Safety should be the first thing on your mind with medications. There is always a risk of giving the wrong pill, the wrong dose, or the wrong person’s medication. If this happens, harm to the person can occur and some reactions can be deadly.

When it comes to patient safety, review following basics and increase your awareness.

1.    Right patient
2.    Right drug
3.    Right dose
4.    Right route
5.    Right time
6.    Right documentation
7.    Right diagnosis
8.    Right response
 
 
THE RIGHT PATIENT
To make sure that the right patient is receiving any drug that has been prescribed, The Joint Commission (TJC) recommends checking two unique patients identifiers ( name and birth date) before medication administration. An alert and oriented patient can be asked directly. If the patient is confused, hard of hearing, unconscious, or otherwise unable to reply, wash your hands first and then check the name, birth date, and identification number on his or her wristband. If a patient does not have an identification wristband, have one made and place it on his or her wrist. As an added safety measure, be sure to check the medication administration record (MAR) and the label on the patients medication box with the wristband. 
 
THE RIGHT DRUG
Each drug that is prescribed has a particular intended action. You must be sure that the drug being given is correct. Carefully compare the drug you are about to administrate with the drug order. Be sure to give the drug in the form ordered by the prescriber (e.g,. pill, capsule, liquid). Thousands of drugs are available today, and many of their names are similar that they can be confusing. Be aware of these easily confused drug names. For more information about them, see “Confusing Drug Name Lists”.
 
THE RIGHT DOSE, ROUTE, AND TIME
A prescribers drug order should be in written form and include all the minimum information required by the U.S government. Verbal orders should accept it only in emergency situations. As soon as the emergency has been resolve, verbal orders should be written and signed. Contact the prescriber whenever a drug order seems unclear or if a drug dosage id higher or lower than expected. For safety, when you contact the prescriber by telephone or follow a verbal order, be sure to write the order, read it back, and ask for confirmation that what you wrote is correct before administering any drug. Be sure to document that you read back the order to the prescriber.
 
THE RIGHT DOCUMENTATION
When you give a drug, record the action immediately. This is essential for all drugs, but it is especially important for drugs given on an as-needed (PRN) basis. Many pain-relieving drugs are prescribed to be given as needed. These drugs often require 20 to 30 minutes to take effect. If you fail to document giving one of this drugs, a patient may request and received a second dose from another health professional. When a patient is receiving a narcotic (opioid) pain drug, a second dose can cause complications such as decrease respiratory rate. Documenting that a drug has been given may prevent another health care professional from mistakenly repeating the dose. 
 
THE RIGHT DIAGNOSIS
Before giving a drug, you must be familiar with the patient’s medical diagnosis. The diagnosis should match the purpose of the drug. Ig the diagnosis does not match its purpose, question the prescription.
You should also check any related laboratory test before giving a drug. For example, if a patient’s diagnosis is digitalis toxicity, be sure to check the digitalis level before giving the drug. If the drug you are giving may cause adverse effects on a major body organ, be sure to check laboratory values related to that organ. For example, before giving an aminoglycoside drug such as gentamicin, you should be sure to check kidney function test results such as creatinine and blood urea nitrogen (BUN). 
Many drugs affect blood pressure, heart rate, or respiratory rate. Be sure to check a patient’s vital signs before giving these drugs. If the patient’s vital signs are outside of the normal limits, you should hold the drug and notify the prescriber. Be sure to check the patient’s vital signs after giving the drug.
 
THE RIGHT RESPONSE
After you give a drug, check the patient to make sure that the drug has the desired effect. For example, check the blood pressure for improvement after giving an antihypertensive drug. Be sure to document what you monitored and any other appropriate interventions. 
 
THE RIGHT TO REFUSE
A patient has the right to refused any drug. Be sure that he or she understand why the drug has been prescribed and the consequences of refusing to take it. When a patient refuses to take a drug, document the refusal, including the fact that the patient understands what may happen if the drug is not taken.
 
Confusing Drug Name List
FOSAMAX (alendronate) for osteoporosis                SINGULAIR (Montelukast) for asthma
FLOMAX (tamsulosin) for enlarged prostate           SINEQUAN (doxepin) for depression 
LAMICTAL (lamotrigine) for epilepsy                       and anxiety
LAMISIL (terbinafine) for fingernail fungus              XANAX (alprazolam) for anxiety
OXYCONTIN (oxycodone) for pain                         ZANTAC (ranitidine) for heartburn
Distropan (OXYBUTYNIN) for urinary incontinence       and ulcers