Question about the 6 rights of medication administration?

[Lucidity]

I just had my first test. There was a question on it that my classmates and I are debating about. It asked which medication administration error would least likely result in being fatal or something like that. Options were: right route, right documentation, right dose, right drug.

I picked documentation. Others picked route.

For most questions I was just able to look up but I am not sure about this one and can't find the answer anywhere. What do you think?

[CT Pixie, BSN, RN]

I was going to say documentation also, just saw the OP came back and let us know it was.

[Stephalump]

Well, I would have to vote for documentation for the reasons already mentioned.

However, I don't really understand the point of the question. Wrong route probably has more potential than wrong documentation to be fatal, but wrong documentation can lead to something fatal (e.g. 'doubling up' on a medication dosage) while wrong route is not always fatal (for example, is giving 2 mg morphine IM rather than IV likely to be fatal? probably not). The issue is that these are all probable and each of the rights, if missed, could be fatal or could be no big deal. It seems to me that this question on serves to try and maximize certain rights an minimize others; yet all the rights are, in my book, equally important.

I found the question a bit odd, too. It's possible it was just intended to get you thinking about the possible consequences of each medication error. There wasn't necessarily some overarching take home message there.

[KelRN215, BSN, RN]

documentation was the correct answer

I hope that your teacher shared examples like we provided of wrong route being fatal so that your classmates who chose that answer could understand how important "right route" is.

[Clovery]

Thanks for posting the answer! I've been thinking about this question for a few days now, and was meaning to come back here and change my mind (originally I thought "route"). But for a fatal error to occur with documentation, it requires two errors to occur, not just one. For example, if a dose of morphine is given but not documented, another nurse would have to come along and also make the error of not assessing the patient before giving an "extra" dose. Two consecutive mistakes are less likely to occur than one... anyway that's my rationale.

Glad you got it right :)

[Devochka]

I think that the question is a stupid question. In the real world, you're not going to be sitting there asking which would be the most fatal and the rationale. Any have the potential of fatality, and all can be equally argued. You have no way of knowing what the writer of the question had in mind when they wrote the question.

[psu_213, BSN, RN]

If someone is killed by a 'wrong documentation' error, I'm sure the family of the deceased will be comforted by know that the nurses too precautions to avoid a more fatal 'wrong route' error.

I came in to work one night at my first job. I was told of a situation during the day about one of my patients for the night. Nurse A was at lunch. Pt rang for pain meds. Nurse B, who was covering nurse A for lunch, gave the pt. oxycodone as ordered. When nurse A came out of the lunch room less than 30 minutes later, the pt was ringing. The pt said they were still in pain. Nurse A checked the chart....Nurse B's dose of oxycodone had not been charted yet. She gave the pt another dose of the oxy. The pt was pretty sleepy the rest of the day, but there were no other effects (i.e. not fatal), but the situation could have been fatal.

A wrong route example...a doctor ordered a certain med IV. It is only a topical powder. The pharmacy at our hospital does not usually carry the drug, but for some reason they had it in the pharmacy (I was not involved in the error, so I don't know the exact circumstances). Pharmacy sent up the med...it was labelled "topical use only." The nurse reread the order, called the doctor who confirmed IV. Nurse reconstituted and gave IV. Evidently the med causes cardiac arrest if given IV. Not sure the final outcome, but definitely had high potential to be fatal.