The 7 Rights of Administration, Patient Rights, and Routes of Administration (Nursing)

00:04 Welcome to med administration.

00:06 So, first of all, you're gonna think, "This is a really daunting task.

00:10 It's like pushing pills." So, first of all, that is not the case.

00:14 There's so many caveats that's really important for us as a nurse to consider because it 100 percent affects patient's safety.

00:22 So, one thing I always like to tell students is anybody can give a medication.

00:28 I can give someone a Tylenol.

00:30 I can give someone a sucker for example, give someone a piece of candy.

00:34 But we administer medications and there's so many pieces about that and we're gonna talk about those shortly. So, you're going to see this a lot.

00:44 This is called the seven rights of medication administration.

00:48 Now, here's the deal. This is taught a couple of different ways.

00:51 You're gonna hear really commonly the five rights of medication administration.

00:57 So, know there's lots of different changes that's gonna come to this because medication administration is so very important for patient safety.

01:06 So, number one, you're gonna hear five rights which includes right medication, right dose, right patient, right route, and right time. That's the basis.

01:17 But as you see here, we've expanded on that, talking about the seven rights.

01:21 Two other rights to keep in mind are the right indication or purpose and also documenting that correctly.

01:29 Alright, so, let's go through these. So, the first one is right medication.

01:34 This seems like a no brainer, right? But one thing you'll hear your nursing instructor say is there's a lot of look alike, sound alike drugs.

01:41 There's a lot of drug names out there. There's a lot of medications.

01:45 So, it's really important to make sure that we have the right medication.

01:50 Alright, so, next is dose. Something to keep in mind.

01:54 Dose makes such a difference in a patient's treatment.

01:57 So, we can definitely under-dose a patient.

01:59 We can also overdose a patient that can definitely turn into really poor patient outcomes.

02:05 So, right dose is really vital. The other thing to consider is right patient.

02:11 Again, it seems so simple but you can imagine, these are so many John Brown's, John Smith for example, and also, a lot of times, when you're taking care of patients, you are taking care of at least one, maybe two, even up to seven patients at a time.

02:28 So, making sure you're giving the medications to the right person is huge.

02:34 And right route is something else to consider.

02:37 So, every medication has a particular way that it's given the best or administered or absorbed by the body.

02:44 So, we have to really consider this for a patient.

02:46 We also have to think about alternative routes if a patient can't take a drug in a particular prescribed way.

02:53 Next is time. So, the time of medication is really important, especially in those things like antibiotics for example or a cholesterol reducing drug.

03:03 Many times, people forget about cholesterol reducing drugs are really best practice is to do it in the evening time because your absorption slows and you're gonna hold on to that cholesterol reducer much longer.

03:17 So, right time is also important. Now, let's talk about indication.

03:21 So, with right indication for example, you can have a drug that has multiple uses.

03:26 As a nurse, we need to think about, "Okay, why is my patient taking this drug?" According to their history or their present illness.

03:35 So, this could vary and drugs have multiple uses, so, we need to consider that so we can evaluate what kind of effect it should have.

03:44 Alright, lastly, let's talk about right documentation.

03:47 So, this is really important that we document the med correctly.

03:51 We also need to know if they refused it, if they've gotten the medication.

03:56 Because the healthcare provider may need to know, is the patient compliant with treatment? The other thing to consider is when you're talking about documentation for example.

04:05 Let's talk about a pain pill when we give a pain medication.

04:10 We don't wanna just say, "Check, we've given that drug." It's really important that we document the time, excuse me, that we've given that drug, what the pain rating is, meaning, how severe was the pain at the time we gave that medication? Also, the quality of the pain, maybe the location, what the characteristic, the reason why it's so important to document that, if I evaluate that pain medication effectiveness later, I need to see, did it go from all the way up to severe pain to really low level pain, did it get better? And, so, we need this documentation to be able to evaluate that.

04:52 When we're talking about giving medications, keep in mind that your patients have rights about giving -- getting those medications themselves.

05:00 So, first of all, we can't just say, "Here you go, have a pill, have a nice day." Right? They need to know what they're taking.

05:07 They need to know what kind of drug it is, what they should look for, the potential side effects.

05:12 Here's the reason why we like to do that.

05:14 Is if I just give a patient a medication, maybe it's a really important cardiac pill.

05:19 They will not know that, let's say they run out at home, that how important that drug is.

05:24 So, education and informing them about the med is so very important.

05:29 They also have the right to refuse the med.

05:32 So, sometimes, we need to communicate with or excuse me, all the time, we need to communicate with the patient about the type of med they're getting and the patient may decide, "No, I don't want that for whatever reason." So, it's important at this point as nurses to educate the patient about the benefits of that drug but always remember, we don't get to force that upon the patient.

05:54 The patient needs to be a part of our treatment plan and they need to have that decision making right.

05:59 Next, let's talk about to have a medication history completed.

06:03 So, the reason why this is important, many times a patient comes into the hospital, they're on a lot of maintenance type of medications to keep maybe their blood pressure under control, their cholesterol under control, maybe mood stabilizing drugs.

06:18 If we don't complete a thorough medication history and get that information from the patient, then, a lot of the times, there are other comorbidities or other illnesses may not be supported when we're taking care of them.

06:32 Let's talk about also if we're giving a drug, some sort of -- some drugs can be part of a research study or maybe an experimental trial. So, the wonderful thing about nursing, there's lots of new evidence and lots of new research and new, evolving medications and new evolving treatments.

06:51 But if the patient is involved in this, it is definitely their right to know and our privilege and our right to inform them.

06:59 So, next, anytime we give a patient a drug, it's really important that we have them properly labelled and packaged.

07:06 So, think about if you went to the pharmacy and picked up your prescription and they just gave you the drug with a sticker that says the name.

07:13 You're gonna forget, "When do I take it? How often do I take it? What dose is this?" So, you can see how that would lead to incompliance and maybe not the patient getting the full benefit of the med.

07:25 So, proper labelling and packaging is really important as well.

07:29 It's also important for patients to have the right to get appropriate supportive therapy.

07:34 Sometimes this is not always medications.

07:37 Sometimes it's medications or even the effects of the medications that we need to help the patient treat -- feel their best.

07:44 Sometimes those meds can also not make them feel very, very good.

07:48 So, we also need to support the patient and make sure they're feeling their best and they're treatment compliant as much as possible.

07:55 Lastly, let's talk about unnecessary medications.

08:00 So, it's very easy as us as healthcare providers to administer a med to try to fix a problem maybe or an illness that the patient has.

08:09 But that's not always necessarily the best thing for our patients.

08:13 If a patient's on multiple meds, there's more opportunity for interactions to occur and side effects to occur.

08:21 So, when we're talking about medication administration, there are several different routes of how we give that medicine.

08:28 Now, it could be as simple as oral medication where they take a pill for example or swallow something or it could be topical or transdermal.

08:37 So, a topic medication's gonna look a lot like, "Oh, maybe a cream or a lotion." And then, we can talk about transdermal.

08:46 Both of these go on the skin but a transdermal for example is usually going to be a slow-release medication patch that goes on a patient.

08:54 Now, with transdermal for example, a nicotine patch is a common one.

08:59 Next, you may have inhalation is a different route of medication administration.

09:04 These most of the time look like inhalers.

09:06 It could be a maintenance inhaler for asthma or even a rescue breathing inhaler.

09:11 Then, we have medications that go in our eyes for ocular or eye drops for example.

09:16 We also have otic medications that go in the ear.

09:21 And lastly, parenteral medications are gonna be really common that you give.

09:25 These are gonna look like your injectables such as your intramuscular or your IV medications.

09:30 A couple of routes that you don't see on here are vaginal and rectal but these are gonna be addressed later cuz these are really less common.

09:37 So, the ones that you see here on this slide are really the most common types of routes of administration you're gonna use.