
 
1 
 
 
 
Medication Administration Competency Checklist  
 
Preceptor/Evaluator’s Name 
Medication Administration 
 
INDICATORS OF PERFORMANCE LEVEL SUMMARY 
 
Direct Observation/Return Demonstration 
Well above standards. May precept peers 
 
If overall performance or competency is rated below the minimum competency level of 2, that performance or competency 
must be reassessed within 30 days of this review. 
 
 
The employee demonstrates skills and competence in the following: 
Level of 
Competency 
1  2  3 
Reviewed “ ” policy # PHAR-940-211, NUR-804-019, PHAR-740-729 
1. Check medication on HMS and or physician orders. 
2. Identifies correct medication patient dose, time, and route before administering 
medication. 
3. Administers medication by the route ordered according to appropriate protocol. 
4. Charts all medication administered using appropriate charting forms. 
-Chart site of injection 
-Chart accurate time of administration. 
5. Demonstrate knowledge of reporting adverse reactions to pharmacy and 
physician. 
7. Correct labeling procedure for IV tubing. 
8.Demonstrate correct IV push IV bolus techniques 
 9. Demonstrate correct IM techniques, SQ technique, Z-track technique 
10. Demonstrate correct Precautions when delivering PO medication. 
11. Demonstrate proper care and flushing of Heparin Locks. 
12. Demonstrate application of topical medication. 
13. Demonstrate proper handling and documentation regarding narcotics, including 
narcotics count. 
14. Demonstrate correct use of the IV Pump, PCA pump, and enteral feeding pump. 
15. Documentation of medication administration. 
16. Objectives: Safety administers medication to assigned group of patient. 
18. Verbalizes indications, contraindication, and side effects of meds to be given. 
19. Dispense medication using aseptic technique, and states the “5 Rights “of 
administration. 
20.Confirm drug dose and time against MAR.(Medication Administration Record) 
21.Check for compatibility of all drugs prior to administration.