Assessment of the Nurse Medication Administration Workflow Process

Table 1

MAP observation rules.

Rule #	Description
1	Each observation must begin with an “enter room” and end with a “move to next room.” The “enter room” should be entered only once when the RN first entered the room and should occur before “greet patient.” The “move to next room” should be recorded after the postdocumentation is done. Between the “move to next room” and “enter room” tasks, if the RN is performing activities related to the medication, then record all such activities.
2	The “other care” task is for direct/hands on patient care such as changing a wound dressing.
3	The “assess patient for other needs” task is for the final check of the patient’s well-being; for example, is there anything else I can do for you?
4	For intravenous medication (IV) administration, the pre/post line flushes are part of administration.
5	For med administration, activities performed away from the bedside should be recorded as “prepare for medication admin” and at the bedside should be recorded as “administer medications.”
6	When the RN does not complete med administration—moves to the next patient—then returns to the original patient to complete med administration, this is considered a new observation and thus a new set of “enter room” and “move to next room.”
7	If the patient does not swallow oral medications, the end time of “administer medication” should not be recorded.
8	Products given to the patient during med administration that are not reviewed/documented on the patient’s med record, for example, Orajel, are not considered medications.
9	The “perform assessment” task is for both mental and physical assessment.
10	Activities at the computer between scanning of meds are considered documentation.
11	Whenever the RN leaves the room during the med admin process, specify one of the “leave room” reasons, not “move to next room.”
12	The “review patient computer record” task is used when the RN is looking at the computer screen listing of prescribed medications. The “review patient medication box” task is used when the RN is looking at the medications. Be careful when recording these tasks as they are next to each other.
13	When an RN goes to the medication room, change location accordingly and record the task as “obtain medications: medication room.” If the RN accesses the pyxis, then record the task as “obtain medications: pyxis” while the other task is still active. Stop the “obtain medications: pyxis” task when the RN closes the pyxis, and stop the “obtain medications: medication room” task when the RN exits the medication room.