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6 rights of medication administration Right drug
Right dose
Right patient
Right route
Right time
Right documentation
Right Drug Proper identification of the ordered drug is
required. Check medication against the physicians
order form. As a Registered Nurse, you have the
responsibility before administering any medication,
to ensure that the dose and drug is appropriate for
the patient. You also have the responsibility to
clarify orders, which are unclear or seem
inappropriate for the clinical condition of the
patient.
Right Dose The RN is responsible for checking the dosage of
the drug, doing the appropriate calculations or
conversions, and knowing the usual dosage.
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Right Patient Proper identification of the patient is required
before medication is administered. HFHS
acceptable method for confirming identification
consists of checking the patients first and last name
and medical record number (MRN) on the
identification band with the name and MRN on the
Medication Administration Record (MAR).
Right Route Route of administration should be part of the
physicians order. The RN is responsible for
preparing and administering medications correctly
by consulting the accompanying instructions from
the pharmacy or drug company.
Right Time The RN is responsible for administering
medications according to scheduled times if that is
how the order is written. Instructing patients on the
timing of self-administered drugs at home is also an
important function for nurses. Instruct using exact
times such as "take at 8:00 in the morning with food
and 5:00 in the evening with food" rather than "take
at meal times" since meal times can vary with
different cultural groups.
Right Documentation The RN is responsible for documenting the
administration of the prescribed medication with
the information required in the appropriate
location such as the Medication Administration
Record (MAR) within the Electronic Health Record.
In addition to the 6 rights there are Drug information
some additional steps which include: Patient information
Distraction
Communication
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Patient education -the names of medications and how to pronounce
them
-what the medications do
-what they look like
-how and when medications should be taken
-possible side effects and food/drug interactions
Who may issue a verbal order? -Licensed independent provider (MD, DO, NP, or
DDS)
-Other licensed healthcare professional (physician
assistant) as a delegated act of a licensed
independent prescriber
When is a verbal order used? -true emergencies
-when issuing a written or electronic order is no
feasible (e.g. during sterile procedures)
Who is permitted to receive a verbal Physician
order? Registered Nurse
Physician Assistant
Pharmacist
Respiratory Therapist
Verbal orders are not to be used antineoplastic agents
under any circumstances for the
prescription of:
Only the following categories of Opioids and other analgesics
medications are acceptable as range Antitussives
orders: Antiemetics
Antihypertensive's
Antihistamines
Anxiolytics
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Penicillin(s) Amoxicillin, ampicillin, augmentin, nafcillin sodium,
pipercillin sodium, penicillin G (aqueous), penicillin
VK, trimox, unasyn
Indications: penicillins are antibiotics used to treat
many different types of infections, such as tonsillitis,
pneumonia, ear infections, bronchitis, urinary tract
infections, gonorrhea, and infections of the skin,
just to name a few.
Serious Adverse Effects: Anaphylaxis, neutropenia,
leukopenia, thrombocytopenia, hepatotoxicity
Nursing Considerations: Give with a full glass of
water on empty stomach and do not give with
acidic fruit juice - it decompresses PCN
Patient Education:
-Seek emergency medical treatment if they
experience signs and symptoms of an allergic
reaction such as: shortness of breath, hives,
swelling of the lips, face or tongue, rash or fainting.
-Contact your physician if they experience severe
or bloody diarrhea and abdominal cramping if
being discharged on penicillin.
-Penicillin may decrease the effectiveness of birth
control pills and a second method of birth control
while taking penicillin may be necessary to ensure
protecting unintentional pregnancy.
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