How do you ensure that you have the right drug for administration to a patient?

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 research shows 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 Six Rights of Medication Administration are a set of guidelines that medical professionals adhere to when administering medication, to ensure the highest level of safety for patients. They are:

1. Identify the right patient

Before a CHOP staff member gives your child medication, make sure the person checks your child's ID band, verifying his full name and medical record number. 

2. Verify the right medication

Ask questions if the medication looks different than usual.

3. Verify the indication for use

When a CHOP staff member gives your child medication, don’t be afraid to ask what it is and why your child is receiving it.

4. Calculate the right dose

Learn about what medications your child will be taking during treatment, including what they do, what dose is needed, and any possible side effects.

5. Make sure it's the right time

Ask questions if the medication is being given at a different time than usual.

6. Check the right route

Learn about what medications your child will be taking during treatment, including when and how to take them.

Introduction

We take medications to diagnose, treat, or prevent illness. They come in lots of different forms and we take them in many different ways. You may take a drug yourself, or a healthcare provider may give it to you.

Drugs can be dangerous, though, even when they’re meant to improve our health. Taking them correctly and understanding the right way to administer them can reduce the risks. Read on to learn the importance of using medication as directed.

There are several different ways drugs can be administered. You’re probably familiar with injections and pills that you swallow, but medications can be given in many other ways as well.

Routes of medication administration are described in the table below.

The route used to give a drug depends on three main factors:

  • the part of the body being treated
  • the way the drug works within the body
  • the formula of the drug

For instance, some drugs are destroyed by stomach acid if they’re taken by mouth. So, they may have to be given by injection instead.

Not all types of medications can be administered at home or by someone without special training. Doctors, nurses, and other healthcare providers are trained in how to give you medication safely.

Administration of medication requires thorough understanding the drug, including:

  • how it moves through your body
  • when it needs to be administered
  • possible side effects and dangerous reactions
  • proper storage, handling, and disposal

Healthcare providers are trained in all of these issues. In fact, many healthcare providers keep in mind the “five rights” when they administer drugs:

  • the right patient
  • the right drug
  • the right time
  • the right dose
  • the right route

Medication errors happen all too often in the United States, even when drugs are given by professionals. The Food and Drug Administration receives more than 100,000 reports of medication errors annually through its MedWatch program. These errors can take place when:

  • prescribing a drug
  • entering the drug or dosage information into a computer system
  • a drug is being prepared or dispensed
  • a drug is taken by or given to someone

The “rights” are a starting point in helping to make sure that medications are given correctly and safely.

It’s important to take only the dosage described in the prescription label or other instructions. Dosage is carefully determined by your doctor and can be affected by your age, weight, kidney and liver health, and other health conditions.

For some medications, dosage must be determined by trial and error. In these cases, your healthcare provider would need to monitor you when you first start treatment.

For example, if your doctor prescribes thyroid medications or blood thinners, you would likely need to have several blood tests over time to show if the dosage is too high or too low. The results from these tests would help your doctor adjust your dosage until they find the one that’s right for you.

Many medications need to reach a certain level in your bloodstream to be effective. They need to be given at specific times, such as every morning, to keep that amount of drug in your system.

Taking a dose too soon could lead to drug levels that are too high, and missing a dose or waiting too long between doses could lower the amount of drug in your body and keep it from working properly.

Adverse events, or unwanted and negative effects, can happen with any drug. These effects can include an allergic reaction or an interaction with another drug you’re taking.

To help avoid these problems, be sure to tell your doctor about any other medications you’re taking or any times you’ve had an allergy to drugs or foods.

A drug with high risk of adverse effects may be administered only by a healthcare provider. And in some uncommon cases, your healthcare provider may keep you in their facility so they can observe how the drug affects you.

If you take a medication yourself, it’s up to you to watch for problems, such as a rash, swelling, or other side effects. If you notice any problems, be sure to let your doctor know.

Be sure to take your medications correctly to get the most out them and to reduce your risk of side effects and other problems. Anyone giving you the drug should follow your doctor’s instructions carefully.

Make sure that you understand everything about taking your medication. If you have any questions, talk to your doctor. Some questions you might ask include:

  • I’m not sure how often I should take this medication. Can you explain your instructions more clearly?
  • My nurse gives me my medication now. Can I be trained to give it to myself?
  • I’m having trouble taking my medication. Can a family member or healthcare provider give it to me instead?
  • Are there any side effects I should watch for?
  • What time of day should I take this drug? Or does it matter?
  • Am I taking any medications that this drug could interact with?

How would you ensure a safe administration of the medication?

Safety considerations:.
Plan medication administration to avoid disruption: ... .
Prepare medications for ONE patient at a time..
Follow the SEVEN RIGHTS of medication preparation (see below)..
Check that the medication has not expired..
Perform hand hygiene..
Check room for additional precautions..
Introduce yourself to patient..

Which action should you take to ensure that you are giving a drug to the right patient?

Department of Family Relations.
Identify the right patient. ... .
Verify the right medication. ... .
Verify the indication for use. ... .
Calculate the right dose. ... .
Make sure it's the right time. ... .
Check the right route..

What is the best way to check that you are giving the drug to the right patient?

Double-check that you are giving the ordered dose at the correct time..
Check the name on the order and the patient..
Use 2 identifiers..
Ask patient to identify himself/herself..
When available, use technology (for example, bar-code system)..

What factors should be considered when administering a drug?

One of the recommendations to reduce medication errors and harm is to use the “five rights”: the right patient, the right drug, the right dose, the right route, and the right time.