Medication Administration - Vaginal

Medication Administration - Vaginal 

Purpose: To ensure the safe and effective administration of medications via the vaginal route for residents in compliance with CMS guidelines and the State Operations Manual (SOM) for long-term care facilities. 

Procedure: 

I. Preparation: 

• Place the tablet/suppository in the applicator or draw cream/gel into the applicator. 

• Wash hands thoroughly and wear gloves. 

II. Positioning: 

• Have the resident lie on their back with knees flexed and legs spread apart, or in the Sims position. 

III. Examination and Cleaning: 

• Wearing gloves, examine the perineum. 

• If discharge is noted, clean the area gently with a tissue or washcloth. 

IV. Administration: 

• With one hand, spread apart the labia. 

• Place the applicator into the vagina and advance the plunger to instill the gel or cream or to release the tablet or suppository. Lubricate the tablet, suppository, or applicator prior to administration if required. 

• If not using an applicator, insert the lubricated tablet or suppository approximately 3-4 inches into the vaginal area. Wipe any excess lubricant from the vaginal area with a tissue. 

V. Post-Administration: 

• Advise the resident to remain lying down for about 30 minutes to ensure proper absorption of the medication. 

• Remove gloves and wash hands thoroughly. 

VI. Documentation: 

• Document the administration of the medication in the Medication Administration Record (MAR), including the time, dosage, and any observations or resident responses. 

References: 

• Centers for Medicare & Medicaid Services (CMS), Requirements of Participation for Long-Term Care Facilities. 

• State Operations Manual (SOM), CMS.