The 10 ‘R’s of safe multidisciplinary drug administration

Nurses are responsible for medication administration, and, as with many other nursing interventions, some risk is involved. If an error occurs, a patient may suffer harm or injury, which may lead to a permanent disability or a fatality. To ensure safe drug administration, nurses are encouraged to follow the five rights (‘R’s; patient, drug, route, time and dose) of medication administration to prevent errors in administration. The five ‘R’s do not consider all causes of drug errors; instead, they focus on medication administration at the bedside so they relate only to this stage of a drug prescription. A drug’s journey is more than what happens at the bedside; therefore, the reduction of errors requires more than just the five ‘R’s. This article proposes a multi-professional, evidence-based approach to medicines management, which all clinicians can work towards, together. Clinicians can achieve this approach by considering the National Patients Safety Agency’s definition of a medication error and the values set out by the National Prescribing Centre. The approach utilizes 10 ‘R’s, which provide a benchmark for good practice. The 10 ‘Rs’ advocate the need for the knowledge of the causes of drug errors, how to implement strategies to reduce drug errors, how to ensure safe practice throughout the medication journey, from chemical preparation, to monitoring outcomes, to response