Competencies related to medication administration and monitoring

Reconfiguration of health service delivery has raised questions and concerns about the category of provider qualified to administer and monitor medications on inpatient units. The competency base (i.e. the scope of knowledge, skills and judgements) required, is dependent on the health status of the patient population and the medications prescribed. As part of a larger study addressing nurse competencies (Alcock, 1995), the required knowledge, skills and clinical judgement related to medication administration and monitoring for patients on two long term care units in a long term care facility and two tertiary care units in a general teaching hospital were determined. The total number of medications prescribed across the four units varied from 120 to 256 medications per unit. The number of different drug classes ranged from 27 to 32 per unit and the potential for drug-drug interactions ranged from 47% to 66% of prescribed medications across the units. The findings provide an information base for decisions related to education and to staffing. Various nursing delivery system options and factors which influence competency are discussed.