1.

The Rights of Drug Administration

The Five Plus Five Rights of Drug Administration
5 Traditional Rights
1. Right client
2. Right drug
3. Right dose
4. Right time
5. Right route
5 Additional Rights
1. Right assessment
2. Right documentation
3. Clients right to education
4. Right evaluation
5. Clients right to refuse
A. Right Client
Verify client
Check ID bracelet & room number
Have client state his name
Distinguish between 2 clients with same last names
B. Right Drug
Medication order may be prescribed by:
Physician
Dentist
Podiatrist
Advanced practice registered nurse (APRN)
Components of a drug order:
1. Date & time the order is written
2. Drug name (generic preferred)
3. Drug dosage
4. Frequency & duration of administration
5. Any special instructions for withholding or adjusting dosage
6. Physician or other health care providers signature or name.
7. Signature of licensed practitioner taking.
C. Right Dose
Calculate and check drug dose accurately.
Check PDR, drug package insert or drug handbook for recommended range of specific
drugs.
Heparin, insulin and IV digitalis
Doses with another nurse.
Stock- method vs Unit-dose method

You can calculate using this formula:

Dose you want (mg)
------------------------- x volume on hand = amount (volume in ml)
needed to give
Dose on hand

D.Right Time
Administer drugs at specified times.
Administer drugs that are affected by foods, before meals.
Administer drugs that can irritate stomach, with food.
Drug administration may be adjusted to fit schedule of clients lifestyle, &activities. &
diagnostic procedures.
Check expiration date.
Antibiotics shld be administered at even intervals.
E.Right Route
Assess ability to swallow before giving oral meds.
Do not crush or mix meds in other substances before consultation withphysician or pharmacist
Use aseptic technique when administering drugs.
Administer drug at appropriate sites.
Stay with client until oral drugs have been swallowed.
F.Right Assessment
Get baseline data before drug administration.
G.Right Documentation
Immediately record appropriate info
Name, dose, route,time & date, nurses initial or signature
Clients response:
Narcotics
Analgesics
Antiemetics
Sedatives
Unexpected reactions to meds.
Use correct abbreviations & symbols.
H. Right to Education
Client teaching regarding:
Therapeutic purpose
Side-effects
Diet restrictions or requirements
Skill of administration
Laboratory monitoring
Principle of Informed Consent
I. Right Evaluation
Clients response to meds.
Effectiveness
Extent of side-effects or any adverse reactions.

J.Right to Refuse
Determine, when possible, reason for refusal.
Facilitate patients compliance.
Explain risk for refusing meds & reinforce the reason for medication.
Refusal should be documented immediately.
Head nurse or health care provider should be informed when omission pose threat to patient.