Don't give that medication until you know the 8 core rights of medication administration!
Giving another person medication is big responsibility. In your C.R.M.A. training class or your Med Tech training, you were taught the 8 rights of medication administration. Why is it so important to consistently implement the 8 rights when you are preparing medication to administer to a client or a family member? A consistent and focused approach for every medication preparation can help minimize errors.
What are the 5+3 rights?
The first 5 rights must be
implemented during the medication preparation phase. The medication preparation phase includes your initial review of the MAR (Medication Administration Record), locating the correct medication and preparing the correct medication before administering the medication. The last 3 rights relate to the clients experience and
documentation of your actions.
The first five rights could also be considered the five "corrects"!
1. Right Patient - does the patients name on the MAR match the patients name on the pharmacy medication label?
2. Right Medication - does the medication name on the MAR match the medication name on the pharmacy medication label? This is also a good time to check for any potential allergies or adverse drug reactions!
3. Right Dose - does the prescribed dose on the MAR match the actual listed dose on the pharmacy medication label? This is also a good time to ask yourself if this dose makes sense and is an appropriate dose range.
4. Right Route- does the prescribe route on the MAR match the listed route on the pharmacy medication label?
5. Right Time- does the times or frequencies listed on the MAR coincide with the times and frequencies listed on the pharmacy medication label. Are you about to give this medication in the desired time frame. Remember if medication is listed on the MAR to be given at 8am - you have an hour window on either side. In this example the medication could be administered to the client anywhere between 7am and 9am- unless there are orders or directions for a more specific time frame.
3 Checkpoints!
When preparing a medication - the CRMA must complete these first five checks or rights- at least three times before administering the medication to the client. There are three checkpoints during the preparation process.
1. When you pull the medication from the supply area - This is the first checkpoint for completing the five checks.
2. When you are pouring the mediation into a delivery cup or container - This is the second checkpoint for completing the five checks.
3. Before you return the medication to the supply area, or before you administer the medication to the client - This is the third checkpoint for completing the five checks.
Checking is not over
though!
Before you administer the medication to the client, you must return to the first check - identifying the right client. Instead of comparing name on the medication label and the MAR, you are going to identify that the medication you are about to give belongs to the client receiving the medication. Always use TWO identifiers: ask the client to identify themselves, double check a photo ID, or check with the clients family member or another staff familiar with the client.
Still not done - now we add the last 3 rights.
1. The right to know. The client has the right to know about the medication that you are administering to them. Be prepared to tell the client what the name of the medication is, why that medication has been specifically ordered, and what some potential side effects might be.
2. The right to refuse. The client has the right to refuse the medication. If the client refuses the medication - follow the agencies policy for medication refusals.
3. The right documentation. The medication administration process is not complete until all of the required
documentation has been completed.
Are there more rights?
Different sources list some additional important client rights.
For example you want to make sure that the client has had the right education on why this particular medication has been ordered. It is also important that you have gathered the right data before administering the medication, such as blood pressure or pulse.
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