What are the 'rights' of safe medication administration?

The traditional 'Five Rights' of medication administration are right patient, right medication, right dose, right route, right time. Modern practice has added: right documentation (chart immediately after administration, not before), right reason (the medication should be appropriate for the indication), right response (assess the client's response to determine effectiveness), right to refuse (the client has the right to decline). Verifying the rights requires multiple checks: read the medication label three times (when pulling from the cabinet, when preparing, before administering); use two patient identifiers (name and date of birth, with armband verification — not room number); compare the medication to the medication administration record (MAR); double-check high-alert medications (insulin, anticoagulants, narcotics) with another nurse. Medication errors are a major patient safety issue, and adherence to the rights is the primary defense.