The Fundamentals of Medication Administration

As with anything else in a medical environment, the administration of medicine must be performed as closely to standards as possible for the sake of the patient and practitioner alike. Improper administration can happen for a variety of reasons, any of which could result in serious harm or death and you held culpable. Each patient’s circumstances are different, but these fundamental guidelines are applicable—and should be followed—in any situation as a nurse.

The “Rights” of Medication Administration

A commonly cited list of guidelines for nurses, the “five rights” of medication administration describe the basic aspects of ensuring that medicine is properly administered. These don’t represent a complete set of instructions for medical safety, but rather a set of goals for individual nurses/caretakers to keep in mind while tending to patients. The five rights are given as:

• Right patient
• Right medication
• Right dose
• Right route
• Right time

Sometimes, additional “rights” are listed along with these, such as “right documentation” or “right reason”. However, a nurse’s responsibility is not simply to follow a list of “rights”, but to follow the correct procedure as defined by the organization and to address or report anything—incomplete records, equipment faults, systemic issues, etc.—that interrupts proper care.

Using Medication Administration Records

Medication administration records (MARs), also called drug charts, are included as part of a patient’s medical chart, representing a legal record of the drugs administered to a patient during their stay. Any medical facility needs to have MARs available for each patient. A nursing home MAR may differ slightly in format from an MAR found in a hospital, clinic or urgent care facility, but they all convey the same vital information: the patient’s name, the professional(s) treating them, any known allergies, and prescription details including dosage strength and frequency, route of application, prescribing doctor and a chart for nurses to sign off on when administering the medication. As noted above, while the “five rights” are not the bottom line of medical safety, correctly consulting and filing a patient’s MAR will allow a trained nurse to fulfill them.

Personal and Legal Responsibility

Nurses are obligated to prepare any necessary medications, administer them to the patient as directed and document the completion of the procedure. This includes performing the whole procedure personally—preparing a medication then having another person administer it is strictly inadvisable because it leaves too much room for error and makes all involved personnel culpable in the event that something goes wrong. A nurse that fails to do this and improperly administers medication, or falsifies documentation on such, not only jeopardizes the patient but also their own career.