The administration of mediation is an essential aspect of nursing care. Safe practice is essential and the nurse must be aware of their professional and legal responsibilities in relation to all aspects of medication management. In relation to children’s and young people’s nursing practice, the nurse also needs to consider the child’s developmental stage, their ability to consent to treatment and the role of parents/carers.

Key principles associated with good practice in the administration of medication are:

• The nurse should be able to demonstrate an understanding of the plan of treatment for the child.
  
• The prescription should be legible, unambiguous and it should be legal.
  
• The prescription should be checked for date prescribed, drug prescribed, dose prescribed, route prescribed, duration of treatment, any additional required information, e.g. blood levels required after second dose, and it must be signed.
  
• Any contraindications to the prescribed drug must be identified by the nurse and appropriate action taken.
  
• Allergies must be checked and noted on the prescription chart.
  
• The nurse needs to be aware of the effects that the medication will have on the patient and also be aware of the side effects. The child and their family should be advised accordingly so as to avoid alarm and concern.
  
• The paediatric formulary must be available and referred to prior to the administration of the medication.
  
• Medication should be prepared in a quiet area and interruption should be avoided during this period.
  
• The correct equipment should be collected initially.
  
• The nurse should check the prescription for date, time, frequency, dose, additional information and signature as part of the initial preparation process.
  
• The medicine container should be checked for drug name, dose, expiry date and that the content is clear and not contaminated.
  
• Local policy will determine the number of staff required to administer medication. Student nurses should be involved in this process.
  
• Consent must be obtained before you administer the medication.
  
• The nurse administering the medication must ensure they observe the child taking the medication.
  
• The medication chart should only be signed once the child has swallowed/inhaled the medication. If the child refuses the medication or is unable to receive the medication as prescribed, for whatever reason, then this must also be documented on the prescription chart.
  
• Involve the play therapist and employ distraction techniques as required.
  
• Safely dispose of all equipment used in accordance with local policy.
  
• Discuss any required clinical holding techniques with the child and parents before the first dose of mediation is required.
  
• Adhere to any additional requirements, e.g. if the medication is required to be taken on an empty stomach, then ensure this happens.
  
• If therapeutic serum levels are required, then ensure the child has the required blood sampling performed and that the results are available, scrutinized and acted on before any subsequent administration of the medication occurs.
  
• Remember the five ‘Rs’ of safe drug administration:
  
  
  
  • Right drug
    
  • Right dose
    
  • Right patient
    
  • Right route
    
  • Right frequency
  
  
• Education of the child and parents should happen early in the admission process.