stupid stupid med errors.  I know we are human, but man oh man is it hard to get past making a mistake.  Even when you do the 5 rights EVERY TIME, it can creep up on you. 

Anyone got any procedures in place in your facility that helps prevent med errors past the 5 rights?

We follow the 7 rights

1. RIGHT drug
2. RIGHT patient
3. RIGHT dose
4. RIGHT time
5. RIGHT route
6. RIGHT reason
7. RIGHT documentation

As far as procedures go....I can't think of any right now

We do 7 also.

Take your time, I see most errors made when you rush.

hmm...never heard of doing 7 rights before. 

What about transcribing?  Does your place require 2 signatures?

Maybe there should be an 8th...something like RIGHT allergies so that is checked too.

We need double signature when mixing epidural bags. My old hospital required them for insulin and anticoag injects which I wish we did but I follow that way anyways:)

We learned 10 rights in school:

10 “rights” to med administration:

            Right med

            Right does

            Right time

            Right route

            Right client

            Right client education

            Right documentation

            Right to refuse

            Right assessment

            Right evaluation

We need two signatures when transcribing as well and Night shift does a 24 hour check to insure everything is correct.

The hospital I'm doing my rotation at this semester has an e-MAR, so you have to scan the patient's ID band and then scan the medication. If it doesn't match the dose, med, and time that it's supposed to be given, or doesn't match the patient, it pops up on the screen and informs you :)

Besides that, we just do the five rights.

We are electronic, the MD/APN enters the med order, the RN cannot sign it out until the pharmacist double-checks it (excluding emergent-need drugs that can be over-riden in our PYXIS when they are needed) and the system automatically checks it against the patients documented allergies. No med can be profiled or filled on a new patient until the RN verifies the weight and the allergies of the patient in the electronic system.

We also do not allow mixing of any IV solutions (drips) by the nurses, only by pharmacy, except in "emergent need" situations and then only vasopressors or insulin, no concentrated salts, no pain or sedation drips.

And like everyone else, we require an RN double check for anything high risk.

On our med-surg floors they are in the middle of the TCAB project and one of the things they did was designate "quiet times/zones" around the RN and med cart where when he/she is passing meds they are not interrupted for anything, no phone calls, nothing.