APRN Leadership Implementing Medication Rights

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nurse holding medication

Advanced practice registered nurses (APRNs) play a vital role in medication safety, stopping mistakes before they happen. Using the “rights” of medication administration, APRNs and staff nurses prepare and administer medications to patients utilizing basic safety practices. The rights of medication administration serve as a checklist for patient safety.

The nurse’s role in medication safety also extends beyond patient care. Precautionary measures when administering medications helps develop a culture of safety and supports APRNs, including family nurse practitioners (FNPs), to work within their scope of practice.

“Administering medication is not just a task but has many essential components that can affect patient safety,” Kim Maryniak, MSN, said in “The Value of Responsible Medication Administration” on RN.com. “Nurses are encouraged to take time with medication administration to ensure that the proper steps are done, with a focus, as always, on safe practices.”

As hospitals and medical centers face an increasing number of patients due to the aging population, APRNs must be more diligent than ever to stop medication management mistakes. A vital component of medication safety is earning an advanced nursing degree, including an online master’s in nursing, to provide the best care possible.

Medication Errors and Rights

The rights of medication administration were developed after the Institute of Medicine (IOM), in its 1999 “To Err Is Human: Building a Safer Health System” report, found that medication-related errors accounted for 7,000 deaths annually. In subsequent reports, the IOM, now called the National Academy of Medicine, emphasized the importance of reducing medication errors.

Initially, nurses were taught five rights that focused broadly on safety. Over the years, nursing associations, hospitals and medical practices have expanded the rights. To use the rights properly, nurses are encouraged to run a mental checklist of the rights before administering medications.

Common medication-administration rights include:

Right patient

The patient’s identity (birthdate and name) aligns with the medication orders.

Right medication

The names of the medication correspond with the medication orders. Ensure that the medication has been stored property and within its expiration date. Ask the patient if there are any known allergies to the ingredients in the medication.

Right dose

The dosage being administered meets the prescription orders exactly.

Right route

The way the medication is to be administered matches the prescription orders.

Right time

The medication is being administered at the correct time intervals.

Right documentation

The details about the medication, including the patient’s reaction, route and dosage given, is documented.

Right reason

The medication being administered aligns with the patient’s condition.

Right response

The patient has an appropriate response to the medication.

Right to refuse

Patients have the right to refuse any medication.

Right education

Patients should be educated about the types of medication prescribed and possible reactions.

Joan M. Robinson, MSN, also encourages nurses to follow additional safety precautions when administering medications. In “Medication Safety: Go beyond the basics” published in Lippincott NursingCenter, Robinson said nurses must be familiar with the medications they administer and follow safeguards.

Reducing Medication Errors

Robinson said the route to reducing errors begins with limiting distractions and interruptions.

“Know that interruptions and distractions have a marked effect on your performance, causing a lack of attention, forgetfulness and errors,” she said.

Robinson recommended these suggestions to help nurse leaders facilitate safe medication disbursements:

  • Remind staff nurses that they should make sure they have all the necessary supplies and documentation before starting rounds.
  • Create or enforce utilization of no-interruption zones (NIZs), which allow nurses to perform medical tasks free from distractions. The NIZ can be a dedicated room or a sectioned-off area.
  • Consider instituting a wearable indicator, such as a vest, apron, sash or lighted lanyard, that shows a staff nurse is administering medications and should not be disturbed.
  • Modify work schedules to minimize nurse fatigue and stress to prevent disbursement errors.
  • Ensure that all nurses are familiar with antidotes, reversal agents and rescue agents in the event of an emergency.
  • Pay attention to Tall Man lettering, a visual indicator that highlights sections of drug names that may, at a glance, appear similar. For example: BuPROPion (an antidepressant) vs. BusPIRone (an anxiolytic).

In addition, Minority Nurse suggests healthcare facilities develop a name alert system that prevents patients with similar sounding names from receiving the wrong medication.

“Names such as Johnson and Johnston can lead to easy confusion on the part of nursing staff, so it is for this reason that name alerts posted in front of the (medication administration record) can prevent medication errors,” Minority Nurse said in “10 Strategies for Preventing Medication Errors.”

Other Considerations for Preventing Medication Errors

Minority Nurse also stated that nurses should implement a medication reconciliation program for patients transferring between medical units or facilities. The program would ensure a patient’s medication history travels with them to reduce the risk of over- or under-dosing.

Overarching the many suggestions for medication safety is the need for quality nurse leaders who can help staff nurses accurately distribute medications. For RNs who are wondering why get a masters in nursing, the answer is clear: nurse leaders spearhead changes that promote positive patient outcomes.

At Duquesne University, online master’s in nursing students learn the essential components of nursing leadership, including the nurse role in medication safety.

About Duquesne University’s Online Master of Science in Nursing (MSN) Programs

Duquesne University’s online MSN and online Post-Master’s Certificate programs prepare RNs for roles in nursing leadership. Students learn from professionals who have clinical experience and broad knowledge of healthcare. Students can choose from three areas of specialization in nursing: Family (Individual Across the Lifespan) Nurse Practitioner, Forensic Nursing and Nursing Education and Faculty Role.

The programs meet the standards set by the National Organization of Nurse Practitioner Faculty (NONPF) and also prepares students to pursue testing for FNP certification.

Several national leaders for educational excellence have recognized Duquesne University, including U.S. News & World Report (2017 Best Online Graduate Nursing Programs), the National League of Nurses (Center for Excellence in Nursing Education), and The Princeton Review (Best 380 Colleges). For more information, contact a Duquesne University advisor today.



The Value of Responsible Medication Administration: RN.com

Chapter 37 Medication Administration Safety: Patient Safety and Quality: An Evidence-Based Handbook for Nurses

Medication Safety: Go beyond the basics: Lippincott NursingCenter

10 Strategies for Preventing Medication Errors: Minority Nurse

Medication Error Prevention for Healthcare Providers: Medscape