Experts have called for the five rights to be expanded to the ten rights of medication administration.
When it comes to the safe administration of medications, you can never be too careful, especially as up to 10% of patients experience unwanted side effects or reactions, and that administration errors make up 60% of all drug errors.
The rights of medication administration are there not only to reduce the harm caused by medication errors but also to protect the interests of the patient and the nurse administering.
The 10 Rights of Medications Administration
1. Right patient
- Check the name on the prescription and wristband.
- Ideally, use 2 or more identifiers and ask the patient to identify themselves.
2. Right medication
- Check the name of the medication, brand names should be avoided.
- Check the expiry date.
- Check the prescription.
- Make sure medications, especially antibiotics, are reviewed regularly.
3. Right dose
- Check the prescription.
- Confirm the appropriateness of the dose using the BNF or local guidelines.
- If necessary, calculate the dose and have another nurse calculate the dose as well.
4. Right route
- Again, check the order and appropriateness of the route prescribed.
- Confirm that the patient can take or receive the medication by the ordered route.
5. Right time
- Check the frequency of the prescribed medication.
- Double-check that you are giving the prescribed at the correct time.
- Confirm when the last dose was given.
6. Right patient education
- Check if the patient understands what the medication is for.
- Make them aware they should contact a healthcare professional if they experience side-effects or reactions.
7. Right documentation
- Ensure you have signed for the medication AFTER it has been administered.
- Ensure the medication is prescribed correctly with a start and end date if appropriate.
8. Right to refuse
- Ensure you have the patient consent to administer medications.
- Be aware that patients do have a right to refuse medication if they have the capacity to do so.
9. Right assessment
- Check your patient actually needs the medication.
- Check for contraindications.
- Baseline observations if required.
10. Right evaluation
- Ensure the medication is working the way it should.
- Ensure medications are reviewed regularly.
- Ongoing observations if required.
Points 1 to 5 are the ‘5 Rights of Medication Administration. Points 6-10 are unratified checks that have been suggested by multiple US nursing boards and research panels to enhance patient safety.
The purpose of the assessment is to determine if the patient's drug-related needs are being met and if any drug therapy problems are present.
Know your patient by understanding his or her medication experience before making any decisions about his or her drug therapy.
Elicit only relevant information necessary to make drug therapy decisions.
Always assess the patient's drug-related needs in the same systematic order. First determine if the indication is appropriate for the drug therapy. Second, evaluate the effectiveness of the drug regimen for the indication. Third, determine the level of safety of the drug regimen. Only after determining that the drug therapy selected or being used by the patient is appropriately indicated, effective, and safe do you logically evaluate the patient's adherence to the medication regimen.
Documentation includes the practitioner's assessment of how well the patient's drug-related needs are being met and a description of the drug therapy problems present.
The primary purpose of the assessment is to determine to what extent the patient's drug-related needs are being met. In order to accomplish this, the practitioner gathers, analyzes, researches, and interprets information about the patient, the patient's medical conditions, and the patient's drug therapies. Individuals can have drug-related needs whether they are taking medications or not.
++This chapter describes how all of these activities combine to create an assessment of the patient's drug-related needs. A consistent format will be used to describe the standards of care and the corresponding measurement criteria that apply to the assessment step of the patient care process.
++The assessment step in the patient care process is the most important of the three: (1) the assessment, (2) the care plan, and (3) the follow-up evaluation. It requires work on the part of the clinician and cooperation on the part of the patient. There are standard sets of issues and questions the practitioner must constantly think about and analyze throughout the assessment. The assessment interview is the means through which the practitioner encourages the patient's participation in the patient care process. The assessment interview influences all other components of the patient care process. It influences communication, data accuracy, clinical decision making, ethical judgments, patient adherence, patient satisfaction, practitioner satisfaction, and clinical outcomes.
++Key Clinical Concepts
The personal, one-to-one nature of the assessment process creates the context to demonstrate caring and patient-centeredness.
++There are essential clinical skills that each practitioner must develop in order to conduct a productive assessment. These include inquiry, listening, and observational skills. You must be committed to learning and teaching yourself the skills needed to assess the drug-related needs of your patients.
++To be successful, you must understand and master the basic skills as well as the pharmacotherapy knowledge required to conduct a comprehensive assessment of your patient's drug-related needs because over a 40-year career, a clinician will conduct over 160,000 patient assessments.
++The thoroughness and ...
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