Ch. 12 Medication Management System

Question 1

What are the four most commonly implicated drug classes for ADE ED visits?

Answer 1

1. Anticoagulants
2. Antibiotics
3. Diabetes drug
4. Opioid analgesics

Question 2

What is a medical error?

Answer 2

Any preventable event that may cause or lead to inappropriate med use or pt harm

Question 3

What do federal laws do?

Answer 3

Approval, storage, and dispense of medication

Question 4

What is tracer methodology?

Answer 4

Randomly choosing pt from admission to discharge (and what happens over the course of pt stay); looks at medication

Question 4

What is the purpose of Leapfrog?

Answer 4

Aims to advance pt safety

Question 5

What are Adverse drug events (AED)

Answer 5

Patient injuries resulting from a medical intervention related to a medication Caused from omission or comission

Question 5

What are the WHO’s key action areas for medication?

Answer 5

1. Polypharmacy
2. High-risk situations
3. Transition of care

Question 6

What is the most proximal cause for medical errors?

Answer 6

Lack of knowledge about the drug (on the clinician’s side and pt’s)

Question 6

Types of medication errors: Administration errors

Answer 6

Errors done by a human

Ex: incorrect route of administration, wrong dose prescription/wrong dose preparation, giving the drug to the wrong patient, wrong time, extra dose, or wrong rate

Question 7

Types of medication errors: Monitoring errors

Answer 7

failing to consider patient liver and renal function OR allergies to drugs

Question 7

Types of medication errors: Compliance errors

Answer 7

not following protocol or rules established for dispensing and prescribing medications

Question 8

What is the CMS High Stakes “Star Rating Program”?

Answer 8

Tieing reimbursement to performance on quality metrics in terms of # of stars and rebate bonus %

Question 8

What does the Pharmacy Quality Alliance (PQA) aim to do?

Answer 8

Improve med safety, adherence, and appropriate use by providing a benchmark

Question 8

What is MedWatch?

Answer 8

website for docs/pt to report drugs

Question 9

What are the 4 AHRQ strategies to prevent ADEs?

Answer 9

1. Prescribing
2. Transcribing
3. Dispensing
4. Administration

Question 10

Who are the medication experts?

Answer 10

Pharmacists

Question 11

Pharmacists are performing Medication Therapy Management (MTM) which focuses on….. (5)

Answer 11

• Med review
• pharmacotherapy consults
• anticoagulation management
• immunizations
• Health & wellness programs

Question 12

What are the three most common medication dispensing errors?

Answer 12

1. incorrect medication
2. incorrect doses
3. incorrect directions

Question 13

Why are medical errors underreported in the US?

Answer 13

Reporting is voluntary (only mandated if explicitly tied to reimbursement)

Question 14

What are the two screening tools used by physicians to prescribe medication to the geriatric population?

No need to know what the acronym stands for

Answer 14

STOPP (Screening Tool of Older Persons’ Prescriptions

START (Screening Tool to Alert to Right Treatment)

Question 15

What is medication management?

Answer 15

Preparation and dispensing of medications

Question 15

Is it required by law to reconcile medication?

Answer 15

Yes

Question 16

What is medication reconciliation?

Answer 16

Process of comparing the pt’s meds list against the physician’s orders at each point along the pt’s continuum of care

Question 16

What are the 7 steps to successful safe medication management?

Answer 16

1. Select and procure meds
2. Properly storing medications
3. Prescribe and transcribe meds
4. Prepare and dispense meds
5. Administering meds
6. Monitor the effects on medication
7. Evaluate system

Question 17

What is a formulary? When is it reviewed?

Answer 17

a list of medications that a hospital has approved for use by its medical staff Reviewed annually

Question 18

What two things does a formulary ensure?

Answer 18

1. Med safety 2. Efficacy

Question 19

What is a drug's pedigree?

Answer 19

Chain of custody of a medication from its manufacturer to the pharmacy

Question 20

Can a pt bring their own meds if they are not part of the hospital's formulary?

Answer 20

Yes, but must give to hospital staff since they'll be the ones who control and will administer them

Question 21

What is the JC's Official "Do not use" list?

Answer 21

List of med abbreviations that cannot be used when prescribing medication

Question 22

How many pt identifiers should be used prior to the administration of medications?

Answer 22

At least 2

Question 23

What are the "Six Rights?" (+ 1 commonly left out)

Answer 23

Right.... 1. Patient 2. Medication 3. Dose 4. Time 5. Route 6. Documentation **7. Refuse

Question 24

How are medication errors reported?

Answer 24

Non-punitive (i.e., not pointing fingers/blame)

Question 25

What is drug diversion?

Answer 25

Removal of medication from its intended use in order to use or sell the medication

Question 26

What can drug diversion result in? (4)

Answer 26

- widespread outbreaks of diseases - Increased ED visits - death - loss of productivity

Question 27

What are some forms of regulatory requirements for reporting drug diversion? (4)

Answer 27

- DEA - State regulatory board - law enforcement - FDA

Question 28

What is Failure Mode and Effect Analysis (FEMA)?

Answer 28

**Proactive** tool to analyze potential problems when introducing new processes by considering: - **freq of failure** - **potential harm** - **likelihood of detection**