Skill 76
Topical Skin Applications
Topical administration of medication involves applying drugs locally to the skin, mucous membranes, or tissues. Topical drugs such as lotions, patches, pastes, and ointments primarily produce local effects; but they can create systemic effects if absorbed through the skin. To protect from accidental exposure, apply topical drugs using gloves and applicators. Always clean the skin or wound thoroughly before applying a new dose of a topical medication. Apply each type of medication, whether an ointment, lotion, powder, or patch, in a specific way to ensure proper penetration and absorption.
Delegation Considerations
The skill of administering topical medications cannot be delegated to nursing assistive personnel (NAP). However, some agencies (e.g., long-term care) may allow NAP to apply some forms of topical agents (e.g., skin barriers) to irritated skin or for the protection of the perineum during morning or perineal care. Check agency policies. The nurse directs NAP about:
Equipment
▪ Clean gloves (for intact skin) or sterile gloves (for nonintact skin)
▪ Option: Cotton-tipped applicators or tongue blades.
▪ Ordered medication (powder, cream, lotion, ointment, spray, patch)
▪ Basin of warm water, washcloth, towel, nondrying soap
▪ Option: Sterile dressing, tape
▪ Medication administration record (MAR) or computer printout
