Chapter 5

Question 1

Where can you find information about drugs online?

Answer 1

www.ismp.org

Question 2

SALAD

Answer 2

sound-alike, look-alike drugs

Question 3

LASA

Answer 3

look-alike, sound-alike

Question 4

Medication errors

Answer 4

• preventable
• common causes of adverse health care outcomes
• drugs commonly invovlved: CNS, anticoagulants, and chemotherapeutics drugs
• more potential for harm with “high-alert” medications

Question 5

Issues contributing to errors

Answer 5

• procurring
• prescribing
• transcribing
• dispensing
• administering
• monitoring
• organizational issues
• educational system issues
• sociologic factors
• use of abbreviations

Question 6

JUST culture

Answer 6

• we want you to report

- it’s ok to report errors, you must report

Question 7

Types of medication errors

Answer 7

1. No error, although events occured that could have led to an error
2. Medication error that causes no harm
3. Medication error that causes harm
4. Medication error that results in death

Question 8

Examples of high-alert drugs

Answer 8

• IF you give it wrong it can kill, two nurses must check the dosage
• insulin
• heparin
• potassium

Question 9

How to prevent medication errors

Answer 9

• multiple systems of checks and balances should be implemented to prevent medication errors
• presribers must write legible orders
• authorative resources, such as pharmacists or current drug references or literature

Question 10

SPEAK UP

Answer 10

S = ask questions
P = pay attention
E = education yourself
A = ask someone to advocate 
K = know what your medicines are
U = use in hospital
P = participate in all decisions about your treatment

Question 11

How to prevent medication errors

Answer 11

• assessment
• two patient identifiers
• do not administer if you did not draw up or prepare yourself
• minimize verbal or telephone orders
• -repeat order to prescriber
• -spell drug name aloud
• -speak slowly and clearly
• list indication next to each order
• never assume anything about items not specified in a drug order
• ask questions
• do not try to decipher illegibly written orders; contact prescriber for clarification
• never use a “trailing zero” with medicatio orders
• always use a “leading zero” for decimal dosages
• take time to learn special administration techniques
• always verify
• always listen to and honor any concerns expressed by patients regarding medications
• check patient allergies and identification

Question 12

Reporting medication errors

Answer 12

• reporting to prescriber and nursing management
• document error per policy and precedure
• factual documentation only

Question 13

Medication reconciliation

Answer 13

• process in which medications are “reconciled” at all points of entry and exit to or from a health care entity
• patients provide a list of all the medications they are currently taking
• prescriber then assesses the medication and decides if they are to be continued upon hospitalization