SKILL 5-14 Applying a Transdermal Patch

Skill Checklists for Taylor's Clinical Nursing Skills. A Nursing Process Approach, 5th edition Name Date Unit Position Instructor/Evaluator: Position

Goal: The medication is delivered via the transdermal route and

Excellent Satisfactory Needs Practice the patient experiences the intended effect of the medication. Comments

1. Gather equipment. Check medication order against the original order in the patient’s health record, according to facility policy. Clarify any inconsistencies. Check the patient’s health record for allergies. 2. Know the actions, special nursing considerations, safe dose ranges, purpose of administration, and adverse effects of the medications to be administered. Consider the appropriateness of the medication for this patient. 3. Perform hand hygiene. 4. Move the medication supply system to the outside of the patient’s room or prepare for administration at the medication supply system in the medication area. Alternatively, access the medication administration supply system at or inside the patient’s room. 5. Unlock the medication supply system or drawer. Enter pass code and scan employee identifcation, if required. 6. Prepare medications for one patient at a time. 7. Read the eMAR/MAR and select the proper medication from medication supply system or the patient’s medication drawer. 8. Compare the label with the eMAR/MAR. Check expiration dates and perform calculations, if necessary. Scan the bar code on the package, if required. 9. Depending on facility policy, the third check of the label may occur at this point. If so, when all medications for one patient have been prepared, recheck the labels with the eMAR/MAR before taking the medications to the patient. However, many facilities require the third check to occur at the bedside, after identifying the patient. 10. Lock the medication supply system before leaving it. 11. Transport medications to the patient’s bedside carefully, and keep the medications in sight at all times. 12. Ensure that the patient receives the medications at the correct time. 13. Perform hand hygiene and put on PPE, if indicated.

Satisfactory

Needs Practice

25. 24. 23. 22. 21. 20. 19. 18. 17. 16. 15. 14. the appropriatetimeframe. Evaluate thepatient’s responsetothemedicationwithin after administration. theadministration ofthemedicationimmediately Document hygiene. Remove glovesandadditionalPPE,ifused.Performhand patch. the tapetopatient’s skinincloseproximitytothe time ofadministrationonapiecemedicaltape.Apply Depending onfacilitypolicy, initialandwritethedate your handtopressfrmlyforabout10seconds.Donotmassage. surface. Applythepatchtopatient’s skin.Usethepalmof the coveringonpatchwithouttouchingmedication Remove thepatchfromitsprotectivecovering. was withadisposablewashclothorsoapandwater. facility policy. Gentlywashtheareawhereoldpatch adhesive sidesstickingtogetheranddiscardaccordingto from thepatient’s skin.Foldtheoldpatchinhalfwith Remove anyoldtransdermalpatchesofthesamekind dry, andfreeofhair. Rotateapplicationsites. for anysignsofirritationorbreakdown.Siteshouldbeclean, Assess thepatient’s skinwherepatchistobeplaced,looking Put ongloves. MAR beforeadministeringthemedicationstopatient. occur atthispoint.Ifso,recheckthelabelswitheMAR/ Based onfacilitypolicy, the third checkofthelabelmay required. Scan thepatient’s barcodeontheidentifcationband,if action ofeachmedicationtothepatient. the patientaboutallergies.Explainpurposeand medications. Checkthepatient’s allergybraceletorask Complete necessaryassessmentsbeforeadministering d. c. b. a. two ofthefollowingmethods(TheJointCommission,2018): eMAR/MAR. Thepatientshouldbeidentifedusingatleast thepatient.Compareinformationwith Identify based onfacilitypolicy. Ask thepatienttostatehisorhernameandbirthdate, Check thebirthdateonpatient’s identifcationband. identifcation band. Check theidentifcationnumberonpatient’s Check thenameonpatient’s identifcationband. Do notwritedirectlyonthemedicationpatch. Applying aTransdermal Patch(Continued)

SKILL 5-14