Your Patient Safety Survival Guide by Gretchen LeFever Watson

Author:Gretchen LeFever Watson [Watson, Gretchen LeFever]
Language: eng
Format: epub
Publisher: Rowman & Littlefield Publishers
Published: 2017-05-23T04:00:00+00:00

The Five Rights of Medication Administration can help catch many of the errors that commonly occur during the medication administration process. However, the Five Rights are intended to be the end goal of the medication process, not the be-all and end-all of medication safety. The Institute for Safe Medication Practices writes this about the Five Rights:

They are merely broadly stated goals, or desired outcomes, of safe medication practices that offer no procedural guidance on how to achieve these goals. Thus, simply holding healthcare practitioners accountable for giving the right drug to the right patient in the right dose by the right route at the right time fails miserably to ensure medication safety. Adding a sixth, seventh, or eighth right (e.g., right reason, right drug formulation, right line attachment) is not the answer, either.47

The Five Rights focus on individual performance and not on human factors and system defects that may make completing the tasks difficult or impossible,48 so the Institute for Safe Medication Practices also warns about the danger of engaging in workarounds, even when they don’t result in bad outcomes:

The healthcare practitioners’ duty is not so much to achieve the five rights, but to follow the procedural rules designed by the organization to produce these outcomes. And if the procedural rules cannot be followed because of system issues, healthcare practitioners also have a duty to report the problem so it can be remedied.49

Of course, it is equally imperative that those with the authority to make the system changes respond when medication workarounds are identified. Otherwise, providers will continue to use them and place patients at risk. After all, most nurses carry intense workloads and employ workarounds because they seem like practical ways to get the job done—not because they intend to cause harm. When nobody listens to real challenges they face, nurses carry on in the best ways they know how—even if it means disregarding some safeguards.

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