Is it "5 rights" or "6 rights"?

Nursing Students Student Assist

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Specializes in ED.

Hi. From browsing on here I've noticed you all speak of the "5 rights". I have been trying to review for school this fall in between studying for finals. My med book says "6 rights". Did they add one?

I believe they are:

Right drug

Right dose

Right route

Right patient

Right time

Right documentation

Please tell me If I messed that up. I'm just now starting to learn all of that, and i'd rather know if I am wrong. I've only looked at it a couple of time, so it could very well be flawed.

Specializes in Intensive Care Unit.

Alot of texts leave out documentation as the 6th right. The five that are usually used are the other 5 you mentioned :)

Specializes in ED.
Alot of texts leave out documentation as the 6th right. The five that are usually used are the other 5 you mentioned :)

Did I put them in the right order, or does that matter?

At my school they taught us that there are 7 rights, which is," the right to refuse ", is included It's in our texts books as well. I guess it just depends on where you go and what book you're using. To my understanding they don't have to be in order. The test question that was always given to us was, " name the 7 rights ", not to put them in order.

Specializes in ED.
At my school they taught us that there are 7 rights, which is," the right to refuse ", is included It's in our texts books as well. I guess it just depends on where you go and what book you're using. To my understanding they don't have to be in order. The test question that was always given to us was, " name the 7 rights ", not to put them in order.

The right to refuse was listed separately. I'll go back and look at it. But it was mentioned. Thanks for reminding me of that. Obviously I'll know what they want me to go by when I start in august, I just like to have a head start lol :)

I saw ten rights somewhere once. I think if you remember the seven listed you will be fine. From antiquity, it started with five, then the others were added.

Well, at the school I attended they were 7 rights but, they constantly reminded us that they are a lot more and the list is still growing. For us it was theRight ptRight drugRight doseRight routeRight time or frecuencyRight documentationRight responseI guess every place has its own way to teach this.

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

According to Joint Commission, the AHRQ (Agency for Healthcare Research and Quality ), the INI:The Five Rights of Medication Administration (Institute for healthcare Improvement)and ISMP:Institute For Safe Medication Practices (Institute for Safe Medication Practices) there are "% rights" that are accepted as the standard of care and the bare minimum. However a school/facility wish to expand on that theory/concept is their "right". I get frustrated:madface: with instructors/schools/facilities putting their own spin on these quality measures trying to "make it their own" because it defeated the purpose of having one page for every one to refer to.....therefore minimizing errors.

The "Official" 5 rights........

The Five Rights:

The "Five Rights"—administering the Right Medication, in the Right Dose, at the Right Time, by the Right Route, to the Right Patient—are the cornerstone of traditional nursing teaching about safe medication practice.

While the Five Rights represent goals of safe medication administration, they contain no procedural detail, and thus may inadvertently perpetuate the traditional focus on individual performance rather than system improvement. Procedures for ensuring each of the Five Rights must take into account human factor and systems design issues (such as workload, ambient distractions, poor lighting, problems with wristbands, ineffective double check protocols, etc.) that can threaten or undermine even the most conscientious efforts to comply with the Five Rights. In the end, the Five Rights remain an important goal for safe medication practice, but one that may give the illusion of safety if not supported by strong policies and procedures, a system organized around modern principles of patient safety, and a robust safety culture.

AHRQ Patient Safety Network

Using Barcode Medication Administration to Improve Quality and Safety: Findings from the AHRQ Health IT Portfolio

While the 5 rights is the industries standard it does not prevent med errors but adding more rights isn't effective either.

http://www.ismp.org/Newsletters/nursing/Issues/NurseAdviseERR200707.pdf

It’s been 8 years since we've written about the shortcomings of relying on the five rights of medication use in this newsletter (The “five rights,” April 7, 1999). When we first brought our views to readers, we stressed that the five rights are not the “be all that ends all” in medication safety. 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.

For the basic beginning of safety..... the right drug to the right patient in the right dose by the right route at the right time.

Specializes in ED.
According to Joint Commission, the AHRQ (Agency for Healthcare Research and Quality ), the INI:The Five Rights of Medication Administration (Institute for healthcare Improvement)and ISMP:Institute For Safe Medication Practices (Institute for Safe Medication Practices) there are "% rights" that are accepted as the standard of care and the bare minimum. However a school/facility wish to expand on that theory/concept is their "right". I get frustrated:madface: with instructors/schools/facilities putting their own spin on these quality measures trying to "make it their own" because it defeated the purpose of having one page for every one to refer to.....therefore minimizing errors.

The "Official" 5 rights........

AHRQ Patient Safety Network

Using Barcode Medication Administration to Improve Quality and Safety: Findings from the AHRQ Health IT Portfolio

While the 5 rights is the industries standard it does not prevent med errors but adding more rights isn't effective either.

http://www.ismp.org/Newsletters/nursing/Issues/NurseAdviseERR200707.pdf

For the basic beginning of safety..... the right drug to the right patient in the right dose by the right route at the right time.

Wow! Thanks Esme!! :-)

I've actually seen up to 10 rights, but as others have said, the "official" 5 are the five listed plus documentation as the most common additional right. There's a list of the "10" rights in this article (which is admittedly not the most scientific, but I don't have time to search for the various references where I've seen each of the additional, less common rights mentioned).

And if you want to simplify it: Do your job of administering meds correctly. If you've done it correctly, you have followed the "rights".

Specializes in ED.

Thanks, everyone! :-)

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