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Skills

Medication Administration Competency

6 weeks · 0 milestones

Demonstrate supervised competency in safe medication administration. Proof requires a clinical supervisor's signed competency assessment covering the Rights of Medication Administration (right patient, right drug, right dose, right route, right time, right documentation). The supervisor must be a registered nurse or clinical educator. Self-verification and peer verification are NOT accepted for this outcome — qualified supervisor attestation on an official competency form is the only valid proof artifact. The proof documents supervised competency development, not a record of medications independently administered.

Milestone map

Milestone map

3 milestones

Complete medicine calculation competency assessment under supervision

1–2 weeks

Under direct supervision of a registered pharmacist or registered nurse with medicine administration sign-off authority, complete a medicine calculation assessment covering: oral medicine dose calculation (tablets, liquids), intravenous drug calculation (rate, concentration, volume), weight-based dosing (mg/kg), and reconstitution calculations. The assessment must cover at least 20 calculations across all four types. This is a supervised knowledge assessment — it is not documentation of administering medicines to patients.

Proof required

Submit your completed calculation assessment (signed and dated by the supervising registered professional) including all workings, the assessment score, and the supervisor's attestation that the calculations were completed independently under observation.

What gets checked

  • Supervisor is a registered nurse with medicine administration authority or a registered pharmacist — not a healthcare assistant or student peer.
  • Assessment covers all four calculation types — a single-type calculation set (all tablets only) is not sufficient.
  • Workings are shown — a correct answer without workings does not demonstrate calculation competency.

Common mistakes

  • Assessment completed without a supervisor present — the milestone requires supervised independent completion, not self-assessed practice at home.
  • Calculation types are incomplete — IV rate and weight-based dosing are often skipped in favour of simpler tablet calculations.
  • Answer-only submission without workings — the calculation method must be visible.

Resources

Foundationstart here

Depthgo deeper

What a verifier looks for

  • Confirm the supervisor is a registered nurse with medicine administration authority or a registered pharmacist.
  • Ask the student to demonstrate one IV rate calculation from memory — tests retention beyond the assessment session.
  • Check that all four calculation types are represented in the submitted assessment.

Document 10 supervised medicine administrations

4–8 weeks (dependent on placement and clinical opportunities)

Under direct supervision of a registered nurse or registered pharmacist, document 10 separate medicine administrations. For each, record: the medicine name (generic), dose, route, indication, any allergy checks performed, any patient identification check performed, and the supervisor's sign-off. Medicines should span at least 3 different routes (oral, subcutaneous/intramuscular, intravenous, inhaled, topical, etc.) and 3 different drug classes. All patient data must be fully anonymised in your logbook.

Proof required

Submit your medication administration logbook with all 10 entries, each countersigned by the supervising registered professional. The logbook must show route variety (at least 3 routes) and drug class variety (at least 3 classes). All patient identifiers must be anonymised.

What gets checked

  • Each entry is countersigned by a registered professional — not co-signed by another student.
  • Allergy check and patient identification check are documented for each entry — not a general statement that checks were performed.
  • Route and drug class variety requirements are met — 10 oral paracetamol administrations do not constitute this milestone.

Common mistakes

  • Logbook with only one or two drug routes — variety is a specific requirement, not optional.
  • Missing allergy or patient identification check documentation on individual entries — these checks must be documented for each administration separately.
  • Patient data not anonymised — this is the single most common clinical documentation failure.

Resources

Foundationstart here

Depthgo deeper

What a verifier looks for

  • Check that all 10 entries are countersigned by a registered professional — not co-signed by another student.
  • Verify that at least 3 different routes and 3 different drug classes are represented.
  • Confirm that all patient identifiers are anonymised — review a sample of entries.

Reflect on a medicines safety incident or near-miss under supervision

1–2 weeks

With your clinical supervisor, review a real medicines-related safety incident or near-miss that occurred in your clinical placement (drawn from an incident report, significant event audit, or direct observation). Write a structured reflection (2 pages) applying the Swiss Cheese model or equivalent: what errors occurred, what barriers failed, what barriers held, and what system change would reduce the likelihood of recurrence. Your reflection must be countersigned by your clinical supervisor and all patient and staff identifiers must be fully anonymised.

Proof required

Submit your reflection (2 pages) countersigned by your registered clinical supervisor, confirming it is based on a real incident you reviewed together. All patient and staff identifiers anonymised.

What gets checked

  • Swiss Cheese model (or equivalent systems analysis model) is explicitly applied — not just a narrative of what went wrong.
  • System change proposal is specific and implementable — 'check medicines more carefully' is not a system change.
  • Countersignature confirms joint review — not just that you wrote a reflection.

Common mistakes

  • Reflection based on a published case study rather than a real incident from your placement — supervisor countersignature confirming joint review is required.
  • Systems analysis that lists failure points without applying a framework.
  • System change proposal that places all responsibility on individual practitioners rather than system-level factors.

Resources

Foundationstart here

Depthgo deeper

What a verifier looks for

  • Confirm the supervisor countersignature states that the incident review was conducted jointly.
  • Ask the student to explain one system-level factor that contributed to the incident.
  • Check that the system change proposal is implementable by a clinical team — not requiring regulatory change or major infrastructure investment.

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