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?