Medication errors are a significant issue in healthcare, with the potential to cause serious harm to patients. Fortunately, these errors are preventable and can be avoided with proper measures. This blog will explore ways to avoid medication errors.
There are a number of things that can be done to prevent / avoid medication errors, and one of the most important is to follow the “Five Rights” of medication administration. If all are observed, the potential for mistakes is drastically reduced.
Nurses learn these rules in school. The tendency to skimp on them is a problem that often stems from factors such as overconfidence and staffing shortages. There is no excuse to skimp on rules. Don’t become a statistic. Don’t take chances. Follow these Five Rights with every medication you dispense to keep your patients safe.
These Five Rights are:
- Right Medication
- Right Dose
- Right Time
- Right Route
- Right Patient
1. The Right Medication
Always check the medication label carefully to make sure you are giving the right drug to the right patient. Check the label on the bottle, bubble pack, or other packaging; the doctor’s order; and the medication administration record (MAR). If there are any discrepancies, ask. Check the chart and doctor’s notes and ask the pharmacy. If doubt remains, call the physician for clarification.
2. The Right Dose
Be sure to give the correct dose of medication. Check the doctor’s order, the MAR, and the packaging label. If you are unfamiliar with this medication, check your drug book. Be sure you are using the most up-to-date source. If you are unsure of a dose, ask. Consult with the pharmacist or call the doctor.
3. The Right Time
Again, check the order, the MAR, and the medication label. Give the medication at the correct / precise time. If you are unsure, check the patient’s medication schedule. If you question the frequency, look it up, and if necessary, consult the pharmacist or doctor.
4. The Right Route
Administer the medication through the correct route. For example, if the medication is a tablet, it should be swallowed, not injected. Again, always check the order, the MAR, and the medication label. Can this medication be given as ordered? Can the patient swallow it? Or can it be crushed? Is it available in a liquid form? If it’s an IV med, is it compatible with the solutions and site? If it’s injectable, what other parameters need to be considered?
5. The Right Patient
Most important of all, do you have the right patient? How do you know? Make sure you are giving the medication to the correct patient. Verify all the above steps and then verify the patient information. Check the wristband. Ask the patient to tell you his name and date of birth. If he can’t tell you, does he know his physician’s name? Is there a family member present to verify identification? Never assume that you know this patient or use the room and bed number as the sole means of identification.
The additional rights added by some nursing schools or boards of nursing include the Right Reason (why are you giving this medication?), the Right Documentation, and the Right Assessment. What assessment brings you to decide to administer this medication and what assessment says it was effective or not?
Double-Check and Document
When all these steps have been followed, check for any protocols from your facility, especially in regard to IV or injectable medications. Make sure the patient swallows any oral medications. Never leave a medication for the patient to take later. Observe the patient for a response and any possible reaction. Follow protocols for medications that require frequent monitoring and for any specific procedures or protocols required if this is the patient’s first dose of a medication.
Document on the MAR and anywhere else appropriate whether additional information is needed or appropriate to the situation. Notify the doctor immediately in the event of any reaction or error.
In addition to the “Five Rights”, there are a number of other strategies that can be used to prevent medication errors. These include:
- Using barcoding systems to scan medications before administration.
- Double-checking medications with another nurse or pharmacist.
- Involving pharmacists in the medication process.
- Educating patients about their medications.
By following the “Five Rights” of medication administration and other strategies for preventing medication errors, we can help to keep our patients safe and reduce the number of medication errors. It is important to remember that medication errors are preventable, and we all have a role to play in preventing them.
Quan, K. (2014). The New Nurse Handbook. Fall River Books.