Five rights of medication - how ATLAS prioritises safety at every point

Effective and efficient medication delivery in a care home setting relies on several key aspects of medication management , but above all, ensuring safety is the foundation. As such, nurses and medication leads who regularly administer medicines must be aware of the five rights of medication administration and should always ensure each point is followed when administering medication. A lapse in even one of these principles can have serious consequences for the health and safety of individuals living in care. 

What are the five rights of medication? 

These five rights of medication are: 

• The right person 

• The right drug 

• The right dose 

• The right route 

• The right time 

The five rights of medication administration form the bedrock of safe medication administration, which itself is one of the cornerstones of overall resident wellbeing. Therefore, you must prioritise medication safety if you want to ensure resident wellbeing. 

Regulations surrounding safe medication management 

The CQC have listed medication management as one of the standards in their key line of enquiry for safety. 

Some of the standards for safe medication management include: 

• Is the service’s role in relation to medicines clearly defined and described in relevant policies, procedures and training? Is current and relevant professional guidance about the management of medicines being followed? 

• How does the service make sure that people receive their medicines (both prescribed and non-prescribed) as intended (including controlled drugs and ‘as required’ medicines), and that this is recorded appropriately? 

• How are medicines ordered, transported, stored and disposed of safely and securely in ways that meet current and relevant legislation and guidance? 

Safety is a crucial regulatory standard 

While those responsible for medication administration will have received adequate training, there are nonetheless many risks involved in a real-world setting when it comes to managing meds for people living in care.  

The five rights of medication were put in place to ensure the best interests of both people receiving medication and those who administer it, as well as ensuring that a framework exists to support the reduction of care medication errors. This is crucial, as it was reported recently that the number one reason cited for care homes failing to reach the Safe standard for the CQC is medication errors.  

The limitations of the five rights and how to build on it 

Despite the general framework for safety put in place by adhering to the five rights of medication, there are issues that still exist. While a crucial baseline from which to start, the five rights in isolation have limited scope to improve medication errors because of the following. 

Systemic challenges in a care home environment 

The five rights of medication are the foundational principles of medication management, but adherence to them without any assistance, like an eMAR system instead of out-dated paper records, means that compliance falls very much onto the individual, which leaves a lot of room for error. These issues can manifest in ways: 

• Recruitment and retention issues mean that staff are sometimes rushed to get through medication rounds quickly and therefore can be prone to mistakes 

• Communication issues can arise between GPs, pharmacies and care homes as to the nature of the current prescription and any changes that might have been made. 

• If a paper mar-chart system is being used, then ensuring all five rights are adhered to is a challenge due to the inherent inefficiencies of using paper. 

• Sometimes there can be a lack of training around best practices for medication administration. 

By using ATLAS eMAR, you make sure the five rights of medication are efficiently and safely adhered to 

ATLAS eMAR has been proven to significantly reduce, and in many cases remove medication errors almost all instances where medication errors leading to safety issues have been prevalent in the past. For example, a study by Cardiff University found that after adopting ATLAS eMAR, 21 out of 23 identified error types were completed eradicated in a care home setting. Not 21 out of 23 errors, but 21 out of 23 ways in which errors can occur. More still, missing entries (which can be a big safety issue) were decreased by nearly 90%. 

The transformative impact ATLAS eMAR can have on your care home: 

How does ATLAS eMAR ensure the five rights of administration are safely followed? 

The right person 

ATLAS eMAR’s barcode technology ensures that when a medication box is scanned, the name of the person that it has been prescribed to comes up. In this simple step, it’s easy for care staff or nurses administering medication to see if this medicine belongs to the right person.  

The right drug 

The barcode scanning feature of ATLAS eMAR runs a series of real-time safety checks to ensure that medications are not incorrectly administered. One of them is to check that the right medication is being given to the right recipient. When you scan the barcode, you will be given a full view of who requires what, and from here you can see if it’s the right medication. As well as this, it also provides safeguard notifications against expired medications and potential drug interactions. 

The right dose 

In addition to the above, ATLAS eMAR during medication rounds will also, when the barcode is scanned, provide the exact dosage that the medication is required in. This real-time update means that there is virtually no chance that any resident can be given either too much or too little of the required medication. 

The right route 

When the barcode is scanned, information regarding that medication will be shown on the screen. It will display the name of the medication, the strength, form, the amount to be taken and how often. The method by which the medication needs to be delivered is also available in the system and can be either inputted by pharmacy when receiving a prescription or by the care home when adding a new drug or changing the schedule of an existing one.  

The right time 

When doing a medication round in a care home using ATLAS eMAR, the home screen will give you the option to view the residents in the system. Once you’ve clicked on a particular resident you will have access to the medication that is due that day. Below this, there will be five icons: due now, attempted, due later, away, missing. Using these options, someone administering medication has a clear understanding of exactly when the medication needs to be delivered, whether it’s now or later.