Rights of medication administration

5 traditional rights of medication administration:

1. Right Patient

2. Right Drug

3. Right Dose

4. Right Route

5. Right Time

 

1. Right Patient

For health care providers:

Properly identify the patient. The medication should be prescribed and administered to the right patient.

• Verify the patient's full name (the first name and surname), ID, Registration No, Room No (Inpatient)
• Verify name with patient.
• Make sure the right patient's name written on the medication labels.

Before giving medication, patient should be assessed. (for eg. Blood Pressure? Pulse Rate? Fever? Difficulty in  swallowing food or liquid? Nausea? Pain? etc...)

For patients:

• Make sure the right patient's name stated on the medication labels.
• Medicine should not be shared with others.
  
• Medicine should be stored out of reach of children or pets.
  

2. Right Medication

 

For health care providers:

• Medication must be prescribed by the registered practitioner.
• Check whether right medication is given and administered to the right patient. 
• Prior to the drug administration: Diagnosis and investigation results should be referred to.  Contraindication and Precautions in certain patient group should be considered. Drug and Food interactions should also be looked into. Risk against benefit should be properly weighed.
• The medicine's name, strength and dosage form should be written on the prescription and medicine's container/label. 

For patients:

• Know the name (generic and/or brand) of all the medicines prescribed to you. Not identify the medicine by just its colour or shape or purpose! It's best to have and keep the patient medication record card  (if  any) with you.
• Know what medicine are used for and know the expected side effects after taking the medicine.
• If getting a new or unfamiliar medicine, verify with the doctor or pharmacist.
• When prescription is refilled, if the medicine does not look the same as previous, ask the pharmacist if it is a different brand.
• Check the medicine name, strength and dosage form on the medicine's label/container. Make sure the right medicine is dispensed to you.
• Read the instruction on the label and leaflet carefully before administering the medicine.  If necessary, put on your eyeglasses and turn on the lights to read the label. If you don't understand the instruction, consult with your doctor or pharmacist.
• Check the ingredient list of the medicine/supplements (if any) if you are allergy to any of the ingredient. Inform your doctor immediately if you have any allergy or adverse drug reaction to any of the medication.

3. Right Dose

For health care providers:

• Right dose should be prescribed and administered for the right patient.
• Check, calculate accurately and give a right dose to patient especially for pediatric, geriatric, patient with certain illness such as liver failure, renal failure etc.
• Double checking must be done before and after administering the medicine to patient.
• If the drug is withhold or the dose is adjusted, do the notification.
• Prescription must comply with the related rules and regulations.
• A clear drug name, dosage, strength, frequency and duration of the treatment must be written on prescription.
• Explain to patient on the how to administer the drug, drug dosage, frequency and duration of treatment.

For patients: 

• Read the direction on the medicine label and leaflet carefully. If in doubt, contact your doctor or pharmacist. 

• Always follow the direction on the medicine label as prescribed by your doctor.
• For liquid, use the syringe/measuring cup/spoon  rather than the household spoon.

4. Right Route 

For health care providers: 

• Confirm the route of administration especially for the new drug. Always refer to the reliable drug information.
• Confirm the route, the dosage and also assess ability and suitability before administering medicine to patient.
• Use aseptic technique when administering the medicine to patient.
• Explain to patient on proper way to administer the medicine.

For patients:

• Read the medicine label and leaflet properly. If in doubt, consult your doctor or pharmacist.
• Know the proper way to administer the medicine.

5. Right Time

 For health care providers: 

• Must order and administer the medicine to patient at the right time.
• Explain to patient on the right drug administration time and duration of treatment.
• For oral, explain to patient whether to take the medicine with or without food and tell patient what to avoid when taking the medication.
  

For patients: 

• Follow properly the instruction on the medicine label or leaflet as prescribed by your doctor.
• Administer the medicine at the right time, same time each day.
• Know what to do if a dose is missed.
• Know if the medicine will interact with food/beverage or other medicines.

Another additional rights of medication administration:

6. Right Assessment

For health care providers:

• Patient should be assessed properly and accurately before administering the medicine to patient.
• Before administering the medication to patient, patient should be assessed properly. (for eg Blood pressure? Pulse Rate? Blood Sugar? Fever? Difficulty in swallowing food or liquid? Nausea? Pain? Pregnant? Breast Feeding? etc...)
• Assess for any risks of taking the medication or risks of medication withdrawal.
• The possible benefits against the possible risks must be weighed.

For patients: 

• Consult your doctor or pharmacist before administering any medicine.
• For hypertension, for eg. regularly check your blood pressure.
• For diabetic, for eg. regularly check your blood sugar.
• Immediately inform your doctor or pharmacist if you experience any adverse effects after taking a medicine.
• Inform your doctor if you have any other illnesses.
• Inform your doctor if you have any allergy to medication etc.
• Inform your doctor if you are pregnant or breast feeding.

7. Right Documentation

For health care providers:

• Immediately record appropriate info for eg dose, route, time and date of administration, initial and signature, any notification, amendment, any drug refusal/withdrawal/with hold.
• Use correct abbreviation and symbols.
• Record patient's response to the medication.
• Record in the right document for the right patient.
• The record must be right and accurate.
  

For patients: 

• If required by physician, for patient self monitoring, the record of eg blood pressure/blood sugar level, the dose and timing of the medication, must be recorded/kept in the right document.
• The results/records must be recorded accurately.
• If the patient needs to sign the informed consent, he/she must understand the contents and sign the consent form first before the medicine is administered to the patient.
  

8. Right to Patient Education 

For health care providers:

• Inform patient on the medication's name, its therapeutic purpose, side effects and adverse drug reactions,  precautions, diet restrictions/requirements, skill of medicine administration, route, dosage, frequency, duration of treatment etc.
• Inform patient if they need to do laboratory monitoring or other monitoring/investigation.
• Explain on the principle of informed consent.
• Explain the risks that the patient might encounter when refuse to administer the medication or withdraw from the treatment.
• Provide counseling and give patient information leaflet to patient.

For patients: 

• Patients have the rights to know on the medications they are taking. 
• They have the rights to know the medication name not just the medication purpose!
• The have the rights to know why they are taking the medicine, what are the effects that they should expect after taking the medication, what they should do when they experience the effects.
• They have the rights to know the best treatment available to them.
• The have to know whether and when they need to do the laboratory monitoring and other monitoring.
  

9. Right of Patient to Refuse

For health care providers:

• Explain to patients that they have rights to refuse the medication and explain the withdrawal procedure.
• Explain to patients the risks or what they might encounter by not having taking the medication or by withdrawing from the treatment. 
• Determine when possible the reason for refusal.
• Reinforce the reason for medication. 
• If the patients still refuse to administer the medication, proper documentation should be done and physician should be notified immediately.
• Assess for possible risks/threats to patients when the treatment is omitted.

For patients: 

• Patients have the rights to refuse to administer the medication without giving the reason for refusal.
• However, they must know the risks that they might encounter when not taking the medication.
• Must know the reason for medication.

10. Right Evaluation 

For health care providers:

• Must regularly evaluate and review patient's condition/response after administering the medication to patient.
• Check whether the medication gives positive or negative effects to the patient.
• Evaluate the laboratory monitoring and other monitoring results.
• Review medication/treatment.
• Evaluate the effectiveness of the drug regimen.
• Report any adverse drug reactions immediately.

 For patients:

• Inform doctor or pharmacist immediately if experience any unexpected adverse drug reactions.
• Consult the doctor or pharmacist if have any doubts.

11. Right expiration date

For health care providers:

• Check the expiration date of the medicine before administer or dispense the medicine.
• Do not give the expired medicine to patient.
• Inform the patient on the storage condition of the medicine.
• The expiry date must have on the medicine's label/container.

For patients:

• Check the expiration date of the medication before administering it.
• Store the medicine as directed.
• Do not administer the expired or damaged medicine.

12. Right to Reason

For health care providers:

•  Explain the reason why the patient has to administer the medication.
• If medication fails to be administered for some reason or the medication is omitted/refused for some reason, document/record when possible.
  

For patients:

• Patients have the rights to know the reason they are taking the medication.
• If possible, inform the health care providers the reason the medication omitted/failed to be administered.