Right Time in Medication Administration: A Multifaceted Concept

Friday, 28 July 2017

Juliana J. Brixey, PhD, MPH, MSN
School of Biomedical Informatics and School of Nursing, University of Texas Health Science Center at Houston, Houston, TX, USA
William Scott Erdley, DNS
Behling Simulation Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA

Purpose: The medication administration process is a five-step procedure entailing prescribing, transcribing, dispensing, administering, and monitoring. Medication administration involves giving a pharmacological agent, such as a drug, to a patient or client. Within medication administration the patient expects the right medication, in the right dose, to be at the right time, and by the right route. ‘Right time’, which is clearly identified as an important component of the medication administration process, should therefore be clearly defined as well achievable. ‘Right time’ also implies a measurable period of time. The literature does not clearly define ‘right time’ instead defining through linking to, for example, a prescribing provider’s order or the most recent administration. The purpose of this study was to review the literature to determine themes, trends, and definitions of ‘right time’ of medication administration.

Methods: A retrospective review of the literature was conducted to identify themes and trends of ‘right time’ of medication administration.

Results: A specific definition of ‘right time’ was not readily discovered in the literature. The following trends were identified from the literature. For example, ‘right time’ is coupled with an exact time such as an hour for administration (e.g., at 0600). Moreover, ‘right time’ is intimately related to frequency. For example, twice a day at 0900 and 1700. ‘Right time’ may also be coupled with a range in hours. For instance, every two hours or every six hours. What is more, ‘Right time’ can be extended to a seasonal event. For example, the ‘right time’ to receive the flu vaccine during the flu season. Right time is teamed with vital signs. For example, administer acetaminophen every 6 hours as needed for temperature greater than 100 degree F. ‘Right time’ is also coupled with laboratory values. Administer Warfarin 5 mg for INR < 1.5. Additionally ‘right time’ is frequently denoted with a specific parameter such as with food or without food. These attributes should ultimately be based on drug action, distribution, absorption, metabolism, and excretion.

Conclusion:  A definition for ‘right time’ medication administration needs to be explicitly stated. This research study indicates ‘right time’ is a multifaceted concept without a clear and precise definition. This research begins development of a taxonomy of ‘right time’ drug administration.