General Nursing (RGN)
ADMINISTRATION OF ORAL MEDICATIONS (TABLETS, CAPSULES, CAPLETS ETC.)
This procedure covers safe administration of prescribed solid medication by mouth, including tablets, capsules and caplets, and the sublingual or buccal placement of medicines when specifically prescribed. The nurse verifies the prescription, supports informed choice, assesses swallowing safety and observes the patient after administration.
Purpose
- Achieve the prescribed therapeutic effect
- Provide prophylaxis or support investigation when prescribed
- Administer medication safely while respecting the patient's right to information and refusal
Indications
- A valid prescription for an oral, buccal or sublingual solid medication
- Patient is able to receive the medication through the prescribed route
- Medication is clinically appropriate after checking allergies, swallowing ability and relevant precautions
Equipment
- Medication treatment chart or authorised electronic medication record
- Prescribed medication in its original labelled package
- Clean medication tray or cup and medicine spoon when required
- Drinking water or other prescribed suitable fluid
- Pill cutter or crusher only when authorised and safe for that medication
- Hand hygiene supplies and waste receptacle
Preparation
- Review the prescription, indication, allergies, contraindications, swallowing ability, level of consciousness and relevant observations.
- Prepare medicines for one patient at a time and check the label against the medication record at the required stages.
- Confirm whether the medicine must be swallowed, held under the tongue or placed between the cheek and gum.
Procedure steps
- Perform hand hygiene and identify the patient using approved identifiers.
- Explain the medication name, purpose, route and relevant instructions; answer questions within scope and respect refusal.
- Check the medication, patient, dose, route, time, indication, allergies, expiry and prescription before removing the dose.
- Position the patient upright or as upright as the condition allows and assess readiness to swallow.
- Offer the medication without touching it with bare hands, using clean equipment and the prescribed route.
- For an oral dose, offer water if appropriate and observe the patient swallow; for buccal or sublingual medication, ensure it remains in the prescribed site until dissolved.
- Do not crush, split or mix medication unless the product information and authorised prescriber or pharmacist guidance allow it.
- Observe for difficulty swallowing, choking, vomiting, immediate allergy or other adverse response.
- Dispose of packaging and clean reusable equipment according to policy; perform hand hygiene.
- Record administration or refusal immediately and reassess the patient or therapeutic response as indicated.
Precautions
- Do not give oral medication to a patient with unsafe swallowing, reduced consciousness or an active aspiration risk without appropriate assessment and direction.
- Do not leave medication unattended or record it as given before confirming administration.
- Do not repeat a dose after vomiting without assessment and appropriate clinical advice.
- Escalate discrepancies, omitted doses, refusal, suspected allergy or medication error immediately.
Aftercare
- Ensure the patient is comfortable, has access to water and the call bell, and knows how to report an adverse effect.
- Monitor for the expected effect and adverse reactions within the appropriate time.
Nursing considerations
- Use an interpreter or suitable communication aid when language or hearing affects safe understanding.
- Follow N&MC Ghana standards, facility medication policy and the approved product information.
Possible complications
- Aspiration or choking
- Wrong-patient, wrong-dose or wrong-route medication error
- Allergic or adverse drug reaction
- Missed or duplicated dose
Patient education
- Explain the purpose and important instructions for the medication in language the patient understands.
- Tell the patient to report rash, swelling, breathing difficulty, severe dizziness, vomiting or other concerning symptoms.
Documentation
- Record medication name, dose, route, date and time, and sign or authenticate according to policy.
- Document refusal, omission, swallowing difficulty, vomiting, adverse response and action taken.
Educational resource only. Follow current Nursing and Midwifery Council guidance, local institutional protocols, scope of practice, and clinical supervision.
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