Table 5. The 10 ‘R’s for safe multidisciplinary drug administration
To reduce distractions, consider protected time, the use of a bright tabard or the use of a visual
reminder (such as ‘do not disturb’), communicating to others that you are not to be interrupted
Before administration
The ten ‘R’s Consider the following:
1 Right patient ■ Has this patient been prescribed the drug?
■ Has the patient’s name band been checked? Is there a clear
patient identifier?
■ Does the patient know they are receiving the drug and why?
Before administration
2 Right drug ■ Do you know where to obtain the drug? Are all drugs in one
location and are they clearly labelled?
■ Is this the drug that has been prescribed? Is there a drug with
a similar name?
■ If appropriate, has the drug been checked by another nurse
or health professional?
During preparation
3 Right dosage ■ Is the dose appropriate or usual for the drug being prescribed?
■ If appropriate, has the dose or calculation been checked by
another nurse or health professional?
4 Right time ■ Has the time gap between each drug administration been
adequate, sufficient, too short or too long?
5 Right route ■ Is the route appropriate for the drug being prescribed?
6 Right to refuse
(patient and nurse)
■ Are you able to exercise your clinical judgement and refuse to
give or omit the drug? Do you have a rationale for this and are
you able to demonstrate or explain this to others?
■ Do you know what action to take if the patient refuses the
prescribed medication?
■ Can you identify the barriers to medication administration
and identify suitable approaches to address them (dysphagia
or confusion, for example)?
Immediately before
administration
7 Right knowledge ■ Do you know what monitoring is required prior to administration?
■ Do you know how to prepare and administer the medication in
line with local policies?
■ Do you know the preferences of the patient?
■ Do you understand the pharmacokinetics, pharmacodynamics,
action, possible interactions, side-effects, expected positive
outcome(s), and/or the possible occurrence of adverse effects
(toxicity), or overdose of the drug(s) you are administering?
■ Do you understand the law related to the particular drug(s)?
8 Right questions
or challenges
■ Is this the right prescription, appropriate drug(s) for the patient’s
condition(s)? Is the prescription written correctly and clearly, with
clear unambiguous instructions?
■ Can the writing be easily read?
■ Can you communicate with other professionals if needed?
■ Is there access to available resources (drug formularies and/or
product information leaflets)?
9 Right advice ■ Does the patient know about the drug? If not, can you give the
patient advice/details/information about this/these medication(s)?
After administration
10 Right response
or outcome
■ Do you know the expected response/outcomes of the drug?
■ Do you know how to observe/check for allergic reactions, drug
interaction(s), side-effects and call for assistance?
■ Do you know how and when to complete records of administration
in line with local policy and document any changes?
Table 5. The 10 ‘R’s for safe multidisciplinary drug administrationTo reduce distractions, consider protected time, the use of a bright tabard or the use of a visualreminder (such as ‘do not disturb’), communicating to others that you are not to be interruptedBefore administrationThe ten ‘R’s Consider the following:1 Right patient ■ Has this patient been prescribed the drug?■ Has the patient’s name band been checked? Is there a clearpatient identifier?■ Does the patient know they are receiving the drug and why?Before administration2 Right drug ■ Do you know where to obtain the drug? Are all drugs in onelocation and are they clearly labelled?■ Is this the drug that has been prescribed? Is there a drug witha similar name?■ If appropriate, has the drug been checked by another nurseor health professional?During preparation3 Right dosage ■ Is the dose appropriate or usual for the drug being prescribed?■ If appropriate, has the dose or calculation been checked byanother nurse or health professional?4 Right time ■ Has the time gap between each drug administration beenadequate, sufficient, too short or too long?5 Right route ■ Is the route appropriate for the drug being prescribed?6 Right to refuse(patient and nurse)■ Are you able to exercise your clinical judgement and refuse togive or omit the drug? Do you have a rationale for this and areyou able to demonstrate or explain this to others?■ Do you know what action to take if the patient refuses theprescribed medication?■ Can you identify the barriers to medication administrationand identify suitable approaches to address them (dysphagiaor confusion, for example)?Immediately beforeadministration7 Right knowledge ■ Do you know what monitoring is required prior to administration?■ Do you know how to prepare and administer the medication inline with local policies?■ Do you know the preferences of the patient?■ Do you understand the pharmacokinetics, pharmacodynamics,action, possible interactions, side-effects, expected positiveoutcome(s), and/or the possible occurrence of adverse effects(toxicity), or overdose of the drug(s) you are administering?■ Do you understand the law related to the particular drug(s)?8 Right questionsor challenges■ Is this the right prescription, appropriate drug(s) for the patient’scondition(s)? Is the prescription written correctly and clearly, withclear unambiguous instructions?■ Can the writing be easily read?■ Can you communicate with other professionals if needed?■ Is there access to available resources (drug formularies and/orproduct information leaflets)?9 Right advice ■ Does the patient know about the drug? If not, can you give thepatient advice/details/information about this/these medication(s)?After administration10 Right responseor outcome■ Do you know the expected response/outcomes of the drug?■ Do you know how to observe/check for allergic reactions, druginteraction(s), side-effects and call for assistance?■ Do you know how and when to complete records of administrationin line with local policy and document any changes?
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