PRINCIPLES OF DRUG ADMINISTRATIONI.

There are 10 Rights” of Drug Administration

5 Traditional Rights
1.right client
2.right drug
3..right dose
4.right time5.right route
5 Additional Rights
1.right assessment
2.right documentation
3.client’s right to education
4.right evaluation
5.client’s right to refuse
A.Right Client :Nurse must verify client using two
different identification I.e check ID bracelet & room
number ,have client state his name,etc. The nurse must
find a way to distinguish between 2 client’s with same
last names.
B.Right Drug: This means the patient recieved drug
prescribed by:a.Physician orAdvanced practice registered
nurse (APRN).•Nurse must check medication order is
complete & legible.
 know general purpose or action, dosage & route of
drug
 compare drug card with drug label three times
1. at time of contact with drug bottle/ container
2. before pouring/administering drug
3. after pouring/administering drug.
 Check if patient has any known drug allergy or had
any previous adverse drug reactions.
 Check for any food/drug interactions.
Components of a drug/medication order:
1date & 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 provider’s signature or
name
C.Right Dose: The nurse is responsible for questioning
any dose that is too high or too low.(Always consult
dosage that appears incorrect).use measuring device for
liquid drugs.Dont crush tablet or open capsules unless
directed by a pharmacist.The Nurse must Calculate and
check drug dose accurately.
D.Right Time: Nurse should be familiar with the
abbreviations used for timing medications.
Nurse must :
•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
client’s lifestyle, &activities. & diagnostic procedures.
•Check expiration date.
•Antibiotics shld be administered at even intervals.
E.Right Route
Nurse must :
:•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:Nurse should get baseline data
before drug administration. Asses patient (physical
assessment) and investigations to determine whether
medication is safe and appropriate. If deemed
unsafe,notify ordering physician and document reason
for not administering the medication .
G.Right Documentation:Immediately record appropriate
info
•Name, dose, route,time & date, nurse’s initial or
signature
Client’s response and unexpected reactions to meds.
Use correct abbreviations & symbols.
H.Right to Education:Nurse should inform the patient
on :
•therapeutic purpose
•side-effects
•diet restrictions or requirements
•skill of administration
•laboratory monitoring
Principle of Informed Consent
I.Right Evaluation
client’s response to meds,effectiveness extent of side-
effects or any adverse reactions.
J.Right to Refuse
Nurse must do:
•determine, when possible, reason for refusal.
•facilitate pt’s compliance.
•explain risk for refusing meds & reinforce the reason for
medication.
•Refusal shld be documented immediately.
•Head nurse or health care provider shld be informed
when omission pose threat to patient.
Patient should signed whenever he/she is leaving against
medical advice (LAMA).
MEDICATION ERRORS
Medication errors are preventable events that can lead
to inappropriate medication use or patient harm. They
can occur at any stage of the medication process:
prescribing, ordering, transcribing, dispensing,
administering, and monitoring. Common causes include
similar drug names, illegible handwriting, workload
pressures, and poor communication among healthcare
providers and patients.
TYPES OF MEDICATIONS ERROR
Medication errors can occur at various stages of the
medication process. Here are some examples:

1. **Prescribing Errors**: Incorrect drug selection based

on allergies or inappropriate dosages, such as prescribing
a medication without checking for allergies
2. **Administration Errors**: Administering the wrong
drug or incorrect dosage, like giving Pcm instead of
Promethazine during a procedure
3. **Omission Errors**: Failing to administer a scheduled
dose or forgetting to specify maximum daily doses for "as
needed" medications
4. **Wrong Time Errors**: Administering medication
outside its scheduled time
5. **Improper Preparation**: Incorrectly diluting or
reconstituting medications
ETC
Behaviors to Avoid During Medication Administration:
•Do not be distracted when preparing meds.
•Do not give drugs poured by others.
•Do not pour drugs from containers whose labels are
partially removed or have fallen off.
•Do not transfer drugs from one container to another.
•Do not pour drugs into the hand.
•Do not give expired medications.
•Do not guess about drugs & drug doses. Ask when in
doubt.
•Do not use drugs that have sediment, are discolored, or
are cloudy (& shld not be).
•Do not leave medications by the bedside or with
visitors.
•Do not leave prepared medications out of sight.
•Do not give drugs if the px says he has allergies to the
drug or drug group.
•Do not call the px’s name as the sole means of
identification.
•Do not give drug if the client states the drug is different
from drug he has been receiving. Check the order.
•Do not recap needles. Use universal precautions.