Medication Administration Safety: Medication administration safety is critical in all treatment areas but requires additional safeguards in the ED environment, which is sometimes chaotic. There are multiple mechanisms to reduce the risk of medication error in the ED. These include computer provider order entry systems, medication dispensing cabinets [MDC] (most commonly Pyxis systems), barcoding systems, high-risk medication labeling and segregation, staff education, and pharmacy review of ordered medications prior to administration by ED nurses. 

Medication Dispensing Cabinets: Pyxis systems can be organized so that only certain medications can be removed by a nurse without an electronic order having been entered by a doctor or reviewed and approved by a pharmacist. Doing so allows a nurse to obtain certain critical emergency medications with only a verbal order from a doctor, most commonly when a doctor must stay at a patient’s bedside. In such situations, the ordering doctor is listed as “doctor, Pyxis override.” In non-emergent situations, a Pyxis should be programmed to allow medications to be removed only once the doctor’s order has been placed electronically. Another important design element of the Pyxis is that similar sounding medications can be placed into different areas or drawers of the machine to help eliminate the possibility that a wrong medication is removed by a nurse.

Safe Medication Administration Practices: Staff education also plays an important part in the avoidance of medication errors. Nurses are taught the “five rights” of medication administration, which means that nurses are supposed to verify the right patient, the right drug, the right time, the right dose, and the right route before administering any medication. These are considered the standard for safe medication practices.

Medication administration medical expert specialties include emergency medicine and emergency nursing.

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