/hr
PT: SG - - DOB: 8/26/19 TODAY s EMAR Allergies: NKA
SG- - VS: 1900 2400 0700 ETC 98/56 Supine Room air Room air Room air CBC from one month ago CBC and Chemistry from this am 4.8 13.9 39.2 R
S B SITUATION Initials/Age/Sex SG- - - 85 Male Admit DR. Smith Room: 333 Last Adm. Dx: UTI Adm. Date: night at 1900 Code Status: Full Code Advanced Directive: Y/N Surgery Date: History of this admission: Admitted from Nursing Home last night at 1900 BACKGROUND Past History: Labs/Procedures/Tests: Allergies: NKA HTN; COPD; current smoker CBC/ CHEM @ 0600 A Activity: Up with assist ASSESSMENT Weight: (kg) GU Voiding: cloudy yellow, adequate UO Adm: 75 kg Foley: Today: I & O: Trends: Urine: Neuro Intact: Alert and oriented Dialysis/access/days: LOC: Grips: Skin Color/Temp/Turgor: Warm/dry/pink MAE: PERRLA: Edema: none Rhythm/Tones: Regular rate and rhythm Braden Scale/Fall Risk: CV Metabolic Blood Glucose: Peripheral Pulses: +2 bilat Attach Strip with interpretation: sinus rhythm Pain Lungs 02/02 Sat: 94% RA Meds: Breath Sounds: CTA Drains/Incisions/Closure Device/Dressings SMI/PEP: encourage Resp Tx: IV Site Insertion Date Hanging Adj/gtt Dsg R GI #1 Right AC Last night Abdomen: Soft, non-tender #2 ETC Bowel Sounds: Positive Last BM: #3 yesterday NG/FT: PICC/Centra Diet/Appetite: General diet l Other Information RECOMMENDATION To Do or Report: Smoking Cessation NS @75 ml/hr
PT: SG- - - DOB: 8/26/19 TODAY s EMAR Allergies: NKA Hold for Systolic BP <100
SG- - - Today s am lab Chemistry and CBC 3.2 8.2 25.1 80.2 49 VS: 1900 2400 0700 ETC Room air Room air Room air
S B SITUATION Initials/Age/ SG- - - - 85 Male Admit Smith Room: 333 Sex DR. Last Adm. Dx: UTI Adm. Date: night at 1900 Code Status: Full Code Advanced Directive: Y/N Surgery Date: History of this admission: Admitted from Nursing Home last night at 1900 BACKGROUND Past History: Labs/Procedures/Tests: Allergies: NKA HTN; COPD; current smoker CBC/ CHEM @ 0600 A Activity: Up with assist ASSESSMENT Weight: (kg) GU Voiding: cloudy yellow, adequate UO Adm: 75 kg Foley: Today: I & O: Trends: Urine: Neuro Intact: Alert and oriented Dialysis/access/days: LOC: Grips: Skin Color/Temp/Turgor: Warm/dry/pink MAE: PERRLA: Edema: none Rhythm/Tones: Regular rate and rhythm Braden Scale/Fall Risk: CV Metabolic Blood Glucose: Peripheral Pulses: +2 bilat Attach Strip with interpretation: sinus rhythm Pain Lungs 02/02 Sat: 94% RA Meds: Breath Sounds: CTA Drains/Incisions/Closure Device/Dressings SMI/PEP: encourage Resp Tx: IV Site Insertion Date Hanging Adj/gtt Dsg R GI #1 Right AC This am in Abdomen: Soft, non-tender #2 Bowel Sounds: Positive Last BM: #3 yesterday NG/FT: PICC/Centra Diet/Appetite: General diet l Other Information RECOMMENDATION To Do or Report: Smoking Cessation NS @75 ml/hr
PT: SG - - - - DOB: 8/26/19 TODAY s EMAR Allergies: NKA
SG- - - - Today s am lab Chemistry and CBC