Medication Rights and Three Checkpoint Verification
Key Points
- Five core rights are right patient, right drug, right route, right time, and right dose.
- Additional safety rights include right reason, right documentation, and right response.
- Core rights are verified at three checkpoints: obtaining, preparing, and bedside administration.
- BCMA supports rights verification and can generate high-risk alerts before administration.
Equipment
- MAR and active medication order access
- Patient identifiers (armband and verbal confirmation when possible)
- Medication labels and dosage-calculation support
- BCMA scanner and workstation access
Procedure Steps
- Confirm right patient using at least two identifiers and never use room number as an identifier.
- At medication retrieval, compare label to order for right drug, right dose, right route, and right time.
- During preparation, repeat label-order comparison and verify expiration date and allergy status.
- At bedside, complete the third rights check before administration.
- Confirm right reason by linking medication mechanism to the current indication.
- Use BCMA scanning of patient armband and medication label to reinforce rights verification.
- Administer medication only when all rights checks are satisfied and no unresolved alert remains.
- Complete right documentation immediately after administration and record required details.
- Assess right response by evaluating if the desired effect occurred and document findings.
Common Errors
- Skipping one of the three checkpoints → increased wrong-patient or wrong-drug risk.
- Proceeding after unresolved BCMA or allergy alert → preventable adverse-event risk.
- Incomplete right-reason review → medication given without indication clarity.
- Delayed documentation and response reassessment → poor continuity and missed deterioration.
Related
- medication-administration-documentation-and-reassessment - Covers right documentation and right response in detail.
- oral-medication-administration-safety - Applies route-specific administration checks.
- intravenous-medication-administration-safety - Adds high-alert safeguards for IV delivery.