Ch. 12 - Safety & Quality in Medication Administration

Question 1

Quality & Safety Education for Nurses (QSEN):

Answer 1

Focus --->
    *Safe = medication administration  
    *Prevent = med-related errors 
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Six competencies

Question 2

Avoid Medication Errors:

Answer 2

• Traditional 5 rights of Medication Admin.

* 5+5 Rights of Drug Admin.

Question 3

1.) Right Client

Answer 3

2 forms of ID:
1.) Check wrist (identification band)
2.) Ask (client name, birth date)
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Check for drug allergies

Question 4

2.) Right Drug

Answer 4

Who may write a drug order?:

1. ) Physician 
2. ) Dentist 
3. ) Podiatrist
4. ) Advanced Practice Registered Nurse

Question 5

Components of a Drug Order (1):

Answer 5

Verify order –>

• Date, time
• Drug name, dosage, route
• Frequency, duration
• Signature of prescriber

Question 6

Components of a Drug Order (2):

Answer 6

Telephone Order (T.O) or Verbal Order (V.O)
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RN –> writes order – “TO (or VO) per Dr. Smith/V. Odell, RN”
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Prescriber signs order

Question 7

To Avoid Drug Error:

Answer 7

Read label 3 times:

1. ) Taking container from its location
2. ) Before pouring the med
3. ) After pouring the med

Question 8

4 Main Categories of Drug Orders:

Answer 8

1. ) Standing (routine)
2. ) One-time (single dose)
3. ) PRN (as needed)
4. ) STAT (immediately) *technically a one time order as well

Question 9

3.) Right Dose (1):

Answer 9

Automated / computerized medication – management system ==> most common

Question 10

3.) Right Dose (2):

Answer 10

Keep unit does med in packet until administering
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NEVER administer med that someone else prepared

Question 11

4.) Right Time:

Answer 11

How many times / day: PRN
*Bid (2x day)
*Tid (3x day)
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Qid, qd –> Write out! —- Qid (4x day)
—————————————————–
Q 4hrs, Q 6hrs = (every 4/6 hrs)
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May give 1/2hr before or after ordered time know before and after meal abbreviations

Question 12

5.) Right Route:

Answer 12

Oral (po) = tablet, liquid
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Sublingual = under tongue
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Buccal = between teeth & tongue
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Feeding Tube
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Topical ---> Inhalation, Installation, Suppository,
Parenteral

Question 13

Nursing Implications:

Answer 13

(a) : Assess ability to swallow for oral meds
(b) : Aseptic technique when admin
(c) : Stay with client until orals meds are swallowed

Question 14

6.) Right Assessment:

Answer 14

Obtain appropriate data before you admin

Question 15

7.) Right Documentation (1):

Answer 15

(a) :Drug
(b) :Dosage
(c) :Time
- Route/Site
- Signature (initials)

Question 16

Right Documentation (2):

Answer 16

PRN meds

- Nurses notes --> need for med and clients response * DO NOT pre-chart any information

Question 17

8.) Right to Education:

Answer 17

Clients should receive accurate info regarding their meds

Question 18

9.) Right Evaluation:

Answer 18

(a) :Evaluate effectiveness of med

(b) : Determine client’s response

Question 19

10.) Right to Refuse:

Answer 19

Ask: Why is client refusing?

Question 20

Six Nurses Rights When Administering Medication (1):

Answer 20

1. ) Right to complete and clear order
2. ) Right to have the correct drug, route, and dose dispensed
3. ) Right to have access to information

Question 21

Six Nurses Rights When Administering Medication (2):

Answer 21

4. ) Right to have policies to guide safe medication administration
5. ) Right to administer meds safely and to identify system problems
6. ) Right to stop, think, and be vigilant

Question 22

Culture of Safety:

Answer 22

Medication Error:

“Any Preventable event that may cause or lead to inappropriate medication use or to harm a patient”

Question 23

Bar Code Label Requirements for Human Drug Products & Blood:

Answer 23

Bar code method of medication admin.

-wristband has a scanner that organizes info about pt and reinforces pt safety with admin.

Question 24

To Prevent Drug Errors:

Answer 24

The Joint Commission (TJC)

-May not use certain abbreviations, acronyms, & symbols d/t misinterpretation (“DO NOT USE” list)

Question 25

Disposal of Medication (1):

Answer 25

(a) : Follow specific info on drug label/insert
(b) : Do not flush meds down the toilet unless instructed
(c) : Remove drug from original container

Question 26

Disposal of Medication (2):

Answer 26

(d) : Dispose in a sealed bag with kitty litter / coffee grounds
(e) : Remove all identifying information on container

Question 27

Sharps Safely (1):

Answer 27

Occupational Safety & Health Administration (OSHA) Needlestick Safety & Prevention Act of 2000
- d/t ANA Campaign Safe Needles Save Lives

Question 28

Sharps Safely (2):

Answer 28

Employers must ensure that no preventable needle stick injuries occur

Question 29

Sharps Safely (3):

Answer 29

Dispose of used gloves, needles/syringes

-NEVER re-cap used needle

Question 30

Look-alike & Sound-alike Drug Names:

Answer 30

(a) : Certain drug names sound alike and are spelled similsry
(b) : Lightning bolt symbolizes safety concerns

Question 31

Other Information:

Answer 31

Guidelines for Correct Administration of Medications

Question 32

Behaviors to Avoid During Medication Administration (1):

Answer 32

(a) : DO NOT be distracted when preparing meds
(b) : DO NOT give drugs poured/prepared by others
(c) : DO NOT give expired drugs

Question 33

Behaviors to Avoid During Medication Administration (2):

Answer 33

(d) : DO NOT leave drugs at bedside
(e) : DO NOT give drug if p/t states he/she has allergies to the drug or drug category
(f) : DO NOT mix drugs with a large amount of food or beverages