What Are the 6 Rights of Medication Administration?
Every time a nurse, doctor, or other health care practitioner administers medication to a patient, there’s the risk of a medication error. Every year, the FDA typically receives more than 100,000 reports of medication errors, and it’s estimated that these preventable mistakes could be responsible for as many as 9,000 deaths annually.
To combat the prevalence of medication errors, clinicians are taught to observe the 6 Rights of Medication Administration. In this case, “rights” doesn’t refer to an entitlement of some kind (the right to free speech, for instance) but rather to 6 things that have to be confirmed as “right” before a clinician administers medication to a patient.
If you’re responsible for overseeing the clinical administration of medication at a healthcare or residential facility, or if you’re responsible for providing medicine to a loved one or friend in your role as a caregiver, taking the time to properly confirm these six “rights” before each dose of medication will go a long way towards reducing the likelihood of committing a medication error.
Right Patient
The first step to ensuring accurate medication administration is to confirm that the medication is given to the right patient. While patient accuracy has increased due to the advent of technologies like scannable armbands and a greater focus on obtaining verbal identity verification whenever possible, a significant number of wrong-patient errors are committed every year.
Whenever administering medications of any kind, the person administrating must have a positive verification of the patient’s identity before proceeding. In older patients, whose hearing may be poor or whose mental capacity may not allow them to be a reliable source of confirmation, wristbands or other identification tools may need to be used.
Right Medication
Ensuring the medication given is the same as prescribed is the second “Right.” There are hundreds of thousands of different medicines available in the US today:
- The FDA has approved more than 20,000 prescription medications that remain available.
- There are more than 300,000 commercial over-the-counter medications that contain more than 800 different active ingredients.
- There are also countless dietary supplements, herbal remedies, and other non-FDA-approved products that don’t classify as “medication” but can still cause harmful interactions.
Considering that there are only so many possible variations of pill sizes, shapes, and colors, the possibility of confusing two oral-route medications is considerable. The risk multiplies when you include other types of pharmaceuticals – injectables, transdermals, suppositories, and liquids – that are mostly indistinguishable when they’re outside of their packaging.
It is vital to ensure that the medication being administered is right. At each dosing period, the person administering the drug should double-check the patient’s orders against the medication packaging to ensure accuracy.
Right Dose
By far, the most common error in medication administration is inaccurate dosing. Particularly for medications for which the dosing must be measured via a syringe, drip rate, or simple volume measurement (take one teaspoon twice a day, for instance), the possibility for a mid-dosage is high. Another area for potential problems is when a pill is supposed to be halved or otherwise segmented before administration.
Again, checking the patient’s orders or the label on their prescription medication should be done every time to ensure that the correct dose is given. If there is any confusion about the dosage, nothing should be administered until the issue can be resolved by consulting with the prescribing provider.
Right Time
Another common error is giving medication at the wrong time. Especially for patients who are taking numerous medications with complex interactions, an error of as little as a half-hour can cause significant complications as different drugs interact in different ways. Certain medicines must be taken with food, others without; certain medications must be taken on a rigid schedule to prevent over- or under-medication.
Always verify the exact timing of each dose of a medication before administering the dose. Again, if there is any confusion regarding timing, clear it up with the prescribing provider as quickly as possible before giving the medication.
Right Route
This right concerns clinical staff more than nonprofessional caregivers since nonprofessionals typically only administer oral-route, topical, and suppository medications, which are less likely to be confused with one another.
Injected medications are the usual cause of a wrong-route error. Most injected medications are injected into a muscle (intramuscular), into a vein (intravenous), or just under the skin (subcutaneous). If a medication intended for one of these routes is injected by a different route, it can cause significant problems, leading to severe pain, hospitalization, or even death.
Regardless of whether the medication is to be injected, taken orally, or administered through another route, always verify the correct route of administration before giving the medication.
Right Documentation
In clinical settings, overdoses can occur when one clinician is unaware that a different clinician has already administered a dose of a particular medication. In the home, it’s more common that a patient or caregiver has forgotten that the drug has already been given, and a second dose is administered.
That’s where the final right – right documentation – comes into play. In a hospital or other facility, the patient’s chart should be updated immediately after administering any medication. At home, caregivers should always keep and use a checklist or other form of positive record that a dose of medicine has been given so that nobody is relying on their memory to keep a patient safe.
Angus Lake Healthcare is your local pharmacy consultant, serving facilities and their residents across Central Georgia.
Another way to avoid medication errors is to keep your patients’ medication easily organized and administered with compliance packaging options from Angus Lake Healthcare. Schedule a consultation today to learn more: 478-233-1828.
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