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Nurses have an integral role in medication management and the imperative responsibility of administering medications safely. Achieving safe medication administration involves complex and multifaceted processes, far surpassing the universal framework of the seminal five rights of medication administration (Martyn et al., 2019). Nurses must apply sound clinical reasoning and judgment to determine the safest strategies for administering medications (Solberg et al., 2022). The standardized rights of medication administration, as well as essential questions nurses must consider during the process, are explored in this article. The importance of using evidence throughout decision making is highlighted, and considerations for withholding medications are linked through discussion.
Rights of Medication Administration
For decades, the five rights for administering medications have been a recognized safety standard (Martyn et al., 2019). The framework of the seminal five rights (i.e., right patient, drug, dose, time, route) has evolved, and other rights considered as additional influences on medication administration processes have been identified in changing healthcare environments (MacDowell et al., 2021). A literature review by Martyn and coauthors (2019) reflected one to seven rights being added (inconsistently) to the seminal five.
The rights framework has a crucial role in medication administration yet is not an independent entity for achieving safety. Nursing responsibilities associated with administering medications reach beyond adherence to the standardized guidelines (Hanson & Haddad, 2022; MacDowell et al., 2021; Martyn et al., 2019; Solberg et al., 2022). Nurses must "assess patients and situations, apply foundational knowledge, plan and administer medications, evaluate patients' responses to medications and teach patients about taking their medications safely" (Rohde & Domm, 2018, p. e403). Essential actions to achieve safe, quality outcomes involve clinical reasoning and judgment focused on patients' individualized needs (Bucknall et al., 2019; Solberg et al., 2022). Nurses often must adapt processes to meet unique patient needs or overcome barriers during medication administration. The solution may not be addressed through use of the standardized step-by-step process, requiring nurses to use critical thinking, problem-solving skills, additional resources, and clinical collaboration with interprofessional team members (Bucknall et al., 2019; Martyn et al., 2019). Table 1 lists 10 rights of medication administration and associated questions nurses must consider as clinical reasoning and judgment are applied.
Use of Evidence
A mainstay in nursing practice is the use of...