{"id":5197,"date":"2024-07-30T14:00:30","date_gmt":"2024-07-30T14:00:30","guid":{"rendered":"https:\/\/www.vivian.com\/community\/?p=5197"},"modified":"2024-07-29T20:17:10","modified_gmt":"2024-07-29T20:17:10","slug":"medication-administration","status":"publish","type":"post","link":"https:\/\/www.vivian.com\/community\/healthcare-education\/medication-administration\/","title":{"rendered":"Reduce Errors with the 10 Rights of Medication Administration"},"content":{"rendered":"

Nurses are the primary care providers within an acute care setting and frequently give medications to patients. When delivering prescribed drugs to patients, nurses are the gatekeepers to patient safety and preventing errors. It\u2019s their responsibility to understand and implement the expanded 10 rights of medication administration so they know how and why these rights are used.\u00a0<\/span><\/p>\n

Medication Administration and Medication Errors<\/b><\/h3>\n

According to a <\/span>study posted on the National Library of Medicine<\/span><\/a> site,<\/span> medication errors are the most common and preventable cause of patient injury and death. Reported medication errors happen in acute care settings at a rate of 6.5% and contribute to 44,000 to 98,000 hospital deaths annually.<\/span><\/p>\n

It\u2019s important to understand that this number is likely not an accurate representation of actual medication errors, just the reported numbers. For a medication error to be reported and included in these numbers, a nurse must first recognize the mistake and then lean on <\/span>nursing ethics<\/span><\/a> associated with acknowledging and reporting it.<\/span><\/p>\n

Contributing Factors to Medication Errors<\/b><\/h3>\n

Patient load and acuity may make a nurse less diligent when administering medications, leading to <\/span>mistakes that cause anxiety<\/span><\/a>. If you\u2019re a new nurse struggling with this task, ask for help from senior staff or <\/span>seek a nurse mentor<\/span><\/a> for tips on managing your time. Medication administration is never a task to rush.\u00a0<\/span><\/p>\n

Utilizing the 10 rights of medication administration throughout the medication process helps you stay focused on the task and reduce errors. Over time, medication rights may become a subconscious act for many nurses, but these rights must always remain a top priority to decrease medication errors and <\/span>increase patient safety<\/span><\/a>.<\/span><\/p>\n

The 10 Rights of Medication Administration<\/b><\/h3>\n

The original five rights of medication administration are:\u00a0<\/span><\/p>\n

\u00a01.<\/b> \u00a0Right Patient
\n\u00a02.<\/b> \u00a0Right Drug
\n\u00a03.<\/b> \u00a0Right Dose
\n\u00a04.<\/b> \u00a0Right Time
\n\u00a05.<\/b> \u00a0Right Route<\/p>\n

Additional medication rights were later introduced to enhance medication safety even further. These include:<\/span><\/p>\n

\u00a06.<\/b> \u00a0Right Documentation
\n\u00a07.<\/b> \u00a0Right Reason
\n\u00a08.<\/b> \u00a0Right Response
\n\u00a09.<\/b> \u00a0Right Education
\n10.<\/b> Right to Refuse<\/p>\n

\"Nurse<\/h4>\n

1. Right Patient<\/strong><\/h4>\n

When administering medication, the nurse must ensure it\u2019s for the right patient. To complete patient verification, confirm two separate verifiers on the medication administration record (MAR). Typically, the nurse verifies the patient’s identity by asking for their full name and birthdate and checking their wristband. The hospital wristband has a medical record (MR) number the nurse must match with the MR number on the chart. For accuracy, the nurse compares these identifiers to the name and birthdate on the MAR.<\/span><\/p>\n

To decrease medication errors, the best practice is to bring the MAR to the bedside to verify a patient\u2019s identity. All patients in acute care settings must have their identity verified and wear a wristband on admission. In some cases, like psychiatric settings, patients may not wear wristbands or be able to tell you their identity. In these cases, the nurse administering medicines must ensure the right patient by confirming the patient\u2019s identity through a nurse who\u2019s familiar with them. Also, a picture of the patient will usually be attached to the MAR to ensure accuracy with administration.<\/span><\/p>\n

2. Right Drug<\/strong><\/h4>\n

When administering medication, you must confirm that the prescribed drug is correct for the patient. Some medicines have very similar spelling, or doctors will use trade names, while hospitals provide medications by their generic names. Take your time and read the whole medication name, and ensure accuracy in knowing your generic and trade names. When in doubt, look up the medication using a reliable source like <\/span>Davis\u2019s Drug Guide for Nurses<\/span><\/a>.\u00a0<\/span><\/p>\n

Some facilities have paper charts that require physicians to write orders on paper, which a nurse or unit clerk then transcribes onto the MAR. Policies are in place to safeguard this process and ensure proper transcription. For example, when one nurse writes a medication on the MAR, another nurse must double-check it for accuracy.<\/span><\/p>\n

More often than not, a physician\u2019s writing is challenging to decipher. Sometimes, it can take a team approach to decode the medication and dosage a physician prescribed. Many medications have a specific dosage, and working with familiar doctors makes it easier to understand what they\u2019ve written. To be honest, I find this one of the trickiest parts of <\/span>travel nursing<\/span><\/a>\u2014<\/span>learning the doctor’s script and deciphering new handwriting.\u00a0<\/span><\/p>\n

If you\u2019re ever unsure what an order says, ask the unit’s senior nurses for help reading orders. When in doubt, call the doctor. It\u2019s also their responsibility to help decrease medication errors, and that process starts with prescribing and transcribing with accuracy.<\/span><\/p>\n

3. Right Dose<\/strong><\/h4>\n

As a nurse, knowing and understanding standard dosing for medication is essential. Sometimes, a dose must be calculated based on a patient\u2019s weight, especially for children. A nurse must obtain an independent double-check with calculated medication doses when working in pediatrics. An independent double-check involves another nurse independently performing the calculations without seeing your results and comparing the answers for accuracy. High-alert medications, such as insulin and low molecular weight heparins, also warrant an independent double-chek.<\/span><\/p>\n

If you notice an incorrect dose for your patient or have concerns about a high or low dose, take your time and question it. If something seems off, clarify with the physician or pharmacist to avoid mistakes.<\/span><\/p>\n

The pharmacy is a massive asset for drug and dosage knowledge and is crucial in reducing medication errors. Pharmacists are experts in dosing and drug interactions, as they must thoroughly examine all electronic or paper orders for accuracy.\u00a0<\/span><\/p>\n

4. Right Time<\/strong><\/h4>\n

Nurses should administer medications prescribed by the physician as directed, spacing dosages appropriately to achieve and sustain therapeutic effects. Timely administration is crucial for regularly scheduled medications, preoperative drugs and for pain relief to ensure patient comfort.<\/span><\/p>\n

Nurses should stay within a half-hour window from the prescribed time to ensure medication accuracy and maintain therapeutic levels of the drug. For example, it\u2019s crucial to administer insulin before meals but wait until the meal arrives to avoid hypoglycemia. Other medications, like pantoprazole, should be taken one hour before a meal for optimal effectiveness.<\/span><\/p>\n

5. Right Route<\/strong><\/h4>\n

Nurses administer medication to patients through various routes, each of which can significantly impact absorption time and the overall effectiveness of the treatment. Some common routes of administration, with their abbreviations, include:<\/span><\/p>\n