10 Rights of Medication Administration
Whether you are a nurse giving medication or a patient receiving medication, it is important to understand the 10 rights of medication administration. You may be giving medications to a family member or taking them yourself. Safety should be the first thing on your mind with medications. There is always a risk of giving the wrong pill, the wrong dose, or the wrong person’s medication. If this happens, harm to the person can occur and some reactions can be deadly. While there has always been protocol for giving drugs in the hospital, it is important for everyone to know the safety rules for medications. In the past, you may have heard of the “5 Rights of Medication Administration: right patient, right drug, right route, right time, and right dose.” Medical practices have changed to include a few more rights.
10 Rights of Medication Administration
1. Right Patient
Make sure you are giving the right medication to the right person.If you are at home and giving medication to a family member, make sure you check the bottle and giving the right prescription to the right person.
If you work in the medical field, always ask the patients name, check an ID band, and check the medication bottles to compare before giving a medication.
2. Right Medication
When your doctor prescribes a medication, there will be a prescription label on the bottle. It isn’t safe to just grab any bottle and take any pill. Even pharmacies can make mistakes. Check your pills and your prescription label carefully to make sure you have the right medication. Check the label every time you grab your bottle to take a dose. Most pill bottles are easily mixed up because they look so much alike. Also, never store a different medication in an empty pill bottle that was used for something else.
In a healthcare setting, check the medication supply and compare it to the doctor’s orders to make sure it is the right one. Some medications have “sound alike” names. These include the drugs Inderal (Heart Medication)/Adderall (ADHD Stimulant), Celexa (Anti-depressant)/Celebrex (Anti-Inflammatory), Paxil (Anti-depressant)/Plavix (Blood Thinner), and many others that could be dangerous medication errors if mixed up.
3. Right Dosage
This is one of the most important in the 10 rights of medication administration. Before you leave the doctor’s office, ask how much of the medication you should take. Then if you are unsure after you leave, talk to the pharmacist. When you get home do not “play” with dosages. Do not break pills in half or take more or less than the doctor wants you to. Check to see if it takes more than one pill to make your right dosage. For example; you may need two 25mg tabs to make a 50mg dosage.
In the healthcare setting, check the doctor’s orders to your supply of the medication on hand. Calculate the dosage yourself to make sure it is right. Be aware of the difference of a pediatric dose and an adult dose.
4. Right Route
If your doctor gives you pill form and you can’t swallow, you may need to ask for liquid form of the medication. This is especially important for children that cannot swallow pills yet. Check to see if the medication is given by suppositories (rectal or vaginal) and only use topical creams and lotions on the skin.
Nurses should always make sure their patients can swallow pills okay and make sure the medication is given the right route. Some injections can either be IM (In the Muscle) or Sub-Q (In the fatty tissue).
5. Right Time
If your doctor orders a medication at HS, this means take it at bedtime. Some bedtime medications can make you sleepy. If you see the letters, QAM that means take the medication in the morning.
6. Right Documentation
Athome you should keep a journal of the meds you take, what time you took them and how much you took. If you give yourself injections, write down the injection site since most injection sites should be rotated.
Nurses need to write down a medication that is given after they give the actual dose. Nurses should also document injection sites. Any medication documentation needs to be initialed yourself, never let anyone document for you.
7. Right Client Education
Know the side-effects of the medications you and your loved ones are taking. Let them know what they are and have them tell you if they feel an unwanted reaction to the medication.
The same thing goes for nurses in the hospital, let your patients know what to expect from the medication: side-effects, benefits, and reactions that might happen.
8. Right to Refuse
At home or in the hospital, people taking medications have the right to refuse medications. If someone tells you they don’t want to take something, simply dispose of the medication and call the doctor to let them know. Nurses must legally document a refusal of medication.
9. Right Assessment
Have a copy of the patient’s medical history. Medications like blood pressure medications always warrant a quick blood pressure check before giving a blood pressure medication. Ask the doctor what number is too low to give the medication.
10. Right Evaluation
Make sure you check for drug allergies and interactions between different medications. Doctors and pharmacists don’t always catch them and we need to be a third set of eyes. At home, it is important to keep a drug guide so you can check prescriptions against each other.
Medication Administration Guidelines
After learning about the 10 rights of medication administration, here are the guidelines for medication administration. Whenever a medication is given, follow these guidelines for medication safety:
1. Let them know what they are taking and answer questions.
2. Give them responsibilities. Hand them their meds and let them take them.
3. Give them privacy.
4. Don’t get distracted while giving medications.
5. Use a quiet place for medication administration.
6. Don’t leave bottles open or leave them out on a counter. Keep small children in mind.
7. Wash your hands with soap and water before giving someone medicine.
8. Wash your hands after you give someone medicine, especially if there are multiple sick people in your home.
8 rights of medication administration
May 27, 2011 00:10 by Lisa Bonsall, MSN, RN, CRNP
Chances are that some of you may not have known that in addition to the well-known 5 right of medication administration, some experts have added 3 more to the list.When it comes to patient safety, it’s never a bad time to review some of the basics and increase your awareness of newer recommendations. Please add any of your own tips and medication safety advice by leaving a comment. Thanks!
Rights of Medication Administration
1. Right patient
- 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).
2. Right medication
- Check the medication label.
- Check the order.
3. Right dose
- Check the order.
- Confirm appropriateness of the dose using a current drug reference.
- 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 ordered.
- Confirm that the patient can take or receive the medication by the ordered route.
5. Right time
- Check the frequency of the ordered medication.
- Double-check that you are giving the ordered dose at the correct time.
- Confirm when the last dose was given.
6. Right documentation
- Document administration AFTER giving the ordered medication.
- Chart the time, route, and any other specific information as necessary. For example, the site of an injection or any laboratory value or vital sign that needed to be checked before giving the drug.
7. Right reason
- Confirm the rationale for the ordered medication. What is the patient’s history? Why is he/she taking this medication?
- Revisit the reasons for long-term medication use.
8. Right response
- Make sure that the drug led to the desired effect. If an antihypertensive was given, has his/her blood pressure improved? Does the patient verbalize improvement in depression while on an antidepressant?
- Be sure to document your monitoring of the patient and any other nursing interventions that are applicable.
Reference: Nursing2012 Drug Handbook. (2012). Lippincott Williams & Wilkins: Philadelphia, Pennsylvania.