The Six Rights and Drug Administration

Right Patient

When administering a drug, the nurse must be certain that the patient receiving the drug is the patient for
whom the drug has been ordered. This is accomplished by checking the patient’s wristband containing the
patient’s name. If there is no written identification verifying the patient’s name, the nurse obtains a wristband or other form of identification before administering the drug. In some instances the nurse
may ask the patient to identify himself. However, the nurse should not ask, “Are you Mr. Jones?” Some
patients, particularly those who are confused or have difficulty hearing, may respond by answering yes even
though that is not their name.

Some nursing homes or extended care facilities have pictures of the patient available, which allows the nurse to verify the correct patient. If pictures are used to identify patients, it is critical that they are recent and bear a good likeness of the individual.

Right Drug

Drug names are often confused, especially when the names sound similar or the spellings are similar. Nurses
who hurriedly prepare a drug for administration or who fail to look up questionable drugs are at increased risk for administering the wrong drug

Right Dose, Route, and Time

The nurse should obtain a primary care provider’s written order for the administration of all drugs. The
primary care provider’s order must include the patient’s name, the drug name, the dosage form and
route, the dosage to be administered, and the frequency of administration. The primary care provider’s signature must follow the drug order. In an emergency, the nurse may administer a drug with a verbal order from the primary care provider. However, the primary care provider must write and sign the order as soon as the emergency is over.

It is important to question any order that is unclear. This includes unclear directions for the administration of the drug, illegible handwriting on the primary care provider’s order sheet, or a drug dose that is higher or lower than the dosages given in approved references.

Right Documentation

After the administration of any drug, the nurse records the process immediately. Immediate documentation is particularly important when drugs are given on an as-needed basis (PRN drugs). For example, most analgesics require 20 to 30 minutes before the drug begins to relieve pain. A patient may forget that he or she received a drug for pain, may not have been told that the administered drug was for pain, or may not know that pain relief is not immediate and may ask another nurse for drugs. 

If the administration of the analgesic were not recorded, the patient might receive a second dose of the analgesic shortly after the first dose. This kind of situation can be extremely serious, especially when narcotics or other central nervous system depressants are administered. Immediate documentation prevents accidental administration of a drug by another individual. Proper documentation is essential to the process of administering drugs correctly.

by Umaee
source: Introductory clinical pharmacology
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