Six Rights of Medication Administration

Definition

The Six Rights (sometimes extended to Ten) are standardized verification steps nurses must complete before administering any medication. They are a cornerstone of medication safety.

The Six Rights

• Right Patient: Verify using two identifiers (name, date of birth, medical record number). Do NOT use room number.
• Right Medication: Check the label three times (when retrieving, when preparing, at bedside). Verify against the MAR.
• Right Dose: Calculate carefully. Double-check high-alert medications (insulin, heparin, opioids).
• Right Route: Verify oral, IV, IM, SubQ, topical, etc. Never substitute routes without order.
• Right Time: Administer within facility window (typically 30 minutes before or after scheduled time). For time-critical meds (antibiotics, anticoagulants), stricter.
• Right Documentation: Record immediately after administration, not before. Include dose, route, time, site, and patient response.

Additional Rights (Ten Rights)

• Right Reason: Understand why the medication is ordered.
• Right Response: Evaluate therapeutic effect.
• Right to Refuse: Respect patient's informed refusal; notify provider.
• Right Education: Teach the patient about the medication.

High-Alert Medications

Require two-nurse verification: insulin, heparin/anticoagulants, opioids (PCA), chemotherapy, concentrated electrolytes (KCl, NaCl hypertonic).

NCLEX Relevance

Medication errors are a top nursing liability topic. The Six Rights appear in multiple client needs categories, especially Safety and Pharmacology.