Nurses’ use of the five rights of medication administration in a comprehensive care unit: a best practice implementation project

INTRODUCTION: The "five rights" of medication administration are used by nurses daily to prevent patient medication errors. The five rights of medication administration are the right patient, drug, route, dose, and time. In the United States alone, between 7,000 and 9,000 medication administration errors occur annually. Internationally, medication errors are a leading cause of injury and harm. OBJECTIVES: This project aimed to improve compliance with medication administration rights in a comprehensive care unit among nurses in the acute care hospital setting. METHODS: This project was conducted using an audit and feedback strategy, as recommended by the JBI Evidence Implementation Framework. Included in the project was the use of the JBI Practical Application of Clinical Evidence System (PACES) for pre- and post-audit data analysis and the JBI Getting Research into Practice (GRiP) approach to identify barriers, strategies, and outcomes. The project identified eight best practice criteria for medication administration to be used by nurses, including the five rights. After the baseline audit, barriers were identified, and educational interventions were implemented to improve adherence to best practices. A follow-up audit was conducted, and the results of both audits were compared. RESULTS: In the baseline audit, two of the eight criteria, including checking the expiry date of medication and verbal identification of patient identifiers, were found to have lower adherence. Nursing staff education and visual reminders were implemented. A post-implementation audit was conducted, showing improved compliance with medication administration best practices. CONCLUSIONS: Staff education and visual reminders for best practices improved adherence to the five rights of medication administration. Annual competency training to reinforce best practices will prevent the incidence of medication errors, thereby maintaining quality and safety in patient care. SPANISH ABSTRACT: http://links.lww.com/IJEBH/A321.