The 5 Rights of Medication Administration
The 5 Rights are the foundation of safe medication administration. Every time you give medication, you must check all five rights — never skip this, even if you are familiar with the resident and their medication.
Important:Some organisations use 7, 8 or even 10 Rights — adding Right Documentation, Right to Refuse, Right Reason, and Right Response. While these extended frameworks are valuable, the core 5 Rights remain the essential minimum for every medication administration. Always follow your organisation's policy.
Right Patient
Confirm the identity of the resident before administering any medication. In care homes, this means checking the resident's name on the MAR chart against the resident themselves. Use at least two identifiers — typically the resident's full name and photograph on the MAR chart, or their name and date of birth. Never assume a resident's identity based on their room number alone. If you are unsure, verify with another member of staff before proceeding.
Right Medication
Check that the medication you are about to administer matches exactly what is prescribed on the MAR chart. Read the medication label carefully and compare it to the MAR entry. Check the generic name and brand name, the form (tablet, capsule, liquid, patch), and the strength. If a medication appears different from what you normally give (e.g. a different colour or shape due to a change of supplier), verify with the pharmacy before administering. Never administer medication from an unlabelled container.
Right Dose
Administer the correct dose as prescribed on the MAR chart. If a tablet needs to be halved, ensure it is scored for splitting. If the dose requires measuring (e.g. liquid medication), use an appropriate measuring device — never estimate. Double-check calculations for any dose that varies or requires conversion. If the prescribed dose seems unusually high or low, or differs from what you would normally expect, clarify with the prescriber or pharmacist before administering.
Right Route
Ensure the medication is given by the correct route as prescribed. The route may be oral (by mouth), sublingual (under the tongue), topical (applied to skin), inhaled, via PEG tube, or by injection (where appropriately trained staff are available). Never crush a tablet or open a capsule unless it is specifically authorised — some medications are modified-release or enteric-coated, and crushing can cause rapid-release of the drug, leading to overdose. If a resident has difficulty swallowing, consult the pharmacist about alternative formulations.
Right Time
Administer medication at the correct time as indicated on the MAR chart. Standard abbreviations include: OD (once daily), BD (twice daily), TDS (three times daily), QDS (four times daily), and STAT (immediately). Some medications must be given at specific times relative to food (e.g. before meals, with food, on an empty stomach). If a dose is missed, follow your organisation's policy on late administration — some medications have a wider window than others. Always record the actual time of administration on the MAR chart.
Additional Rights (Some Organisations)
Right Documentation
Sign the MAR chart immediately after administration — never pre-sign or sign later from memory. Record the actual time of administration, and note if a dose was refused, omitted, or administered late.
Right to Refuse
Competent residents have the right to refuse medication. If a resident refuses, document the refusal on the MAR chart, explain the reason, and try again later if appropriate. Never force medication. If refusal persists, inform the GP and nurse in charge.
Right Reason
Understand why the medication is being given. Check the indication on the MAR chart and be aware of what the medication is for. If the reason seems unclear or the resident no longer needs the medication, flag it for GP review.
Right Response
Monitor the resident after administration for the intended effect and any adverse reactions. For example, does the resident appear less anxious after PRN lorazepam? Has their pain reduced? Record the outcome.