Legal aspects of medication

Points to be remembered
• Follow the principles of medication
– Five rights
– 3 checks (while selecting the medicine from locker; while
preparing medicine; before administering to the patient)
• Check type of order
– Stat order
– Single dose order
– Scheduled order
– Standing order
– PRN order
 Legal aspects
• Medication error
• Questioning the medication order
• Federal law
• Orders
 Medication error
• If the nurse gives the wrong medicine to the
wrong person, an error has been made.
• If the nurse has the right medicine but wrong
dose or wrong route, a medication error has
been made.
• If the nurse gives the medication at the wrong
time, an error has been made.
•
 Error ...
• Nurses must inform the health care
practitioner of the error made. If an antidote
must be given, the health care practitioner
needs accurate information to make
appropriate care decisions.
• The nurse is responsible and held accountable
for questioning any medication order if, in the
nurse’s judgment, the order is unclear or in
error.
• The nature of the error may be in any part of
the drug order, and the nurse should seek
clarification from the health care practitioner.
• A drug error has serious legal implications if
the nurse involved could have been expected,
on the basis of knowledge and experience, to
have noted the error.
• If the health care practitioner disregards the
nurse’s query, another line of authority must
be pursued by the nurse to prevent a drug
error.

• The medication in question should not be

administered until the order has been
clarified.
• The nurse should withhold any drug when the
client’s health may be jeopardized. Notify the
health care practitioner of the need to
withhold the medication and the reason
withholding it is necessary.
• When the nurse is not able to read or
understand the order, the prescriber should
be contacted for clarification.
 Documentation
• Details of documentation should be done
– Name/age/sex /identification of the patients
– Drug
– Date and time
– Dose
– Route
– Proper signature
– Reaction or side effects if any.
Assessment and immediate care
of patient with drug reaction
 Assessment and immediate care of patient
with drug reaction
• Provide supplemental oxygen and observe. If
hypoxia continues, prepare to help insert an
artificial airway.
• Insert an I.V. line for giving emergency drugs
and volume expanders.
• Continually reassure the patient and explain all
tests and treatments to reduce fear and anxiety.
• Continuously assess the patient’s response to
treatment.
• Monitor vital signs and cardiopulmonary and
neurologic function.
• Observe for complications associated with
anaphylaxis, such as vascular collapse and acute
respiratory insufficiency or obstruction etc.
• Closely observe a patient with known allergies for
anaphylaxis when giving a drug with high anaphylactic
potential
 Storage of drug
• There should not be any damage by light or
temperature
• Should be arranged in such a way that they
are easily traceable when required.
• Store in secured place to prevent loss or theft
• Avoid contamination
• Control humidity
• Cold storage facility in store
 Storage...
• First in first out system
• Controlled drug container should be double
locked and recorded strictly.
 Indent of drugs
• Indent: Order for goods under specified
conditions of sale, the acceptance of which by
the supplier constitutes a contract of sale.
• it depends on institutional policy.
eg. BPKIHS, some other institutions.