The 10 ‘R's of safe multidisciplinary drug administration

Abstract

Nurses are responsible for medication administration, and, as with many other nursing interventions, some risk is involved. If an error occurs, a patient may suffer harm or injury, which may lead to a permanent disability or a fatality. To ensure safe drug administration, nurses are encouraged to follow the five rights ('R's; patient, drug, route, time and dose) of medication administration to prevent errors in administration. The five 'R's do not consider all causes of drug errors; instead, they focus on medication administration at the bedside so they relate only to this stage of a drug prescription. A drug's journey is more than what happens at the bedside; therefore, the reduction of errors requires more than just the five 'R's. This article proposes a multi-professional, evidence-based approach to medicines management, which all clinicians can work towards, together. Clinicians can achieve this approach by considering the National Patients Safety Agency's definition of a medication error and the values set out by the National Prescribing Centre. The approach utilizes 10 'R's, which provide a benchmark for good practice. The 10 'Rs' advocate the need for the knowledge of the causes of drug errors, how to implement strategies to reduce drug errors, how to ensure safe practice throughout the medication journey, from chemical preparation, to monitoring outcomes, to response.

Nurses’ rights of medication administration: Including authority with accountability and responsibility

“…To that end, the initial five rights have morphed to be many, though there is little consensus about what the additional rights should be. Various other proposed rights include the Right to Refuse, Right Knowledge, Right Questions, Right Challenges, Right Reason, Right Advice, Right Education, Right Preparation, Right Assessment Data, Right Documentation, Right Frequency, Right History, Right Drug Approach, Right Drug–Drug Interaction, Right Evaluation, Right Information, and Right Response or Outcome . The focus of these rights remains largely on the individual nurse and his/her performance and responsibilities.…”

“…To that end, the initial five rights have morphed to be many, though there is Response or Outcome. [1][2][3][4] The focus of these rights remains largely on the individual nurse and his/her performance and responsibilities.…”

Reducing Medication Errors in the OR

“…Discussion about appropriate medication administration varies. Some sources state that medication should be administered to the patient according to five basic “rights” (ie, the right patient, right medication, right dose, right route, right time) 5‐7 . One source cites more rights, expanding the list to include the right of refusal, right knowledge, right questions or challenges, right advice, and right response or outcome 6 .…”

“…Some sources state that medication should be administered to the patient according to five basic “rights” (ie, the right patient, right medication, right dose, right route, right time) 5‐7 . One source cites more rights, expanding the list to include the right of refusal, right knowledge, right questions or challenges, right advice, and right response or outcome 6 . Another source suggests changing the model to include greater consideration of the patient and the nature of the administration system, and recognizing that medication administration is a task that involves many components 5 .…”

Medication Administration Error and Associated Factors among Nurses in Referral Hospitals, Amhara region, Ethiopia, 2019

“…It can also affect human relationships and threaten trust in the healthcare system as a whole (4,5). Errors in medication administration can occur through failures in any of the ten rights which are right patient, right medication, right time, right dose, right route, right education/advice, right to refuse, right assessment, right evaluation/response and documentation (8,9).…”