In the course of patient care, the most important factor is the related to the drugs that are being delivered to him or her. Any minor error can lead to fatal results. To minimize this problem, nurses and other forms of medical practitioners are trained to give drugs to the patient in accordance with the 5 rights of medication administration. The 5 Rights of Medication Administration are :
- The right patient
- The right time
- The right drug
- The right dose
- The right route.
These as individual rights do not contribute much to a safe drug administration. But if followed by the medical practitioner with precision, where the practitioner double checks at each and every step. Then it may lead to a safe environment for the patient.
1. The first right of medication administration.
The first of the 5 rights of medication administration is to check that the drug that is being delivered, is done so to the right patient. In such cases, the nurse and as well as the patient should together contribute toward the fulfillment of this right. The patient should also be verbal and make sure that the nurse identifies him or her correctly. On the part of the nurses, the nurse should always identify the patient before performing any kind of procedure or drug administration. As a typical hospital institute has a large number of nurses, who run between departments regularly. Some nurses even work part-time and are not really familiar with the hospital setting. Accompanied by it, the large number of patients that are coming in and going out of the hospital is so large that it is difficult to create time for double checks. Such scenarios may lead to fatal results. To avoid incidences like these, there should be absolute surety on the part of the nurses to ensure that the drug or the procedure they are about to administer is on the right patient. To ensure this, they should always check on the ID bracelet of the patient before starting the procedure. For the purpose of double checking, they should also ask the patient to verify his or her name, along with the age, and the allergies that he or she is susceptible to.
2. The second right of medication administration.
Generally, the hospitals work on a ‘before/after’ rule. According to this, they have a time limit as to how before or after the specified time by the doctor, can the nurses administer the drug. This is done to avoid any mishaps due to human error. Therefore, it’s the patient’s duty to confirm with the hospital administration about their specific rule for their own safety. The patient should always ask the physician who is ordering the drug that how many times are they liable to receive the drug in the 24 hr duration. It is also very important to cover all the facets of time at which the drug is administered with the food that is being provided to the patient. Whether it should be taken before the meal or after the meal. Whether it should be taken without a meal or only with a snack. These parameters depend
on the interactions that occur between the drug and the food. Most of the drugs that are present in the market and are generally administered to the patient interact greatly with the food. Such interactions affect the absorption procedure of the food and drugs. If the patient is being administered with more than one drug then care should be taken that there are no harmful results of the interaction of those drugs. Because certain drugs interfere with the
absorption of other drugs and this may not be good for the patient. To make the drugs more effective, care should be taken to ensure their bioavailability and administering drugs with a certain amount of time gap if the drugs hinder the absorption of each other.
3. The third right of medication administration.
The third of the 5 rights of medication administration is the most important of all the rights. It is the giving of the right drug to the patient. Administration of the wrong drug is the most common occurring error that happens. The patient should also ensure that the drug that he or she is being given is the same drug that was ordered and is the generic form of that drug. There are various circumstances that may lead to such errors.
Such lapse in drug administration may be due to identical names and identical packaging of the drugs with the same type of labels. But one of the main causes is the poor form of communication between the physician that orders the drug and the dispensary or the nurse.
To overcome such miscommunication, one should avoid the use of abbreviations while ordering drugs or writing down the dosage and should always repeat that verbally. The nurse should also ensure that the drug that is being given is necessary for the patient. In case of unsure, one should avoid administering the drug before a double check with the physician.
4. The fourth right of medication administration.
The fourth right ensures the administration of the right amount of dose of the drug. The calculation of the dose that is to be administered should always be rechecked before prescription. If there is unsurety of the dose, one should have the calculations done by a second person who is authorized and is well trained to do so. While calculating the dose of the drug that is to be given, the patient’s age, weight and statics of his or her vitals act as the main parameter. Therefore it is very much important to have accurate readings of these factors before calculating the dose. This must be taken care of especially in the case of newly born or old patients, where a slight change in the required dose has a very large effect.
5. The fifth right of medication administration.
The effect of drug largely depends on how the drug is being administered. This involves the route through which the drug has to be passed and the form of the drug that is to be given to the patient. It is necessary to confirm all these parameters as they play a major rule in deciding the bioavailability of the drug. There are several routes through which the drug can be administered which involve oral, rectal, sublingual, intravenous, intramuscular, and subcutaneous. Mainly, the through which the drug is being administered depends upon the patient’s age and the rate of bio-absorptivity that the drug requires. Other than these, the route also decides the dose that is to be given to the patient. For example, oral drugs have a higher dose than the drugs that are to be given through an injection. Therefore, this requires specific care as to how the drug is to be given. The oral dose of a specific drug may prove to be fatal if the same dose is given through an IV (Intravenous). During IV administration of drugs, care should be taken that the drug does not infiltrate the soft tissue, as it may lead to a serious soft tissue injury. This is also due to the fact that drugs that are administered through an IV, have a rapid course of action as they are directly introduced into the bloodstream.
These 5 rights of medication administration. are must know for every physician, nursing staff and health worker for the safety of patients.