The headlines on medication errors are numerous. “Hospital Medication Error Kills Patient in Oregon,” is one such headline whereby a patient died from being given the wrong medication. Not all medication errors result in death, but over 700,000 emergency department visits annually are attributed to adverse drug events or injuries resulting from the use of medications according to the Centers for Disease Control and Prevention.
It is for this reason that nursing and patient education pertaining to medication safety is extremely important. Before noting the solutions, it is important to gain a solid understanding of the federal regulations governing the medication administration. The federal regulations pertaining to the safety of medication administration can be found in the state operations manual of the Centers for Medicare and Medicaid Services, which notes that any personnel administering medications must confirm the following prior to each administration:
1. The identity of the patient
Acceptable patient identifiers include but are not limited to: the patient’s full name, an identification number assigned by the hospital, or date of birth. Identifiers must be confirmed by the patient’s wrist band, patient statement (when possible), or other means outlined in the institution’s policy. The patient’s identification must be confirmed to be in agreement with the medication administration record or treatment administration record and medication labeling prior to medication administration to ensure that the medication is being given to the correct patient.
2. The correct medication
Make sure that the medication being administered to the patient matches the prescription for that patient. Similar sounding medications, such as Aciphex and Aricept, or Adderall and Inderal, can easily result in dire consequences for all involved.
3. The correct dosage
Verify that the medication matches the prescribed dose, and that the prescription itself does not reflect an unsafe dosage level (i.e., a dose that is too high or too low).
4. The correct route
This ensures that the method of administration including orally, intramuscular, intravenous, etc., is the appropriate one for that particular medication and patient.
5. The appropriate time
This ensures adherence to the prescribed frequency and time of administration.
These are often referred to as the five rights of medication administration, but a sixth right is often noted as the “right documentation.” Many nurses may consider the five rights as somewhat elementary, but they are certainly not. Other than a prescriber or dispenser error, numerous medication errors result from a breach in the one of these five rights. It is for all these reasons that medication safety truly matters, and it is important for nurses to become familiar with various strategies to prevent or reduce the likelihood of medication errors.