SAINT MICHAEL’S COLLEGE OF LAGUNA
SCHOOL OF NURSING
PERFORMANCE CHECKLIST
ORAL MEDICATION
Name: _______________________________________ Date:________________________
Clinical Instructor:_______________________________ Performance Grade:____________
Equipment:
Medicine tray:
Medication card
Oral meds
Drinking water
Rating Scale: 2 – Good (Done) 1 – Needs Improvement (Not done)
• Done Not done Remarks
Preparation
• Perform hand hygiene prior to medication
• preparation.
• Prepare medications for ONE patient at a
• Time.
• Know the actions, special nursing
• considerations, safe dose ranges, purpose of
• administration, and potential adverse effects
• of the medications to be administered.
• Perform necessary calculations to verify
• correct dosage.
The medication label must be checked for name, dose, and route, and
compared with the MAR at least three different times:
• When the medication is taken out of the drawer.
• When the medication is being prepared.
• At the bedside, prior to medication administration to the patient.
Procedure
1 Introduce yourself, your role and the purpose of your visit,
2• Confirm patient ID using two patient identifiers (e.g., name and date of
birth).
3 1. Assist the patient to an upright (or a side-lying) position if they are unable
to be positioned upright:
1. Offer water or other permitted fluids with pills, capsules, tablets, and
some liquid medications.
2. Ask if the patient prefers to take the medications by hand or in a cup
and if they prefer all medications at once or individually.
4 Remain with the patient until each medication is swallowed. Never
leave medication at the patient’s bedside
5 1. Assist the patient to a comfortable position, ask if they have any
questions, and thank them for their time.
6 1. Ensure safety measures when leaving the room:
1. CALL LIGHT: Within reach
2. BED: Low and locked (in lowest position and brakes
3. on)
4. SIDE RAILS: Secured
5. TABLE: Within reach
6. ROOM: Risk-free for falls (scan room and clear any
7. obstacles)
7 1. Perform hand hygiene.
8 1. Document medication administration and related assessment findings.
Report any concerns according to agency policy.
9 Evaluate the patient’s response to the medication within the appropriate
time frame. Note: Most sublingual medications act in 15 minutes, and
most oral medications act in 30 minutes.
Comments: ____________________________________________________________________
____________________________________________________________________
Name and Signature of Clinical Instructor Signature of the Student
______________________________ ___________________