You have probably heard of the ‘5 Rights of Medication Administration‘, it’s been around for a few years now, but some experts, including various Nursing Boards, claim this should be expanded to the ‘10 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 medications administration are there not only to reduce harm caused by medications errors but also 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 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 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’ as per the NMC and Nice Guidelines in the UK. Points 6-10 are unratified checks that have been suggested by multiple US nursing boards and research panels to enhance patient safety.