Medication Safety and Administration – 5 Rights of Medications & “As Needed” PRN Medications

There are 5 rules/rights to medication administration you must learn before you are able to safely administer to your patient. You must follow these rules each time you give your patient medication throughout the day. * Always ask your patient if they have any medication allergies.

1. Name: Ensure you have the correct first and last name of the patient on the bottle of medication or blister packet. Always ask your patient what their full name and birthdate is. Compare this information with what is written on the medication bottle or blister packet.

2. Medication: Check the medication name to make sure it is the right one due to be given at that time.

3. Dose: Check to make sure it is the right dose. Check to see if you are giving 1 tablet, half a tablet or multiple tablets of the same drug.

4. Time: Check to make sure it is the right time to give the medications. You are able to give medications 30 minutes before or 30 minutes after the scheduled time for when the medication is due. If you are unable to give the medication, document the reason why you were not able to.

5. Route: Ensure you have the right route for medication to be delivered. This could be by mouth (PO), under tongue (SL), nose, ear, transdermal, rectum (PR), subcutaneous (SC), intramuscular (IM), intravenous (IV).

In addition, remember to Document the medication: Always document what time you gave the medication, this will ensure that the patient will not get a double dose or a missed dose. You will be documenting all medications in a Medication Administration Record (MAR). Each patient will have their own MAR in which you will document the time the medication was given, along with your initials.

*Medication Administration Tip: Most patients will tell you if they notice anything unusual with their medications. Listen to them. If they tell you something about their medication such as that it is the wrong color, then do not administer it to them. Any medication discrepancy or questions should be discussed with your supervisor before administering.

Medication Safety – “PRN” “As Needed” Medications

If medications are to be given “As Needed” or “PRN” this means that they are not scheduled to be given at any particular time throughout the day, but can be given when the patient requests it.

Most common “As needed” medications are for pain control. You must abide by the time frame on the bottle before giving any of these medications as it will be clearly outlined how frequent the medication can be given in a day. For example – Tylenol can be given every 4 hours. However, the amount of Tylenol given in a day must not exceed 4 grams in a day. Also, the maximum amount of Tylenol that can be given in a single dose cannot exceed 1 gram. Therefore, you must be documenting and checking how much Tylenol the patient has received in the last 24 hours before giving any subsequent doses. These precautions are listed with all medications to ensure no harm is done. Narcotics – Drugs such as hydromorphone or morphine may also be given on a as needed medication. These medications are controlled medications and must be counted each time one is administered. You will write how many your gave, how many are remaining, the time given and your initials. All this information will be recorded in the Medication Administration Record (MAR).