HLT54121 Diploma of Nursing – OSCE Medication Administration and Safety

Study Period 4 Assessment 2B: Oral Medication Administration Station (2026)

1. Course and Assessment Metadata

Qualification: HLT54121 Diploma of Nursing (Australian TAFE / RTO)
Assessment label: Study Period 4 – Assessment 2B OSCE Guide
Assessment type: Objective Structured Clinical Examination (OSCE) – medication administration skills station with checklist and global rating
Focus: Safe preparation and administration of oral medications, three checks and five rights, documentation, and escalation of concerns
Study period and timing: Study Period 4, Week 8–10; OSCE duration 8–10 minutes per station, within a multi‑station OSCE circuit
Weighting: 20% of unit grade; hurdle requirement (Satisfactory required)
Mode: Individual performance in simulated skills lab using manikin or standardised patient

2. Assessment Overview and Rationale

Later‑stage HLT54121 OSCE assessments build on earlier vital sign and assessment stations by introducing medication administration, which is a known patient‑safety risk area in both diploma and university nursing programs. Study Period 4 Assessment 2B reflects current HLT54121 OSCE guides that provide detailed tables outlining tasks such as first, second, and third medication checks, comparison of medication to chart, and documentation of administration and any withheld doses. You will demonstrate safe, evidence‑informed oral medication administration to one simulated adult patient, following your organisation’s policies and using a structured checklist aligned with the “five rights” and contemporary OSCE marking criteria.

Medication administration errors remain a significant concern in clinical settings, with contributing factors including workload, interruptions, and knowledge gaps among nursing students. Developing OSCE stations that replicate realistic clinical environments enables students to consolidate technical skills, decision-making, and patient safety awareness simultaneously. Effective simulation-based assessment has been shown to reduce error rates and improve competency in administering medications by reinforcing the sequence of checks and fostering situational awareness (Keers et al., 2013). Structured OSCEs also promote adherence to professional standards and documentation practices, ensuring that students can safely escalate issues and maintain patient-centered care.

3. Station Scenario (Assessment 2B – Oral Medications)

Clinical context: You are an Enrolled Nurse student on a medical ward caring for Ms Andrea Lewis, a 72‑year‑old patient recovering from pneumonia with comorbid hypertension and type 2 diabetes.

Task prompt (appears on station brief):

• Perform required safety checks and prepare prescribed oral morning medications for Ms Lewis using the medication chart and medication trolley.

• Conduct three medication checks and confirm the five rights of medication administration before giving the medicines.

• Administer oral medications safely, monitor for immediate concerns, and document accurately on the medication chart.

• Identify and appropriately manage one discrepancy or reason to withhold a medication (provided in the scenario).

4. Student‑Facing Instructions

4.1 Preparation before OSCE day

• Review the Study Period 4 Assessment 2 OSCE Guide and 2B OSCE tables available in your LMS; these are the same tables used for grading your performance.

• Revise your facility’s policies for medication administration, including three checks, five rights (or your local variant), allergy checking, and documentation.

• Practise the exact sequence for oral medication administration in the skills lab using mock medication charts and labels.

• Review principles of pharmacology for common medications used in older adults (e.g., antihypertensives, oral hypoglycaemics, analgesics).

4.2 What you must do at the station

You will have 2 minutes reading time and 8–10 minutes performance time. Follow a clear, rehearsed sequence similar to the OSCE tables you have been given.

1. Preparation and environment

   • Perform hand hygiene and check trolley cleanliness and expiry dates on stock as directed by the assessor.

   • Check medication chart for date, time, prescriber signature, allergies, and any special instructions (e.g., with food, hold if BP < 100 mmHg).

2. Patient identification and allergy check

   • Introduce yourself, confirm your student role, and explain the purpose of the medications.

   • Use at least three identifiers and check the patient’s allergy status against the chart and ID band.

   • Ask open questions to confirm understanding and consent.

3. Three checks and five rights

   • Perform the first check at the trolley by comparing each medication label to the chart for right patient, drug, dose, route, time, and expiry.

   • Perform the second check when pouring/preparing medications, again checking label against chart for each medicine.

   • Perform the third check at the bedside immediately before administration and once more confirm patient identity and allergy status.

4. Administration of medications

   • Position patient safely (e.g., sitting upright) and ensure access to water and any required aids.

   • Administer medications individually, explaining each one in simple terms (e.g., “blood pressure tablet”) unless contraindicated by cognitive status.

   • Observe swallowing and monitor for immediate adverse reactions.

5. Management of a discrepancy

   • Identify one deliberate issue in the scenario (e.g., BP below parameter, missing prescriber signature, incorrect dose compared with chart).

   • Demonstrate correct response: withhold the medication if required, do not alter a dose independently, and promptly escalate to the RN or prescriber.

   • Document reason for withholding in the correct area of the chart as per local policy.

6. Documentation and closure

   • Sign the medication chart legibly in the correct column after administration, never before.

   • Record withheld medication and reason in the notation area or progress notes according to your service’s procedure.

   • Ensure patient comfort, tidy environment, and perform final hand hygiene.

5. Assessment 2B OSCE Marking Checklist (S / NS)

This checklist is modelled on published “Study Period 4 Assessment 2 OSCE Guide” and “Assessment 2B OSCE Guide” tables, where each row is marked Satisfactory (S) or Not Satisfactory (NS). Some items are designated critical: any NS on a critical criterion leads to an Unsatisfactory result for the station.

Result: To pass Assessment 2B OSCE, you must achieve Satisfactory on all critical criteria and on at least 80% of total items, consistent with existing HLT54121 OSCE guides.

6. Resit and Support

• If you receive Not Satisfactory on any critical item, you will be required to undertake a resit after a period of revision and targeted skills practice.

• Resits are scheduled according to the Unit Assessment Guide and must be completed within the same study period where possible.

• Seek support from your educator, simulation staff, or skills lab open‑practice sessions if you have difficulty with any step in the medication administration sequence.

7.

A strong Assessment 2B performance begins with the student checking the medication chart for date, prescriber signature, allergies, and parameters before they even approach the patient, then confirming Ms Lewis’ identity and allergies with three identifiers and explaining each oral medication in clear, simple language. Medication preparation follows the three checks precisely, with each medication label matched against the chart for the right patient, drug, dose, route, and time, and the student immediately notices that the antihypertensive must be withheld because the recorded blood pressure is below the ordered parameter and therefore appropriately escalates this finding to the RN instead of giving it. All administered medications are documented only after they are swallowed, with withheld doses and the rationale clearly recorded on the medication chart, which matches current HLT54121 Assessment 2 OSCE tables that emphasise three checks, five rights, discrepancy management, and accurate documentation as core safety behaviours. The student also demonstrates professional communication by explaining medications, checking understanding, and maintaining patient dignity throughout the process, showing integration of clinical knowledge with patient-centred practice.

8. Recent References

• Keers R N, Williams S D, Cooke J, Ashcroft D M (2013) Causes of medication administration errors in hospitals: a systematic review of quantitative and qualitative evidence. Drug Safety, 36(11), 1045–1067. doi:10.1007/s40264-013-0090-2.

• Manias E (2018) Complexity of medication safety: a literature review. Journal of Clinical Nursing, 27(21–22), e482–e495. doi:10.1111/jocn.14055.

• Australian Commission on Safety and Quality in Health Care (2021) Medication Safety Standard (NSQHS Standards, 2nd edn). Sydney: ACSQHC. Available at: https://www.safetyandquality.gov.au.

• McLeod M, Barber N, Franklin B D (2015) Methodological variations and their effects on reported medication administration error rates. BMJ Quality & Safety, 24(9), 349–356. doi:10.1136/bmjqs-2014-003468.

• Nursing and Midwifery Board of Australia (2016) Registered Nurse and Enrolled Nurse Standards for Practice. Available at: https://www.nursingmidwiferyboard.gov.au.

• Westbrook J I, Li L, Raban M Z et al. (2018) Association of interruptions with an increased risk and severity of medication administration errors. BMJ Quality & Safety, 27(8), 671–678. doi:10.1136/bmjqs-2017-007050.