Nine Rights of Medication Administration

When I was in nursing school, we learned about five rights of medication administration. However, as time goes, there are more and more “rights” added and today I want to discuss “nine” important rights about medication administration. The first five are the oldest ones.
1. Right patient: Always start with the correct patient. Use two patient identifiers like full name and birth date.
2. Right medication: Check the order, medication label and expiry date.
3. Right dose: Again, check the order, calculate correctly. See if there are any contraindications or limits on how much dose the patent can safely take
4. Right route: Is this a PO medication for a patient who is NPO? Is it an IV medication which you cannot give through peripheral IV?
5. Right time: What is the frequency? Is it time? When was the last dose?
6. Right documentation : With electronic charting, it is very easy to simply “click” on the wrong patient chart and enter a dose. This also include, lab values, vital signs, blood sugar etc which should accompany the medication documentation as required.
7. Right reason: Is there a right reason for this patient to get this medication? Look for patient past/present history.
8. Right response : Evaluate the patient for effectiveness of the medicine. Monitor parameters as required.
9. Right to Refuse: Autonomy is an ethical principle we should follow. Make sure the patient clearly understands about the medication and its use and side effects etc. If a competent patient decide not to take it after explanations, make it an informed refusal.

There we go : The NINE rights of medication Administration.