The nurse is preparing to administer medications and demonstrates knowledge of the 6th right by:

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6 Rights of Medication Administration

The 6 Right-answers host Administering Medication

Sometimes considered 5 or 6 "Rights" the "R's" of medication administration are a systematic approach designed to reduce administration errors. These 6 rights include the right patient, medication, dose, time, route and documentation. Futhermore, nurses are also urged to do the three checks; checking the MAR, checking while drawing up medication and checking again at bedside. It is important to check for allergies as well before administration. Shortly after medication administration, the patient should be assessed, and they should also be educated on what they are given.

10 KEY FACTS

Some facilities have differing protocols however it is imperative that the nurse verifies the name on the patient's armband prior to administering any medications.

Read the medication label carefully! Be sure to compare the strength, concentration and type of medication to the order. Considerations include only administering a medication that you prepared yourself and being generally familiar with the medication.

Compare the dose of the medication to the MAR. Be cautious as many medications come in different strengths based on route and a mistake could prove fatal. The nurse may also have to modify dosing based on weight, age, or variable tests like blood glucose. Some medications have very complex or specific doses and may require a second nurse to sign off. Examples of these medications include Insulin, Heparin, and Chemotherapeutic agents based on protocol.

Compare the time the medication should be administered to the current time. Never administer additional or missed doses. Be familiar with abbreviations. Check the MAR to assure the last dose of medication was administered at the appropriate time.

Method of delivery of medications can substantially alter the effects of the drug. Broad classifications include enteral, through the digestive system, and parenteral, directly to the tissues and topical which is applied to the skin.

Documentation is key to the nurse’s role. Proper documentation of your medication administration in the MAR is crucial.

The "6 Rights" should be implemented at "three checkpoints". First compare the "rights" alongside the Medication Administration Record (MAR) immediately after obtaining it. Second, check the "rights" during medication preparation outside the room, whether this is by mixing, placing a pill into a cup for easier administration or preparing for an IV or injection. Third, check the "rights" again at the bedside before administering the drug to the patient. Developing a regular practice reduces errors.

It is crucial to check if the patient has any allergies to the medication prior to administering it. Cross reference by checking the Medication Administration Record (MAR) and asking the patient.

You may be required to do certain assessments prior to administering some medications. This may include vital signs, blood glucose, lab values, or a comprehensive assessment.

The nurse's role is important in educating the patient on certain side effects a medication might have and drug interactions. Some drugs could have a synergistic effect or an antagonistic effects with other medications.

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Medication administration

Medication administration is a process that carries great responsibility in requiring that you know which medication is supposed to be given, as well as to whom, and when.  Remembering the various information that you need to keep track of can be overwhelming, but it is vital that you are aware of them.  We highly recommend familiarizing yourself with the seven rights of medication administration in order to protect both your patients and yourself.

Right Individual

Making sure that you have the right individual is obviously a very important step in medication administration.  The standard is to check with at least two other sources that you have the correct person before administering medication.  The most experienced of nurses can make a  mistake if tired, overworked, or managing several patients at once.  Despite your level of experience, you should always verify that you are giving the right person the right medication.

Right Medication

It goes without saying that ensuring that you have the right medication is paramount for a variety of reasons. Different patients can have different medical allergies, adverse reactions, and unexpected symptoms that could lead to catastrophic results.  Read the label of the medication, triple-check the patient’s charts, and make sure you are administering the correct medication for that patient.

Right Dose

The right dose is incredibly important as well, as the wrong dose could lead to overdosing a patient and possibly harming them.  The patient’s correct dose should be noted in their chart, and you should also know the form in which they should be receiving medication.  Are they taking pills, receiving medications through IV, or swallowing liquids?  These methods all require various doses. 

Right Time

Many medications have a specific time that they need to be administered, either due to the patient’s other medications or around their meals.  Not all medications require a specific time, but it is your responsibility to know which ones do and don’t.  Every time that medication is given to a patient, it should be recorded so that anyone treating them is aware of when medication was last administered. 

Right Route

“Route” in this case refers to where and how the medication is given to a patient.  While most medications are taken orally, this is not always the case.  The notes surrounding the way that medications should be administered are important to keep communication clear as nurse shifts change or others administer medication.  Medication can be given in several ways including rectally, vaginally, through the skin, in the eyes, in the ears, into the lungs, etc.  This leaves a lot of room for error if not correctly communicated. 

Right Documentation

It is the sole responsibility of the person administering the medication to properly document that administration.  Without proper documentation, communication can get lost between medical professionals.  Always double-check your documentation and make sure that all details are present and correct.

Right Response

Last, but certainly not least, is the response that the patient has to the medication administered.  Anytime that a patient is given medication, their response should be recorded to make sure that it is known to all treating the patient.  Additionally, the level to which the medication helps the patient should be recorded to keep track of what medication is working and what isn’t.  

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