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Nurses six rights for safe medication administration
- 1.the right to complete and clearly written order.
- 2.the right to have the correct drug route and dose.
- 3.the right to have access to information
- 4.the right to have policies on med administration
- 5.the right to adminster medications safely and to identify problems in the systme.
- 6.the right to stop, think, and be vigilant when administering medications.
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Right Documentation.
- -Nurses and other health care providers use accurtate documentation to communicate with each other.
- -many medication errors result from inaccurate documentation.
- -ensure that accurate and apprioriate documenation exist before and after giving medications.
- -verify inaccurate documentation before giving medications..
- before giving meds ensure that documentation in the MAR clearly reflects the clients full name, the name of the ordered med written out in full, the time the med is to be adminstered. and the medciation dosage, route,and feguency.
- -common problems with med orders include; incomplete info, innacurate dosage form of strenght, illegible order or signiture, inncorect placement fo decimal points leading to wrong dosage and nonstandard terminolgy.
- -After adminstering the med, indicate which med were given on the clients MAR per agency policy to verify that the medication was given as ordered.
- -record med admin as soon as med are given to client.
- -Always record given med to prevent errors. like giveing the same med again. rsulting in negative outcomes.
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Right Time
- -Nurse need to know why a medication is ordered for certian times of the day and whether thay are able to alter the time schedule.
- -each agency has a recommened time schedule for medications ordered at freguent intervals.
- -nurses can alter these recommended times if necessary or appropriate.
- -the prescriber often gives instructions about when to administer a medication.
- -preoperative med is to be given on call-med is given whe the operating stafd members are coming to get the client for surgery.
- -give priority to med that are given at certain times.
- -some meds require the nurse's clinical judgement in determining the proper time for administration.
- -before discharge in the hospital setting, evaluate a client's need for home care, escpecially if the client was admitted due to a problem of med admistration.
- -clients leave the hospital with a basic knowledge of their med.
- -do all the necessary arrangments for client to know the effects of meds and the time client is to take medication.
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Right route
- -Always consult the prescriber if an order does not designate a route of administration..Likewise if the specified route is not reccommened route, alert the presriber immediately.
- -when adminstering injections, precautions are necessary to ensure that the nurse gives the medications correctly.
- -it is also impotrant to prepare injections only form preparations designed for parenteral use.
- -the injection of a liguid designed for oral use produces local complications such as a sterile abscess or facal systemic effects.
- -medication companies label parenteral medications for injection use only.
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Rigth client
- -Medication errors often occur because one client gets a drug intended of another client. it is important that a med is givent to the right cient.
- -Before giving a med to a client use 2 client identifiers when admistering meds.
- -include the client'e name, ID number, DOB or a telephone number.
- -do not use the client's room number as a identifier.
- -to identify a client correctly in a acute care setting, compare the cient identifiers on the MAR with the clients id while at the client's bedside.
- -if an identification bracelet becomes somudged or illegible or is missing, get a new one for the client.
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Right Dose
- -The unit dose system is designed to minimize errors.
- -when preparing a med form a large volume or strenght than needed or when the prescriber orders a system of measurment different form the pharmacy supplies, chances of errors increases.
- -when performing med calculation or conversions have another qualified nurse check the calculation doses.
- -After preparing the med, prepare the med using standard measurement devices. use graduated cups, syringes, and scalded droppers to measure meds accuratley.
- -at home have client use kitchen measuring spoons rather than teaspoon/tablespoon, which vary in volume.
- -only break tablets that are scored by the manufacturer. when necessary to break a scored tablet make sure the break is even. discard tablets tha do not break evenly.
- -verify agency policy before administering a tbalet that had been opened, cut or repacked.
- -often tablets are crushed an given with food, be sure to completley clean a crushed device before crushing a tablet.
- -mix medication with small amount of food or liguid. do not use client's favorite food or liguid because the med can alter their taste and decrease the clients desire for them.
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Right drug/medication
- -A med order is reguired for every medication you adminster to a client.
- -regardless how you recieve an order, compare the prescriber's written orders with the MAR when medication is initially ordered.
- -verify med info whenever new MARs are written or distributed or whe clients transfer from one nursing unit or health care setting to another.
- -Once the information on the client's MAR is accurate, use the MAR to prepare and administer meds.
- -when preparing meds form bottles or containers, compare the label of the medication contianer with the MAR 3 times.
- -before removing the contianer form the drawer or shelf.
- -as the amount of med ordered is removed form the contianer.
- -before returning the contianer to storage.
- -never prepare med form unmarked contianers or with illegible lables.
- -finally verify all meds at the client's bedside with the client's MAR and use atleast 2 identifiers before giving the client any medication.
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Apply the 6 right of medication adminstration in a clinical setting to prevent errors.
- Right drug
- Right dose
- Right route
- Right time
- Right client
- Right documentation.
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Implement nursing actions to prevent medication errors.
- 1. A medication error can cause or lead to in appropriate medication use or client harm.
- 2. Med errors include inaccurate prescribing, adminsitering of the wrong med, giving the med using the wrong route, or time interval and adminsitering extra doses or failing to administer a medication.
- 3. prevention is the key.
- 4. Medication error are related to proffessional practice, health care product design or procedure and system such as product labeling and distribution. when an error occurs the client saftey and well being become top priority.
- 5. Nurse assesses client, reports to physician, once client is stable incident is reported to supervisor or manager.
- 6. Nurse is responsible for preparing a written occurent incident report with in 24 hours of error.
- 7. includes client identification into, location and time of incident anaccurate factual descrition of what occured and what was done and signiture.
- 8. error is not part of med record. protects health care proffessionals and institution.
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