The 6 Rs and preparing for a medicines round

The 6 Rs provide a practical safety check before giving medicines: right person, right medicine, right route, right dose, right time and the person's right to decline. They support professional judgement and local policy by reducing avoidable errors.

Using the 6 Rs in practice

• Right person: identify the person according to local policy, especially where residents have similar names or room allocations change.
• Right medicine: check the medicine name, formulation and label against the MAR or eMAR.
• Right route: administer by the route prescribed, for example oral, topical, eye, inhaled or transdermal patch.
• Right dose: confirm strength, dose, any variable-dose instructions, the correct measuring device and maximum dose limits.
• Right time: check the prescribed time, spacing between doses, relation to food and whether the dose has already been given.
• Right to decline: ask and explain; respect capacity and escalate if refusal raises safety concerns.

Preparation reduces risk. Before a round, ensure the MAR or eMAR is available, medicines are present, keys and equipment are to hand, measuring devices are clean, the environment is calm and any changes from handover are understood. Rushed rounds increase the chance of mistakes.

Ask the person if they are ready before removing a dose from its packaging, unless the care plan specifies otherwise. Do not leave doses out for later unless this has been risk assessed, agreed and recorded in the care plan.

Reducing interruption risk

The 6 Rs work best when staff slow down enough to use them. If you are interrupted, pause and restart the check rather than guessing where you were.