Drug administration is an integral part of nursing. Medication errors can be pernicious to patients’ health. Medicines are prescribed by physicians and dispensed by pharmacists but the responsibility of correct administration rests within the scope of nurse practice. Each nurse is individually responsible for their practice. The result of medication errors varies from mild to deadly. But these errors can be widely preventable by strictly maintaining and following the five rights of drug administration- the right patient, the right drug, the right dose, the right route and the right time.
According to the National Coordinating council for medication error prevention and Analysis (NCC MERP), medication error is defined as “any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of a healthcare provider, patient, or consumer”.
As a professional registered nurse, it is my responsibility to keep my patients safe. When caring for patients at the long-term care facility, there might be shifts that you care for 18-22 patients and you are in charge of medication administration for those patients. Few months back I recalled an event when I was working as an evening shift nurse supervisor. I received a call from the floor nurse reporting an incident, a medication error. The floor nurse was preparing medication for the evening rounds but got distracted by a family member who was visiting their father. The nurse had to stop the medication preparation because of this distraction. After the conversion with the family member, the nurse resumed the medication preparation but this time was distracted by a phone call and at the same time the nursing assistant reported to the nurse that one of the resident’s was requesting his pain medication. The nurse while on the phone went to medication cart and pulled out medication what she thought it was for the right patient but instead it was another tablet which had similar packing. The nurse administered the drug without performing the five rights of drug administration. During the shift change, nurse noted a discrepancy in narcotics and then realized the medication was pulled from the wrong cabinet. The incident was reported in our safety portal and the patient was monitored for any adverse effects. This particular incident helped me to realize the importance of following the five rights of drug administration and to avoid any distraction such as phone calls, updating family with resident’s progress during medication rounds.
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