Medication Rights & Safe Administration

The traditional 5 rights — right patient, right drug, right dose, right route, right time — are the minimum safety framework, but current practice recognizes at least 9 rights, adding right documentation, right reason, right response, and right to refuse. Each right is a checkpoint, not a formality. Right patient requires two identifiers (name and date of birth or medical record number) — room number is never an acceptable identifier. Right drug means verifying against the medication administration record (MAR) at three distinct points: when pulling the medication, when preparing it, and at the bedside before giving it. Right dose demands independent calculation verification for high-alert medications (insulin, heparin, opioids, chemotherapy). Right route matters because a drug safe IV may be lethal intrathecally. Right time has a standard administration window of 30 minutes before or after the scheduled time unless facility policy specifies otherwise. Right response means you reassess after administration — pain medication requires a follow-up assessment, typically within 30-60 minutes for oral and 15-30 minutes for IV. If the client refuses, you document the refusal, educate on consequences, and notify the provider — you never force, coerce, or simply skip documentation.