Medication safety during your hospital stay

Getting the Right Medicine

All hospitals have a process to make sure you get the right medicines. A mistake could cause a problem for you. This is the order of the steps in the process:

• Your doctor writes an order for medicine for you in your medical record. This prescription goes to the hospital pharmacy.
• The hospital pharmacist reads and fills the prescription. The medicine is labeled with the type of medicine and your name, and then sent to your nurse.
• Your nurse reads the prescription label and gives you the medicine. This is called “administering” the medicine.
• Your nurse and the rest of your health care team monitor (watch) you to see how you respond to the medicine. They will watch to make sure the medicine is working. They will also look for side effects the medicine could cause.

Filling Your Prescriptions

The pharmacy may receive some prescriptions by computer (electronic) and some handwritten ones. Electronic ones are easier to read than handwritten ones. This means there is less chance of a medicine error from electronic prescriptions.

Your doctor can tell your nurse to write down a prescription for medicine for you. Then your nurse can send the prescription to the pharmacy. This is called a “verbal order.” Your nurse should repeat the prescription back to your doctor to make sure it is right before sending it to the pharmacy.

Your doctor, nurse, and pharmacist will check to make sure any new medicines you receive will not cause a bad reaction with other medicines you are already taking.

The 5 Rights of Medicine

The 5 rights of medicine are a checklist nurses use to make sure you get the right medicine. The 5 rights are the:

• Right medicine (Is the right medicine being given?)
• Right dose (Is the amount and strength of the medicine correct?)
• Right patient (Is the medicine being given to the right patient?)
• Right time (Is it the right time to give the medicine?)
• Right route (Is the medicine being given the right way? It may be given by mouth, through a vein, on your skin, or another way.)

Tips to Stay Safe

You can help make sure you get the right medicine the right way during your hospital stay by doing these things:

• Tell your nurse and other health care providers about any allergies or side effects you have had to any medicines in the past.
• Make sure your nurse and doctor know all the medicines, supplements, and herbs you were taking before you came to the hospital. Bring a list of all these with you. It is a good idea to keep this list in your wallet and with you at all times.
• While you are in the hospital, do not take medicines you brought from home unless your doctor tells you it is okay to. Make sure to tell your nurse if you take your own medicine.
• Ask what each medicine is for. Also ask what side effects to watch for and tell your nurse about.
• Know the names of the medicines you get and what times you should get them in the hospital.
• Ask your nurse to tell you what medicines they are giving you. Keep a list of what medicines you get and what times you got them. Speak up if you think you are getting the wrong medicine or getting a medicine at the wrong time.
• Any container that has medicine in it should have a label with the name of the medicine on it. This includes all syringes, tubes, bags, and pill bottles. If you do not see a label, ask your nurse what the medicine is.
• Ask your nurse if you are taking any medicine that is a “high-alert” medicine. These are medicines that can cause harm if they are not given the right way, even if they are used for the right purpose. A few high-alert medicines are blood thinners, insulin, and narcotic pain medicines. Ask what extra safety steps are being taken if you are taking a high-alert medicine.

Alternate Names

Five-rights; Medication administration; Medical errors - medication

References

Bates DW. Medication safety in the hospital In: Wachter RM, Goldman L, Hollander H., eds. Hospital Medicine. 2nd ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2005.

Update Date: 5/17/2012

Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.