Medicine safety during your hospital stay

When you're in the hospital, work with your health care team to ensure that you get the right medicines the right way.

All hospitals have a process in place to make sure you get the right medicines. A mistake could cause a problem for you. The process is as follows:

• Your health care provider writes an order in your medical record for your medicine. This prescription goes to the hospital pharmacy.
• Staff in the hospital pharmacy reads and fills the prescription. The medicine is then labeled with its name, dose, your name, and other important information. It's then sent to your hospital unit where your health care team can use it.
• Most often, your nurse reads the prescription label and gives you the medicine. This is called administering the medicine.
• Your nurse and the rest of your health care team monitor (watch) you to see how you respond to the medicine. They watch to make sure the medicine is working. They also look for side effects the medicine could cause.

Most of the prescriptions the pharmacy receives are sent by computer. Electronic prescriptions are easier to read than handwritten prescriptions. These systems have safeguards designed to avoid errors. This means there is less chance of a medicine error with electronic prescriptions.

Your provider can tell your nurse to write down a prescription for you. Then your nurse can send the prescription to the pharmacy. This is called a verbal order. Your nurse should repeat the prescription back to your provider to make sure it is right before sending it to the pharmacy.

Your provider, nurse, and hospital pharmacist will check to make sure any new medicines you receive do not cause a bad reaction with other medicines you are already taking.

The Rights of Medication Administration is a checklist nurses use to make sure you get the right medicine. The rights are as follows:

• Right medicine (Is the right medicine being given?)
• Right dose (Is the amount and strength of the medicine correct?)
• Right patient (Is the medicine being given to the right patient?)
• Right time (Is it the right time to give the medicine?)
• Right route (Is the medicine being given the right way? It may be given by mouth, through a vein, on your skin, or another way)
• Right documentation (After giving the medicine, did the nurse make a record of it? The time, the route, dose, and other specific information about the medicine should be documented)
• Right reason (Is the medicine being given for the problem it has been prescribed for?)
• Right response (Is the medicine providing the desired effect? For example, after being given a blood pressure medicine, does a patient's blood pressure stay at the desired range?)

You can help make sure you get the right medicine the right way during your hospital stay by doing the following:

• Tell your nurse and other providers about any allergies or side effects you have had to any medicines in the past.
• Make sure your nurse and provider know all the medicines, supplements, and herbs you were taking before you came to the hospital. Bring a list of all these with you or bring the medicines to show your health care team. It is a good idea to keep this list in your wallet and with you at all times.
• While you are in the hospital, do not take medicines you brought from home unless your provider tells you it is OK. Make sure to tell your nurse if you take your own medicine.
• Ask what each medicine is for. Also, ask what side effects to watch for and what to tell your nurse about.
• Know the names of the medicines you get and what times you should get them in the hospital.
• Ask your nurse to tell you what medicines they are giving you. Keep a list of what medicines you get and what times you got them. Speak up if you think you are getting the wrong medicine or getting a medicine at the wrong time.
• Any container that has medicine in it should have a label with your name and the name of the medicine on it. This includes all syringes, tubes, bags, and pill bottles. If you do not see a label, ask your nurse what the medicine is.
• Ask your nurse if you are taking any high-alert medicine. These medicines can cause harm if they are not given the right way, even if they are used for the right purpose. High-alert medicines include blood thinners, insulin, and narcotic pain medicines. Ask what extra safety steps are being taken if you are taking a high-alert medicine.

Medication safety - hospital; Five rights - medication; Medication administration - hospital; Medical errors - medication; Patient safety - medication safety

Centers for Disease Control and Prevention. Medication safety program. www.cdc.gov/medicationsafety/index.html. Updated February 23, 2023. Accessed March 11, 2024.

Wachter RM, Shojania KG. Quality, safety, and value. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 10.

Updated by: Frank D. Brodkey, MD, FCCM, Associate Professor, Section of Pulmonary and Critical Care Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.