In this article, we will discuss the 5, 6, 8, 10 Rights of Medication Administration. Nurses administer medication to improve an acute or chronic health condition. And, because of this medication administration is essential to nursing practice.

Medication administration consumes a large portion of a nurse’s time during a shift. The Rights of Medication Administration are in place to ensure safe and consistent nursing practice.

When I first started nursing, soon to be 30 years ago, there were only 5 rights of medication administration. Consequently, over time there has been a need to add additional rights. This was to help avoid medication administration errors. For further information read this article titled Nursing Rights of Medication Administration.

The original 5 Rights of Medication Administration are as follows:

1. The Right Patient
2. The Right Drug
3. The Right Route
4. The Right Time
5. The Right Dose

Since that time the Right Documentation is a new addition to the Rights of Medication Administration.

This article 8 Rights of Medication Administration also includes the Right to Refuse and the Right Response. I have also seen the Right Patient Education, and the Right Assessment, and the Right Evaluation added to some list.

The purpose of the Rights of Medication Administration is to ensure patient safety and decrease medication errors. Let’s take a look at the 5, 6, 8, 10 Rights of Medication Administration.

The Right Patient

During a busy shift, a nurse administers medication to numerous patients. Medication administration happens at varying times throughout the day. Medication errors occur when a medication is given to one patient when it was intended for another.

• First, always check, double-check, and triple-check that you have the right patient.
• Second, check your patient’s chart for the order.
• Thirdly, check the medication with the order.
• Then, make sure you are entering the right patient’s room.
• Identify the patient’s name and room number.
• Finally, check the patient’s armband.

The Right Drug or Medication

Make sure you check the drug order against the drug label at least three times. Medications come from the pharmacy with either the Brand or Generic name. The order may have the brand name and the drug dispensed may be the generic form. Also, the generic name of one drug may look almost identical to the generic name of another.

READ YOU MEDICATION ORDERS AND DRUG LABELS CAREFULLY!!

The Right Route

The route means how the medication will enter the body. Some medications have more than one route of administration.

• Always, check the order to make sure it includes a route.
• If the order has no route listed call the prescriber.
• Never assume, even if there is only one route of administration for the drug.
• You need a clear and correct order prior to the administration of any medication.
• The medication must be given the route ordered.
• However, for example, if a patient cannot swallow a pill you can get an order for a liquid.
• Any change in route requires a new order.

The Right Time

It is extremely critical to give some medications at the times on the medication order. Two examples are insulin and pain medication.

• Some medications need to be given before meals to be effective.
• Some medications need to be given after meals or at bedtime.
• The medication record should come with times of administration.
• It is important to give the medication at the time that is on the medication record.
• Medications should be given within 1/2 hour of the time before or after.
• However, this does not apply to PRN medications.
• If the medication is order every 4 hours, and you give the medication 1/2 before time throughout the day, you will eventually reduce the window for that medication.
• When a medication is ordered every 4 hours, it is because it can safely be given every 4 hours and not every 3 hours or 2 hours.
• If a medication has an order for a time that is not specific, say HS (hour of sleep), the time is open for interpretation.
• Some patients may go to sleep at 7 PM and want their medication at that time.
• Others may go to sleep at 10 PM and want their medications then.
• With those types of orders, the 1/2 hour before or after the window is irrelevant. 

As a student nurse or new nurse, any time you are not sure ALWAYS ASK QUESTIONS!

The Right Dosage

The right dose is how much of a medication is suppose to be administered at one time.

• You may have to perform medication calculations and conversions.
• Be careful. Some dosages contain decimals.
• You will need to learn conversions.
• The dosages of medication do not always come from the pharmacy at the exact dose.
• You may need to give two tablets or 1/2 of a tablet.
• Never assume that you will receive the exact dose from the pharmacy.

If you need help with calculation and dosage, try our eBook Calculation and Dosage One Method. This book contains all the variations for calculations using dimensional analysis in a quick and easy format. And if you need brushing up on basic math like fractions and decimals try our free eBook Calculation and Dosage Basic Math. Both books teach math principles nurses need in a short, precise form.

The Right Documentation

If a medication is not documented, it was not given.

• Always record immediately after the medication is given.
• You must document each and every time you administer a medication.
• And, always check your documentation.

We have covered the 5 and 6 Rights of Medication Administration, now we are at the 8  thru 10 Rights of Medication Administration.

The Right To Refuse

Patients have the right to refuse treatment. This includes medications.

• If your patient refuses their medication, you should talk to them to find out why.
• The patient may need education about the medication or they are having some side effects they are relating to the medication.
• Become your patient’s advocate and try to get to the bottom of the issue.
• However, if your patient continues to refuse the medication, chart that the patient refused and notify the healthcare provider.

The Right Client Education

Patient education is a nursing best practice for any situation, not just medication administration.

• However, you should always educate the patient on the medication you are giving them and be able to answer any questions they may have.
• Sometimes, you may find that a family member gave an old medication list and the patient may tell you they are not taking the medication any longer.

The Right Assessment

You should assess the patient’s history for drug reactions and allergies.

The Right Evaluation

You should also perform an assessment on your patient after medication administration. Especially, for drugs like pain medication, insulin and new medications.

Summary

Using the 5 Rights, 6, Rights, 8 Rights, and 10 Rights of Medication Administration you can reduce errors and keep the patient safe. That’s a good thing.

Source

Bonsall, MSN, RN, CRNP, Lisa. “8 Rights of Medication Administration.” Lippincott Nursing Center, 27 May 2011, https://www.nursingcenter.com/ncblog/may-2011/8-rights-of-medication-administration. Accessed 1 May 2021.

Hanson A, Haddad LM. Nursing Rights of Medication Administration. [Updated 2020 Nov 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK560654/

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