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Lessons · Nursing · the rights of medication administration

The rights of medication administration, in order

Before a medication leaves your hand: the right patient, the right drug, the right dose, the right route, the right time, and then the right documentation, written after it is given.

Hone is a place to practise a career, one idea a day. This is one of its lessons, written out in full and free to read without an account.

What it is for

It is a list because at 0600, with a corridor of patients and an interruption every ninety seconds, the only defence against a wrong tablet is a sequence that does not depend on memory. Patient first, always: every check after it is wasted if it is the wrong person.

How to think about it

Say the list in order, every time, at the cart and again at the bedside. Who, then what, then how much, then how, then when, then write it down. Documentation is last because it records what happened, and charting before giving is charting something that has not happened yet.

Worked example

1. Right patient
Two identifiers, checked against the record, before anything else.
2. Right drug
The label against the order, letter for letter.
3. Right dose
The order's amount against the label's strength, and the arithmetic on paper.
4. Right route
By mouth, into a vein, under the skin: the order says which.
5. Right time
The scheduled time, and the window the unit allows around it.
6. Right documentation
Signed after it is given, with the time it was given.

Your turn

Write which right is checked first at the bedside.

1. Right 

The trap

Charting first so it is not forgotten. A dose signed for and then interrupted is a dose the record says was given and nobody gave. Documentation is the last right for exactly that reason.

Practise the rights of medication administration on HoneA question on it now, a coding challenge where there is one, and it is remembered for review. Free, no email needed.