Dispensing includes preparing and giving medication for a client to take later, taking steps to ensure the pharmaceutical and therapeutic suitability of the medication for its intended use, and taking steps to ensure its proper use. Nurses dispense with or without the involvement of a pharmacist.
Dispensing with a pharmacist’s involvement
When a pharmacist has already reviewed a medication’s suitability and dispensed it for the client, nurses ensure its proper use. Examples of dispensing with a pharmacist’s involvement may include:
- Providing a client leaving on a day pass with medication to take while away
- Giving a client medication supplied by a provincial agency as part of an outpatient treatment program (e.g. BC Renal Agency, BC Centre for Disease Control)
- Providing a health care worker accompanying a client to an appointment outside the organization with medication for the client to take while away
- Giving a client discharged from an inpatient unit medication (e.g. antibiotic, inhaler) to take home with them
Dispensing without a pharmacist's involvement
When a pharmacist has not reviewed the medication’s suitability (or it’s unclear if this was done), nurses ensure the medication’s pharmaceutical and therapeutic suitability for the client and its proper use. Examples of dispensing without a pharmacist’s involvement may include:
- Providing a client discharged from ER with enough pain medication to manage until the pharmacy opens the next day
- Providing a client at a treatment centre a course of antibiotics to treat an infection
Checking for pharmaceutical and therapeutic suitability
- Check that the medication is appropriate for the client, and the dose and frequency are within usual range.
- Verify the information with client when possible.
- Review the client’s best available medication history and other personal health information
- Assess the client’s known allergies and ensure medication allergy information is documented
- Consider potential medication interactions, contraindications, therapeutic duplications, side effects, adverse effects, and any other potential problems
- Consider the client’s ability to follow the medication regimen
- Explain what the physician has ordered and confirm the client is able to take the medication as prescribed
Ensuring proper use
- Check the prepackaged medication against the client-specific order
- Ensure the product has not expired
- Label the medication legibly with:
- Client name and second client identifier (birth date, PHN, etc.)
- Medication name, dosage, route, and strength
- Directions for use
- Amount dispensed
- Date dispensed
- Initials of the dispensing nurse
- Name, address, and telephone number of the dispensing agency
- Name and designation of the prescribing practitioner
- Any other information that is appropriate and/or specific to the medication
- Hand the medication directly to the client, or, if appropriate, to the client’s substitute decision-maker or other authorized delegate
Documenting
Document the dispensed medication in the client’s chart, including:
- Date dispensed
- Allergies and adverse medication reactions, if available and not already noted in the client’s record
- Name, strength, dosage of medication
- Amount dispensed
- Intended duration of therapy, specified in days (if applicable)
- Directions to client
- Name of prescribing practitioner
- Signature and title of the person dispensing the medication
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