Why is adherence to 6 rights of medication administration important in nursing
practice? What are the risks involved in not following this practice?
Discuss your approved project question including background and rationale for choice
Find- five (5) journal articles related specifically to your approved question and provide
a synopsis of your understanding of these articles. These articles MUST be either peer-
reviewed primary research journal articles or systematic reviews. (400 words)
Whilst on placement take some time to critically observe the practices in your clinical
area, in relation to your question, and record your findings. Critical observation can
include: discussion, dialogue with clinicians in your area of speciality and/or
observation of practice in other areas.
Discuss your observations in light of your readings. (400 words)
REPORT FORMAT ESSAY 2
Background and rationale of choice
The six rights of medication administration that are of great significance in the nursing
practice are; the right to the right drug, right frequency, right dose, right patient, administration,and
right regimen. Nurses play an important function in the health care industry. The patients’
lives rely heavily on the proper functioning of the nurses. Errors have occurred severally
during the various stages of medication (prescribing, documenting, dispensing and
administering) prompting for intervention by the stakeholders. Mistakes by these
professionals can result in detrimental consequences for the patients. The six rights of
medication administration are designed to reduce the errors, focusing on an improved
personal performance while dealing with patients. Due to the problem mentioned above, I
have chosen to investigate whether nurses followed the advocated six rights of medication
Franklin, N. (2011). Identifying medication documentation errors using
handwritten versus pre-printed ICU flowcharts. Sydney, Australia.
The research paper seeks to identify whether the use of pre-printed ICU
flowcharts resulted in a reduction in the number of medication documentation errors.
The audit results demonstrated no significant difference between the use of handwritten
ICU flow charts compared to using pre-printed ICU flowcharts. Although the
difference is not as significant, the text insists on the need to follow the six rights of
medication for better health care.
Griffiths, M. (2013). Nursing Standard. Medicines Management, 28(1), 29.
This paper aims to examine the prevalence of all care left undone by nurses.
Low nurse staffing levels in health care institutions is associated with worse patients’
REPORT FORMAT ESSAY 3
outcomes. Increased workloads to the nurses reduce the competency levels and quality
of work. Lack of maximal concentration is also evident in these cases, and the medical
staff can wrongly administer medications. The text emphasizes on the use of the six
rights as a way of ensuring no work is left undone by the nurses.
Hayes, C., Jackson, D., Davidson, P. M., & Powet, T. (2015). Medication
errors in hospitals: a literature review of disruptions to nursing practice during
drug administration. Journal of Clinical Nursing, 24(21), 14.
The study focuses on exploring the known facts about the distractions on the
medical administration, especially by the undergraduate students. Although some
interruptions are unavoidable, interruptions in the medical management process more
so to the nurses is a substantial safety concern in the healthcare setting. There is,
therefore, need to reduce these interruptions significantly. Since interruptions cannot be
eliminated, the text emphasizes to educate nurses on how to safely and confidently
manage the interruptions. The paper elaborates on the need to reduce interruptions in
the workflow for better implementation of the rights of medication by the nurses.
Hewitt, J., Tower, M., & Latimer, S. (2015, January). An education
intervention to improve nursing students’ understanding of medication safety.
Disaster Management Nursing Education, Nurse Education in Practice, 15(1), pp.
The paper identifies medication safety as a significant issue in the health
industry. Medication events and associated errors result to system failure and further
medical complications. Medication administration involves coordination of various
medical staff; team factors, therefore, play a significant role in the quality of Medicare
provided to the patients. Management design includes decisions by a multidisciplinary
REPORT FORMAT ESSAY 4
team making implementation of various health environment improvement strategies
fail. The paper insists on proper coordination for proper implementation of strategies
meant to insist on application of the rights of medication.
Ramasamy, S., Baysari, M., Lehnbom, E., & Westbrook, J. (2013, August).
Evidence briefing on interventions to improve medication safety. Australian
Commission on the Safety and the Quality in Health Care.
This briefing paper discusses double checking as a strategy of reducing medical
administration errors and in turn, improves the efficiency of health care. Many medical
institutions have strategies to double check, although the lack of explicit definitions
making them is followed inconsistently. Studies insist double checking is a resource-
intensive and better use of resources, coupled with reduced interruptions to work
significantly increases the quality of care. Double checking is a strategy employed in
the six rights to improve the quality of care as emphasized by the paper.
During my placement, I interacted with various nurses every day. Only one of the
nurses followed the six rights of medication administration a case which raised concern. Most
of the nurses did not check the expiry of drugs administered to the patients. The nurses did
not either check patient IDs nor have a medication chat with the patient to establish their ID.
The act was attributed to their prior knowledge of the patients. A more extreme case
witnessed involved a nurse carrying medication of two patients with no labels in them.
Familiarity with patients can bring about complacency in handling patients, underlining the
importance forging the rights of drugs, for a reduction in medication errors (Griffiths, 2013) .
A growing dependence on the medication therapy as the main intervention strategy
for most illnesses, the patients due to receive medications are at an increased risk for harm. In
REPORT FORMAT ESSAY 5
a bid to avoid errors, the nurse has to have a complete and clearly written order drafted by the
physician. The law should incorporate all necessary components the nurse may require.
Concrete and do explicit rules have to be provided and vague dosages avoided. This will
significantly reduce the instances of errors related to dosages and wrong medication to
patients, ensuring a patient is given the relevant drug, and in the right dosage.
Verbal orders from the physician should not be accepted. Although many of the
nurses encountered are aware of this, they choose to ignore it aiming to save time. Writing of
orders for the physicians by the nurses is also not acceptable with this putting the patients at a
significant risk, and consequently risking their nursing license. Nurses should also require
clearly written orders to avoid confusion brought about by drugs with close names. Cefoxitin,
for example, can be easily confused by Cefotetan if not written clearly.
The nurses have a right to have the correct drug route and drug dose provided to them.
Pharmacists are tasked with providing of the right medication. In instances of the wrong drug
being administered, the nurse is supposed to notify the pharmacist for a correction. In cases
where the nurse is required to go and collect the medicine in person, quality time is wasted
putting the patient’s life in jeopardy (Franklin, 2011) . Time wasting in gathering the drugs
necessary to care for the patient puts the nurse under unnecessary pressure to administer the
drugs to the patient on time. In these situations, medication mistakes are likely to happen,
coupled with not giving the patient drugs at the required time.
Nurses have an obligation to have access to the right information. Updated and easily
accessible drug information should be available for the nurses to ensure proper understanding
of the pharmacodynamics. The information is also necessary to help nurses predict the
expected reaction by the patient. A close interaction between nurses and pharmacist is bound
to increase the nurses’ knowledge of medications and consequently, improve the patients’
REPORT FORMAT ESSAY 6
outcomes and reduce the instances of medication errors occurrence (Hayes, Jackson,
Davidson, & Powet, 2015) .
Proper structures are necessary to ensure nurses administer medications properly.
Health care administration is tasked with formulating an efficient system to provide for
optimal working capacities for nurses. Policies for protecting nurses against litigation should
an error occur are necessary to ease pressure on the health care providers in their daily
protocol, ensuring a convenient environment for the nurses.
Since nurses deal directly with the patients, involving them in the shaping of the
system and designing solution for a safe administration of medication would greatly lead to a
more efficient health care system. Observation of potentially harmful situations should
prompt the nurses to speak up and report system glitches. By advocating for a better patient
care system, the nurses also support for a better working condition for them. This ensures a
smooth coordination of activities for better patient care outcomes (Ramasamy, Baysari,
Lehnbom, & Westbrook, 2013) .
Probably the most crucial aspect, when administering medications, nurses should be
in a clear mind to avoid unnecessary mistakes. In a clear mind, one can readily recognize odd
looking orders and ask for clarifications. This is especially crucial when administering
unfamiliar drugs. In this state administering of unsafe medication to the patient is
substantially reduced, avoiding patient poisoning or the potentiality of death.
Giving the patient the correct dosage will reduce the chances of resistance brought
about by incomplete doses. Administering of a drug to the wrong patient can be fatal and
even lead to the death of the patient concerned. Failure to follow the laid down rights of
medication administration by nurses would result in adverse effects to the patient and a
further possibility of death. The rights of medicines, therefore, are applied as an intervention
REPORT FORMAT ESSAY 7
to these medication-related adverse effects related to system failures in the complex process
of drug administration (Hewitt, Tower, & Latimer, 2015) .
Upon discussion with the nurses, they identified setbacks which hindered the flow of
work. Their ideas concerning regulations to be carried out for better patient care were not
considered. Physicians’ failure to comply with given ideas also hindered progress. As a result
improved management intervention to perfect the current system was necessary to bring
about improved patient care.
REPORT FORMAT ESSAY 8
Franklin, N. (2011). Identifying medication documentation errors using handwritten versus
pre-printed ICU flowcharts. Sydney, Australia.
Griffiths, M. (2013). Nursing Standard. Medicines Management, 28(1), 29.
Hayes, C., Jackson, D., Davidson, P. M., & Powet, T. (2015). Medication errors in hospitals:
a literature review of disruptions to nursing practice during medication administration.
Journal of Clinical Nursing, 24(21), 14.
Hewitt, J., Tower, M., & Latimer, S. (2015, January). An education intervention to improve
nursing students’ understanding of medication safety. Disaster Management Nursing
Education, Nurse Education in Practice, 15(1), pp. 17-21.
REPORT FORMAT ESSAY 9
Ramasamy, S., Baysari, M., Lehnbom, E., & Westbrook, J. (2013, August). Evidence
briefing on the interventions to improve medication safety. Australian Commission on
Safety and Quality in Health Care.