MA/RN Ambulatory Clinic Medication Administration

Which department are you completing this survey for?

Name of the employee observed:

There is an order for the medications
If to be administered by MA, medication is not high risk or controlled
Vertifies patient does not have documented allergy to medication
Performs hand hygiene
Medication prep area is clean and free of clutter
Prepares only one patient's medication at a time
Visually inspects medication for particulates, discoloration or or other loss of integrity
Verifies that medication is not expired
Verifies medication selected matches the medication order and product label with medication order (electronic or printed order-printed order must include medication name, conc, dose, route)
Labels medication with patient's 2 patient ID and medication information (if more than 1 patient's medication is administered)
If to be administered by MA and require dose calculation, medication dose checked by Nurse or MD
Provides information about medication to patient/LAR
For vaccination, consent signed and VIS provided to LAR
Performs hand hygiene prior to administration
Verified with patient/LAR medication order with 2 patient ID
Administers medication in appropriate method
Performs hand hygiene after administration
Documents medication in eMAR