Complete guide to the 10 Rights of Medication Administration to help reduce medication errors.
When we talk about the safe administration of medications, there is no such thing as being too careful. Nurses are taught the ‘5 rights of Medication Administration’ however, to ensure safety, experts advise we should make it ’10 Rights’.
This simplified guide can help nurses safely administer medications, reducing the risk of mistakes. With administration errors accounting for 60% of all drug errors and 10% of patients experiencing unwanted reactions or side effects, it is critical to get this right.
But what is medicines management? What are the 10 Rights of Medication Administration? How do I ensure patient safety in medication dose calculation?
This article will cover all you need to know. So, let’s get started.
What is Medicines Management?
The UK’s Medicines and Healthcare Products Regulatory Agency (MHRA) has defined medicines management as a “clinical, cost-effective and safe use of medicines”.
This is to make sure that “patients get the maximum benefit from the medicines they need, while at the same time minimising potential harm”. The term medicines management has also been known as medicines optimisation.
It is a system of processes and behaviours that determine how medicines are used by the NHS and patients, with the end target of optimising the benefits that medical treatment offers, creating the best possible outcome for each patient.
Having good medicines management is a vital part of all nursing and midwifery practices. These skills include prescribing, administration of medicines and supporting people to correctly take their medicines.
The processes in place put the patient at the core of everything, making sure that care is delivered better, as well as having better-informed individuals.
| What stage do medication errors most commonly take place? |
| More than half of errors are made at the point of administration (54%) |
| Roughly 1 in 5 mistakes are made during prescribing (21%) |
| 16% of the total faults are through dispensing. |
Why Is There A 10 Rights of Drug Administration?
The main reason the 10 Rights of Drug Administration was created was to prevent many medication errors. Nurses must understand these rights to administer medications safely. It is a simple and easy guide to help remember the processes in place to avoid errors.
The greatest risk that nurses take is when administering medications. Research has shown that when it comes to the wrong rate, dose or time, there is a 60% error rate. With nurses being responsible for ensuring quality and safe patient care at all times, this number needs to be lower.
When it comes to medication errors, some may cause permanent disability and for others even lead to fatal outcomes. By following these 10 rights of drug administration, harm caused by medication errors may be reduced, as well as protecting the patient and the nurse administering.
| Statistics from BMJ regarding UK nursing errors. |
| Each year, more than 237 million medication errors are made in England. |
| These errors cost the NHS upwards of £98 million. |
| More than 1700 lives every year are lost due to medication errors. |
What Are The 10 Rights of Medications Administration?
So, we know why we use these rights, but what are they? Well, below we have the 10 rights, as well as a short description. Let’s take a look and see what they all mean.
1. Right patient
Patients should be asked for their name, as well as checking his or her identification before giving any medication. Even if you are familiar with the patient and know their name, you should still ask for verification.
Tips:
- You should check the patient’s name on their prescription as well as their wristband.
- You should use 2 or more identifiers before prescribing medicine, also asking the patient to identify themselves.
2. Right medication
Ensuring that you have the correct name and form of the medication is vital. There are plenty of medication names that sound similar, as well as looking alike. Some bottles and tubs can look the same, so be extremely careful.
It is common to misread medication that looks the same. For verbal prescriptions, these similar-sounding names can often lead to errors. To avoid this, you can find more information from this list of look-alike and sound-alike drugs.
Tips:
- You should always ensure to check the name of the medication. Brand names should be voided.
- You should always ensure to check the expiry date.
- You should always ensure to check the prescription.
- You should always ensure to regular review medications, especially antibiotics.
3. Right dose
Before giving out treatments, you should always check the doctor’s order and medication sheet. Remember to be aware of the difference between a paediatric dose and an adult dose.
Tips:
- You should always ensure to check the prescription.
- You should always confirm the appropriateness of the dose by using local guidelines.
- You should always calculate the dosage, as well as ask another nurse to do the same when necessary.
4. Right route
When it comes to the right route, you should take extra time to carefully read how the medication should be administered, as getting it wrong can cause harm. Of course, there are different routes such as IV, oral, IM, SQ and many others.
Tips:
- You should always check, and check again the route that has been prescribed.
- You should always make sure that the patient can receive the medication via the prescribed route.
5. Right time
The right time means when it should be given, as well as the last time it was given. This is to make sure that enough time has passed since their last dose because there is a chance they could end up taking too much.
Tips:
- You should always check to see when the medicine was last administered.
- You should always double-check that you are prescribing treatment at the correct time.
- You should always confirm the time of the last dose to avoid giving too much.
6. Right patient education
When working with a patient, there should be an understanding and knowledge of the client’s history of drug interactions and allergies. This will help to avoid any harmful mistakes and give the patient the best treatment.
Tips:
- You should always check to see if the patient understands what their medication is for.
- You should always make the patient aware that if they experience side-effects or reactions, they should contact a healthcare professional.
7. Right documentation
It is important that when giving treatment to correctly note down all times and remarks on the patient chart. This is to monitor all treatment given to avoid future mistakes.
Tips:
- You should always make sure that after the medication has been administered, you have signed for it.
- You should always make sure that medication is accurately prescribed with a start and end date if appropriate.
8. Right to refuse
An important right to remember is the right to refuse. If a patient refuses to take their medication, you shouldn’t force them to do so. Instead, take a note of the refusal, as well as all reasons why. In some cases, a different medication that is more suitable may be given.
Tips:
- You should always make sure that you have the patient’s consent to administer medications.
- You should always understand that patients have the right to refuse any medication.
- You should always note down the reasons for why the medication was refused, helping to come to an alternative solution further down the line.
9. Right assessment
The patient must be provided with enough knowledge of what drug they would be taking, as well as any side effects that may occur as a result. This will help them understand the process and what is going on.
Tips:
- You should always check that the patient requires a specific medication.
- You should always check for any contraindications.
- You should always observe the baseline if necessary.
10. Right evaluation
This involves reviewing any previous medications and treatments. The reason for this is to see if any bad interactions with the drug have been given. It is recommended to check the expiry date before being given too. We want the best care for our patients, so overlooking these key areas can be dangerous.
Tips:
- You should always make sure that the medication is working in the way it is intended.
- You should always make sure that there are regular reviews of medications.
- You should always have ongoing observations when required.
| Where do nursing errors most commonly take place? |
| The lowest rates are in primary care due to the size of the sector. They account for 38%, almost 4 out of every 10 patients. |
| The highest rates come from care homes, despite having fewer patients than other sectors. They account for 42%. |
| Hospitals on average have 1 in 5 medication errors. |
What Are Common Errors By Nurses?
Nurses have one of the hardest jobs on the planet. They don’t receive enough recognition and praise for the roles they do. There isn’t enough support and funding to help nurses, which can lead to longer hours, resulting in fatigue.
A huge deal of responsibility is placed on nurses and when extremely busy and tired, it can be easy to make a small mistake. They are inevitable and part of human nature, we all do it. Some of the common errors that nurses should avoid include:
- Not understanding the units of measurements for medication.
- Prescribing or misspelling a drug.
- When measuring doses, the wrong equipment may be used.
- Administering medication too fast or too slow.
- Using similar-sounding or similar-looking drugs.
