Before Medication Retrieval – First Checkpoint
Prior to accessing medications from a medication dispensing system (MDS), the nurse should conduct a clinical assessment to determine the appropriateness of the medication. This involves evaluating the patient’s diagnosis, allergies, current clinical condition, and the timing and effects of any previous doses. This step corresponds to the Right Assessment.
Note that some medications may require preparation before administration. Although hospitals may use various types of electronic Medication Administration Records (MARs) and MDS hardware, the core safety principles remain consistent across systems.
Step 1: General Preparation
Begin by performing hand hygiene. Wash hands with soap and water for at least 20 seconds, applying friction to all surfaces. If hands are not visibly soiled, an alcohol-based hand sanitizer may be used instead.
Step 2: First Safety Check – Medication Preparation Area
Access the patient’s electronic health record and open the MAR. Identify the medications due for administration, such as acetaminophen 800 mg every six hours as needed.
Next, log into the MDS and select the correct patient. Confirm the patient's identity by comparing the name displayed in the MDS with the MAR. This confirms the Right Patient.
Navigate to the medication list by selecting “remove meds.” Choose the intended medication and confirm the selection. Press “remove now” and follow on-screen instructions or flashing lights to locate the correct drawer. Retrieve the medication from the designated bin.
Compare the following details:
Once verified, close the drawer and log out of the MDS.
Step 3: Medication Preparation
Prepare the medication according to institutional protocols and best practices specific to the route of administration. Refer to the companion videos in this series for detailed techniques on preparing medications for different routes.
Step 4: Second Safety Check – Pre-Administration
With the labeled medication in hand, verify the following against the MAR on the screen:
Step 5: Final Safety Check – At the Bedside
Upon entering the patient’s room, verify the patient’s identity using two identifiers—full name and date of birth—and match these with the ID band. Log into the electronic health record and review the MAR.
With the medication ready, confirm the following:
Then provide a brief explanation of the medication’s purpose, expected effects, and potential side effects—fulfilling the Right Education. Ask the patient for permission to proceed, respecting their Right to Refuse.
After administration, observe the patient for therapeutic effects or adverse reactions to ensure the Right Evaluation. Promptly document the administration details, including time, dose, route, and any observations, satisfying the Right Documentation.
Note: Actual medication administration and patient monitoring will be covered in a separate video. This segment focuses solely on the acquisition and preparation phase within the Ten Rights framework, in line with current best practices.
According to the landmark 1999 Institute of Medicine report To Err is Human: Building a Safer Health System, medication errors are a leading cause of preventable harm and death in hospitals. To mitigate these errors and enhance patient safety, nurses must consistently adhere to the Ten Rights of medication administration. These include the right patient, right medication, right dose, right time, right route, right documentation, right education, right to refuse, right assessment, and right evaluation.
This video focuses on the acquisition phase of medication administration. It demonstrates how to apply the Ten Rights framework across three critical safety checkpoints: before, during, and after retrieving medications.
Before Medication Retrieval – First Checkpoint
Prior to accessing medications from a medication dispensing system (MDS), the nurse should conduct a clinical assessment to determine the appropriateness of the medication. This involves evaluating the patient’s diagnosis, allergies, current clinical condition, and the timing and effects of any previous doses. This step corresponds to the Right Assessment.
Note that some medications may require preparation before administration. Although hospitals may use various types of electronic Medication Administration Records (MARs) and MDS hardware, the core safety principles remain consistent across systems.
Step 1: General Preparation
Begin by performing hand hygiene. Wash hands with soap and water for at least 20 seconds, applying friction to all surfaces. If hands are not visibly soiled, an alcohol-based hand sanitizer may be used instead.
Step 2: First Safety Check – Medication Preparation Area
Access the patient’s electronic health record and open the MAR. Identify the medications due for administration, such as acetaminophen 800 mg every six hours as needed.
Next, log into the MDS and select the correct patient. Confirm the patient's identity by comparing the name displayed in the MDS with the MAR. This confirms the Right Patient.
Navigate to the medication list by selecting “remove meds.” Choose the intended medication and confirm the selection. Press “remove now” and follow on-screen instructions or flashing lights to locate the correct drawer. Retrieve the medication from the designated bin.
Compare the following details:
Once verified, close the drawer and log out of the MDS.
Step 3: Medication Preparation
Prepare the medication according to institutional protocols and best practices specific to the route of administration. Refer to the companion videos in this series for detailed techniques on preparing medications for different routes.
Step 4: Second Safety Check – Pre-Administration
With the labeled medication in hand, verify the following against the MAR on the screen:
Step 5: Final Safety Check – At the Bedside
Upon entering the patient’s room, verify the patient’s identity using two identifiers—full name and date of birth—and match these with the ID band. Log into the electronic health record and review the MAR.
With the medication ready, confirm the following:
Then provide a brief explanation of the medication’s purpose, expected effects, and potential side effects—fulfilling the Right Education. Ask the patient for permission to proceed, respecting their Right to Refuse.
After administration, observe the patient for therapeutic effects or adverse reactions to ensure the Right Evaluation. Promptly document the administration details, including time, dose, route, and any observations, satisfying the Right Documentation.
Note: Actual medication administration and patient monitoring will be covered in a separate video. This segment focuses solely on the acquisition and preparation phase within the Ten Rights framework, in line with current best practices.
Before Medication Retrieval – First Checkpoint
Prior to accessing medications from a medication dispensing system (MDS), the nurse should conduct a clinical assessment to determine the appropriateness of the medication. This involves evaluating the patient’s diagnosis, allergies, current clinical condition, and the timing and effects of any previous doses. This step corresponds to the Right Assessment.
Note that some medications may require preparation before administration. Although hospitals may use various types of electronic Medication Administration Records (MARs) and MDS hardware, the core safety principles remain consistent across systems.
Step 1: General Preparation
Begin by performing hand hygiene. Wash hands with soap and water for at least 20 seconds, applying friction to all surfaces. If hands are not visibly soiled, an alcohol-based hand sanitizer may be used instead.
Step 2: First Safety Check – Medication Preparation Area
Access the patient’s electronic health record and open the MAR. Identify the medications due for administration, such as acetaminophen 800 mg every six hours as needed.
Next, log into the MDS and select the correct patient. Confirm the patient's identity by comparing the name displayed in the MDS with the MAR. This confirms the Right Patient.
Navigate to the medication list by selecting “remove meds.” Choose the intended medication and confirm the selection. Press “remove now” and follow on-screen instructions or flashing lights to locate the correct drawer. Retrieve the medication from the designated bin.
Compare the following details:
Once verified, close the drawer and log out of the MDS.
Step 3: Medication Preparation
Prepare the medication according to institutional protocols and best practices specific to the route of administration. Refer to the companion videos in this series for detailed techniques on preparing medications for different routes.
Step 4: Second Safety Check – Pre-Administration
With the labeled medication in hand, verify the following against the MAR on the screen:
Step 5: Final Safety Check – At the Bedside
Upon entering the patient’s room, verify the patient’s identity using two identifiers—full name and date of birth—and match these with the ID band. Log into the electronic health record and review the MAR.
With the medication ready, confirm the following:
Then provide a brief explanation of the medication’s purpose, expected effects, and potential side effects—fulfilling the Right Education. Ask the patient for permission to proceed, respecting their Right to Refuse.
After administration, observe the patient for therapeutic effects or adverse reactions to ensure the Right Evaluation. Promptly document the administration details, including time, dose, route, and any observations, satisfying the Right Documentation.
Note: Actual medication administration and patient monitoring will be covered in a separate video. This segment focuses solely on the acquisition and preparation phase within the Ten Rights framework, in line with current best practices.
Acquiring medication from a medication dispensing device and administering it involves using the ten "rights" of medication safety at 3 different safety checkpoints. The first safety check that includes the ten "rights" occurs after acquiring the MAR and entering the medication dispensing device. The second safety check occurs after the medication has been removed and prepared according to best practices and facility protocols. At each safety checkpoint, the medication is verified with the patient's e...
Chapters in this video
0:00
Overview
1:04
The Three Safety Checkpoints
6:54
Summary
Videos from this collection: