LibGuides: GradStart Nurses' Survival Guide: Medications Administration and Safety

Medications Administration and Safety

It is essential that nurses are competent in the administration of medications as otherwise patients are put at risk of serious harm. There are many resources to help new nurses develop their competences and deliver the medications people need safely.

NSQHS: Medication Safety Standard
The Medication Safety Standard aims to ensure that appropriate medicines are safely administered by clinicians, including nurses. The Standard outlines the key elements of safe practice.

Clinical Guidelines on the Intranet

Current SWSLHD Policy, Procedures & Guidelines can be found on the Intranet - for internal access only.

See for example:

SWSLHD_Proc2021_059 Medication Administration

NSW Health Policy Directive PD2022_032 Medication Handling

Medications resources

The Medications tab in CIAP gives access to important resources including the Australian Medicines Handbook, MIMS and Micromedex, the AMH Aged Care and Children's Dosing Companions, the Injectable Medicines Handbook and the Paediatric Injectable Medicines Handbook, NatMed Pro (Natural Medicines) and the Therapeutic Guidelines.

CIAP Speciality Guide for Medications
This useful guide to the Medications Information resources in CIAP helps you find the most relevant place for specific information e.g, for children, aged care, cancer patients etc.

A few key resources

Australian Medicines Handbook
Provides comparative information, dosage, and practical advice on Australian medicines including class statements and therapeutic information.
Micromedex
An authoritative US database providing in-depth information on medicines. Drug monographs include detailed information on dosing for specific indications, adverse effects, comparative efficacy and pharmacokinetics. Includes Drug interactions and Trissel's IV Compatibility.
MIMS
Provides approved Australian product information and Consumer Medicines Information (CMI), Product Information (PI), drug product images, drug interactions and SHPA's Don't Rush to Crush handbook.
NatMed Pro
Formerly Natural Medicines - provides high quality, evidence-based information about complementary and alternative therapies, diet, exercise and nutrition. Includes interations between standard and complementary/ alternative medicines.
Therapeutic Guidelines
Provides Australian evidence and expert opinion-based guidelines and advice on drug use for specific indications. Produced by an independent not-for-profit organisation.

Tools and Calculators

In the CIAP Tools tab you will find a number of calculators which help with medications.

Body Surface Area Calculator (eviQ)
Calculator from eviQ (a cancer treatment information database) from the Cancer Instute NSW.
Don't Rush to Crush (SHPA) via MIMS
Helps you work out if it is safe to administer a medicine in crushed form.
Dose Driven IV-Drip Rate Calculator (EBMCalc)
Uses desired dose, weight, drug in bag and bag volume to calculate IV drip rate
Ideal Body Weight and Adjusted Body Weight for Adults (UpToDate)
Ideal body weight (IBW) and adjusted body weight (AdjBW, also known as “adjusted dosing weight”) may be used to determine weight-based dosing for some medications and in some estimates of kidney function.
Lab Interpretation (UpToDate)
Aid to understanding and responding to test results

NSW Health Clinical Excellence Commission - Medication Safety

Medication Safety Team - CEC
The Medication Safety team supports the safe and quality use of medicines by identifying and addressing emerging medication safety risks and monitoring, evaluating and optimising medicines use across NSW. Contact for Medication Safety queries and NSW Medicines Formulary queries

Lippincott Nursing Procedures

Lippincott Nursing Procedures - Medications
The Lippincott Procedures available via CIAP include a number of procedures related to medication administration endorsed by the Australian College of Nursing. You will find general guidance on best practice as well as Drug therapy for older adults, Medication reconciliation, Oral drug administration and more.

Medication errors

Medication errors can be caused by various factors. Here are a few articles to get you thinking:

Eassey, D., Smith, L., Krass, I., McLAchlan, A., Brien, J. A. (2016). Consumer perspectives of medication-related problems following discharge from hospital in Australia: a quantitative study. International Journal for Quality in Health Care. 28(3), 391-7.
Link to full-text

Wagner, E. A., Fuhrmann, S., Brant, A., VanCamp, C., Dettore, J., Guzman, Y. (2020). Interruptions then and now: impact on nurses' clinical reasoning, emotions, and medication safety. Journal for Nurses in Professional Development, 36(6), 338-344. https://dx.doi.org/10.1097/NND.0000000000000667
Link to full-text

Williams, G & Halstead, A (2023). Reducing missed medications in surgical patients. British Journal of Nursing. 32(15);730-734
Link to full-text

Wright, K. M., & Bonser, M. (2020). The Essential Steps of Medication Administration Practices Project medication administration improvement practices among acute inpatients in a tertiary hospital: a best practice implementation project. JBI evidence implementation, 18(4), 408–419. https://doi.org/10.1097/XEB.0000000000000236
Link to full-text

A Selection of Books and eBooks

Briggs Drugs in Pregnancy and Lactation by Gerald G. Briggs; Roger K. Freeman; Craig V. Towers; Alicia B. Forinash
Call Number: Doody eBook collection
ISBN: 9781975162375
Publication Date: 2021-04-30
Essential for ob/gyn physicians, primary care physicians, and any health care provider working with pregnant or postpartum women, puts must-know information at your fingertips in seconds. An easy A-to-Z format lists more than 1,400 of the most commonly prescribed drugs taken during pregnancy and lactation, with detailed monographs designed to provide the most essential information on possible effects on the mother, embryo, fetus, and nursing infant. Each templated monograph includes: Generic US name (trade names in index) , Risk factors; Pharmacologic class;Pregnancy and breastfeeding recommendations; Pregnancy, fetal risk, and breastfeeding summaries; Updated references.
Calculate with Confidence by Morris, Deborah
Call Number: QV 748/MOR/7
ISBN: 9780323396837
Publication Date: 2017
Learn the three major methods of drug calculation! Calculate with Confidence, 7th Edition focuses on the increasing responsibility of the nurse in medication administration, prioritizes client safety with QSEN, and includes updated content that reflects the current scope of practice. This popular text covers the ratio and proportion, formula, and dimensional analysis methods offering a step-by-step approach to the calculation and administration of drug dosages.
Clinical Dosage Calculations (3rd ed) by Brotto, Vanessa & Rafferty, Kate
Call Number: QV 748/BRO/3
ISBN: 9780170423694
Publication Date: 2020
Clinical Dosage Calculations is a local, full-colour text covering the important aspects of dosage calculations you will require to deal with this essential part of clinical practice. An applied skills-focused text, this book uses real-life cases, worked examples and real medication charts and labels. Starting with the fundamental skills to help students deal with mathematics and familiarise themselves with medication charts and labels, the text then moves on to specialist area chapters, allowing them to deepen their skills in a clinical context.
Dosage Calculations Made Incredibly Easy! by Harvey, Margaret
Call Number: ProQuest Ebook Central (Use Athens login to access )
ISBN: 9781496308399
Publication Date: 2016
Dosage Calculations Made Incredibly Easy contains everything health care practitioners need to review and students need to learn about calculating drug dosages. This entertaining and informative reference reviews the basic math needed to perform dosage calculation, including fractions, decimals, percentages, ratios, and proportions. It walks the nurse through the interpretation of hundreds of examples of drug orders and the performance of hundreds of complex dosage calculations, and provides information on deciphering difficult abbreviations, dealing with unclear handwriting, reading medication labels, selecting administration equipment, and more.
Goodman and Gilman's the Pharmacological Basis of Therapeutics, 14th Edition by Laurence Brunton; Bjorn Knollmann
Call Number: CIAP E-book - StaffID to login offsite
ISBN: 9781264258079
Publication Date: 2022-11-01
The go-to reference that medical and health science professionals have relied upon as the pinnacle of authority and accuracy in describing the actions and uses of therapeutic agents in relation to physiology and pathophysiology.
Katzung's Basic and Clinical Pharmacology, 16th Edition by Todd W. Vanderah
Call Number: CIAP E-book - StaffID to login offsite
ISBN: 9781260463309
Publication Date: 2023-11-21
Presented in full-color and packed with hundreds of illustrations, Basic and Clinical Pharmacology is the wide-ranging, engaging guide students have counted on for decades. To be as clinically relevant as possible, the book includes sections that specifically address the clinical choice and use of drugs in patients and the monitoring of their effects, along with case studies that introduce clinical problems.
Math for Nurses by Mary Jo Boyer
Call Number: QV 748
ISBN: 9781975100926
Publication Date: 2019-10-30
Quickly Access Everything You Need to Calculate Dosages Effectively and Ensure Accurate Drug Delivery. Math for Nurses helps you perfect the basic math skills, measurement systems and drug calculations/preparations essential to successful nursing practice. Packed with real clinical examples and practice problems, this pocket-sized reference guides you step-by-step through the problem-solving and practical applications required in the nursing workplace.
A Nurse's Survival Guide to Drugs in Practice by Ann Richards; Sharon L. Edwards
Call Number: QV 55/5
ISBN: 9780702076589
Publication Date: 2020-10-15
Completely updated with revised content written by expert practitioners and educators in the field of drug administration and pharmacology. The book provides the underpinning current knowledge required for professional judgement and safer medication management. A more detailed account of medication management, including drug errors and strategies to mitigate against them occurring, is included. The multidisciplinary nature of drug administration from the naming of drugs, through drug preparation, administration and outcome are taken into account.
Pharmacology Made Incredibly Easy by Rebar, Cherie R.;Heimgartner, Nicole M.;Gersch, Carolyn
Call Number: ProQuest Ebook Central (Use Athens login to access )
ISBN: 9781975177560
Publication Date: 2022
Ready to master the medication process? Tap into the go-to resource for nursing pharmacology basics.Offering clear, concise descriptions of crucial nursing pharmacology concepts and procedures, this easy-to-follow, colorfully illustrated guide offers step-by-step guidance. From initial assessment to safe medication administration and patient care plans, this is the perfect resource for students, as well as a handy refresher for experienced nurses.