Medication safety during your hospital stay
Five-rights - medication; Medication administration - hospital; Medical errors - medication; Patient safety - medication safety
Medication Safety While You’re in the Hospital
Medication safety means you get the right medicine, the right dose, at the right times. During your hospital stay, your health care team needs to follow many steps to make sure this happens. You can also help ensure that you get the right medicines the right way.
Getting the Right Medicine
All hospitals have a process in place to make sure you get the right medicines. A mistake could cause a problem for you. The process is as follows:
- Your doctor writes an order in your medical record for your medicine. This prescription goes to the hospital pharmacy.
- The hospital pharmacist reads and fills the prescription. The medicine is labeled with the type of medicine and your name, and then sent to your nurse.
- Your nurse reads the prescription label and gives you the medicine. This is called administering the medicine.
- Your nurse and the rest of your health care team monitor (watch) you to see how you respond to the medicine. They watch to make sure the medicine is working. They also look for side effects the medicine could cause.
Filling Your Prescriptions
The pharmacy may receive some prescriptions by computer (electronic) and some that are handwritten. Electronic prescriptions are easier to read than handwritten prescriptions. This means there is less chance of a medicine error with electronic prescriptions.
Your doctor can tell your nurse to write down a prescription for you. Then your nurse can send the prescription to the pharmacy. This is called a verbal order. Your nurse should repeat the prescription back to your doctor to make sure it is right before sending it to the pharmacy.
Your doctor, nurse, and pharmacist will check to make sure any new medicines you receive do not cause a bad reaction with other medicines you are already taking.
The Rights of Medication Administration
The Rights of Medication Administration is a checklist nurses use to make sure you get the right medicine. The rights are as follows:
- Right medicine (Is the right medicine being given?)
- Right dose (Is the amount and strength of the medicine correct?)
- Right patient (Is the medicine being given to the right patient?)
- Right time (Is it the right time to give the medicine?)
- Right route (Is the medicine being given the right way? It may be given by mouth, through a vein, on your skin, or another way.)
- Right documentation (After giving the medicine, did the nurse make a record of it? The time, the route, dose, and other specific information about the medicine should be documented.)
- Right reason (Is the medicine being given for the problem it has been prescribed for?)
- Right response (Is the drug providing the desire effect? For example, after being given a blood pressure drug, does a patient's blood pressure actually go down?)
Tips to Stay Safe
You can help make sure you get the right medicine the right way during your hospital stay by doing the following:
- Tell your nurse and other health care providers about any allergies or side effects you have had to any medicines in the past.
- Make sure your nurse and doctor know all the medicines, supplements, and herbs you were taking before you came to the hospital. Bring a list of all these with you. It is a good idea to keep this list in your wallet and with you at all times.
- While you are in the hospital, do not take medicines you brought from home unless your doctor tells you it is OK. Make sure to tell your nurse if you take your own medicine.
- Ask what each medicine is for. Also ask what side effects to watch for and tell your nurse about.
- Know the names of the medicines you get and what times you should get them in the hospital.
- Ask your nurse to tell you what medicines they are giving you. Keep a list of what medicines you get and what times you got them. Speak up if you think you are getting the wrong medicine or getting a medicine at the wrong time.
- Any container that has medicine in it should have a label with the name of the medicine on it. This includes all syringes, tubes, bags, and pill bottles. If you do not see a label, ask your nurse what the medicine is.
- Ask your nurse if you are taking any high-alert medicine. These are medicines that can cause harm if they are not given the right way, even if they are used for the right purpose. High-alert medicines include blood thinners, insulin, and narcotic pain medicines. Ask what extra safety steps are being taken if you are taking a high-alert medicine.
Maxwell S. Therapeutics and good prescribing. In: Walker BR, ed. Davidson's Principles and Practice of Medicine. 22nd ed. Philadelphia, PA: Elsevier; 2014:chap 2.
Wachter RM. Quality of care and patient safety. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 12.
Reviewed By: Laura J. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.