The 6th “R” in Medication Administration

Like any prescribing HCP, I, as a nurse practitioner, recognized that making medication decisions was one of the biggest choices I had to make for patients. My choice had a significant impact on the lives of patients, and I always hoped that the medications I prescribed would alleviate suffering and aid in better health outcomes for the patient. 

For this reason, it was never far from my mind that medication errors are one of the leading causes of injury to patients. I was always thinking of “The Five Rights of Medication Administration” which were established as a guideline to deliver better care and a principle to help prevent medication errors.

“The Five Right's in Medication Administration” are: “the Right patient, the Right drug, the Right time, the Right dose, and the Right route”—all of which are generally regarded as a standard for "safe medication practices" (Grissinger 2010). These rights were established to help minimize what are known as “adverse drug events” which are defined as “an injury due to medication” (“Adverse Drug Events” n.d.). In the United States alone, adverse drug events harm millions of people a year and cost billions of dollars to the US healthcare system. 

In a study published by the National Institute of Health (NIH) “it is believed that preventable medication errors impact more than 7 million patients and cost almost $21 billion annually across all care settings” (Brianna A. da Silva 2016).  Medication errors occur at multiple intersections of patient and clinician interaction; however, the World Health Organization (WHO) has identified one of the leading causes of adverse drug events occur at the point of medication prescribing. The WHO refers to these as “sources of errors in prescribing,” and identifies the leading cause for such errors as “inadequate knowledge about drug indications, contraindications and drug interactions.” This has become an increasing problem as the number of medicines in use has increased” (WHO Safety Curriculum).

As patient appointments and interactions with healthcare providers have become more rushed, and physicians time in technology is devoured by the EHR (estimating nearly 6 hours a day (“ACP Journals” n.d.), there’s been a 6th “R” missing from the 5 Rights of medication administration: the Right information. Not information the HCP is inputting, but information the HCP needs to help minimize adverse drug events at the time of prescribing.  Last year when our team began concepting around TelaRepTM I immediately saw the value from the clinicians' perspective. TelaRep in essence enhanced the 5 Rights of Medication administration, into the ability to practice a 6th right of medication administration, as in the Right Information for providers to access when making prescribing decisions.

TelaRep is the first integrated EHR solution built to provide clinicians with access to the right information at the right time when making prescription decisions. TelaRep allows clinicians to instantly initiate a conversation with their Medical Science Liaison or other pharma rep directly from within their EHR workflow to access the information they need when making medication decisions for patients.  As a clinician myself, I think of TelaRep as the “6th R” in medication delivery - the right information at the right time for clinicians when prescribing medication that will help prevent adverse drug events and help clinicians reduce harm to millions of patients of lives annually in the United States.

Learn more about how TelaRep works.

“ACP Journals.” n.d. Accessed March 15, 2021. https://www.acpjournals.org/doi/10.7326/M18-3684

“Adverse Drug Events.” n.d. Accessed March 15, 2021. https://health.gov/our-work/health-care-quality/adverse-drug events#:~:text=An%20adverse%20drug%20event%20(ADE,care%20settings%2C%20and%20outpatien %20settings

Brianna A. da Silva, Mahesh Krishnamurthy. 2016. “The Alarming Reality of Medication Error: A Patient Case and Review of Pennsylvania and National Data.” Journal of Community Hospital Internal Medicine Perspectives 6 (4). https://doi.org/10.3402/jchimp.v6.31758

Grissinger, Matthew. 2010. “The Five Rights: A Destination Without a Map.” Pharmacy and Therapeutics 35 (10): 542. 

“[WHO Safety Curriculum].” n.d. Accessed March 15, 2021. https://www.who.int/patientsafety/education/curriculum/who_mc_topic-11.pdf