How to apply a transdermal patch
Other platforms explain it with text and video. In VMS you practice it on the patient.
A patch releases drug through the skin for hours or days. Forgotten old patches and heat on the skin are common causes of overdose.
What you need
- New patch
- Gloves
- Pen or label for date, time and initials
- Clippers if hair is present
Step by step
Identify and check
Use two identifiers and confirm drug, strength and time against the order. [1]
Find and remove the old patch
Put on gloves and search the whole body for any old patch. Remove it before placing the new one. [2]
Dispose of the old patch safely
Fold it in half with the sticky sides together. Discard it per policy; opioid patches like fentanyl need a witnessed waste. [2]
Choose a new site
Pick clean, dry, intact skin with little hair, such as the upper arm, chest or back. Clip hair instead of shaving, and rotate sites. [3]
Apply and press
Do not cut the patch. Press it firmly with your palm for about 30 seconds so the edges stick. [2]
Label it
Write the date, time and your initials on the patch or a label beside it. [3]
Teach about heat
Tell the patient to avoid heating pads, hot tubs and long hot baths over the patch. Heat speeds absorption and can cause an overdose. [2]
Common errors
- Leaving the old patch on when the new one goes on.
- Placing the patch on broken skin or under a heating pad.
- Cutting a patch to lower the dose.
Practice it in VMS
In VMS you do this on the patient, not on paper: every step goes on the checklist with a score, and in Teach mode Blocky tells you what comes next.
VMS cases that train this skill
Sources
- The Joint Commission, National Patient Safety Goals
- Open RN, Nursing Pharmacology 2e (CC BY 4.0)
- Open RN, Nursing Skills 2e (Chippewa Valley Technical College) (CC BY 4.0)
Steps adapted from Open RN, Nursing Pharmacology 2e and Open RN, Nursing Skills 2e (Chippewa Valley Technical College), licensed under CC BY 4.0. VMS is not affiliated with these organizations. Updated: 2026-10-11.