Ensuring Accuracy in Medication Selection

The first and foremost right is the Right medication. It involves verifying that the medication being administered is indeed the correct one. Healthcare providers must be vigilant to prevent errors caused by look-alike and sound-alike medication names. These similarities can lead to confusion and result in administering the wrong medication. Thoroughly cross-referencing medication names and consulting resources like The National Pharmacy Associations  list of look-alike/sound-alike drugs can help prevent such errors.

Confirming the Recipient

Before administering any medication, healthcare professionals must positively identify the patient. This includes checking the patient's identification with 3 positive patient indentifiers. Even if the healthcare provider is familiar with the patient, verifying their identity is crucial to prevent mix-ups.

Accurate Dosage Delivery

Checking the medication administration sheet and/or the prescription  is vital to ensure the correct dosage is administered. Pay attention to differences between adult and paediatric doses, and be meticulous in measuring and calculating dosages to prevent under or over-administration.

Administering via the Correct Route

A medication administration route is often classified by the location at which the drug is applied, such as oral or intravenous. The choice of routes depends not only on convenience but also on the drug's properties and pharmacokinetics. It is crucial to understand the characteristics of the various routes and associated techniques. Common routes include:

• Oral Route
• Sublingual Route
• Buccal Route
• Intravenous Route
• Intramuscular Route
• Subcutaneous Route
• Inhalation Route
• Nasal Route
• Rectal Route
• Vaginal Route
• Cutaneous Route
• Otic Route
• Ocular Route
• Transdermal Route

Confirming the correct route of administration prevents potentially harmful effects and ensures optimal drug absorption.

Timing is Key

Adhering to the prescribed schedule is crucial to maintaining consistent therapeutic levels of the medication. Check when the medication should be given and ensure it aligns with the patient's last dose. This helps prevent missed or extra doses.

Also consider if it is a 'time sensitive' medication. Some medicines need to be given at a certain time to make sure they are safe or work effectively.

Examples of these include:

• Medicines that should be given before or after food
• medicines containing paracetamol
• Medicines prescribed to help mobility for people with Parkinson’s disease
• Medicines that should be taken at the same time each day to maximise their effectiveness. For example, warfarin, oral contraception, antibiotics, insulin.

Ensure that the medication results in the intended outcome. If pain relief  medication was administered, has the patient's pain subsided? Do you notice a reduction in allergy symptoms after giving an antihistamine? Record your observations of the patient's progress and any additional actions taken.

Accurate Record-Keeping

Accurate and timely documentation is essential for effective care and legal compliance. Record the administration time, dose, route, and any other relevant information on the medication chart or electronic health record.

Patient Autonomy

Patients have the right to be informed about their medications and their potential effects. Explain the purpose, benefits, and potential risks of the medication, and respect the patient's decision if they choose to refuse it after a thorough discussion.Ensure any refusal of medication has been documented thoroughly. 

Empowering Patients

Provide patients with clear and concise information about the medication they are taking. Explain the expected therapeutic effects, potential side effects, and any specific instructions for administration or monitoring.

Understanding the Patient

Whenever medication is administered, the individual responsible for its administration must ensure that the medication is being dispensed for its intended purpose (for instance, using Ibuprofen for muscle aches, administering an inhaler for an asthma exacerbation). 

Referencing the care plan or  support plans for relevant symptoms can provide assurance that the medication is being administered appropriately. 

It is also essential to remain vigilant and prioritise patient safety, as exemplified by this shocking incident involving a nurse misusing Oramorph to silence patients, which serves as a sobering reminder of the critical importance of responsible medication administration.