Safety, Legal Issues & Resident Rights

Perform the three checks: when removing from storage, when preparing, and before giving to the resident.

High-alert medications (insulin, anticoagulants, opioids) carry higher harm risk and may require an independent double-check.

Verify allergies before every administration and never give a drug the resident is allergic to.

If the order includes a parameter (for example a pulse or blood pressure limit), the value is checked by whoever your state allows to check it, and the dose is held and the nurse told if it falls outside the order.

Many digoxin orders include a pulse check with a hold rate written in the order; hold the dose and notify the nurse if the pulse is below that ordered rate.

Hold antihypertensives when blood pressure is below the ordered threshold and report to the nurse.

Store medications per label instructions, including refrigeration or protection from light where required.

Keep controlled substances in a locked, secured area with accurate counts and documentation.

Dispose of expired or discontinued medications per policy and never administer them.

Administer medications as ordered but do not prescribe, change doses, or make independent clinical decisions.

Accept delegated tasks only when they are within your training, scope, and authorization with nursing supervision.

When unsure about an order's safety, hold the dose and clarify with the nurse before giving.

Respect the resident's right to refuse medication and to be informed about their care.

Protect privacy and confidentiality and administer medications discreetly.

Respond to new or concerning symptoms by checking vital signs and notifying the nurse before administering.