IM1-MED ADMIN FOR EXAM 5,6,7 Flashcards
Medical errors are the __1__ leading cause of death in the United States, after heart disease and cancer, according to findings published in BMJ, 2016…. and based on 34,416,020 hospitalizations, over ___2_____ deaths stemmed from a medical error
- 3rd
- 251,000
Typically, nurses have more than ___ orders per shift
50
Medication orders require how much of the nurse’s time?
- 1/3
Medication errors cause at least ___ death every day in the U.S.
1
Medication errors INJURE more than ___ million people every year in the US
1.3 Million
The US spends more than ____ billion each year on patients who have been affected by med errors
40
Medication errors have been made by __1___% of the nurses. . In addition, __2__% of the participants reported medication errors on the verge of occurence
- 64.55%
- 31.37 %
The most common types of reported errors were wrong ____ and ____
- Dosage
- Infusion Rate
The most important cause of medication errors was lack of ______?
- Pharmacological knowledge
Medication errors can result in
List 5
- Death
- Life threatening situation
- Hospitalization
- Disability
- Birth defect
True or false: Medication errors can be prevented?
Trie
Can inappropriate medication use cause harm?
Yes
A provider ____ and ____ meds
- Prescribes
- Monitors
A pharmacist ____ and ____ meds
- Verifies
- Prepares
A nurse _____ and ____ meds
- Administers
- Monitors
What are points of medication errors?
- Ordering/prescribing
- Transcribing
- Dispensing
- Administering
- Monitoring
As nurses we are “monitors” what does this mean for us?
- We are responsible for recognizing S/S of a reaction
What are the 10 types of medication errors
- wrong patient
- wrong drug
- wrong route
- wrong time
- wrong dose/omitted dose
- wrong dosage form
- wrong technique
- deteriorated drug error- (expired, discolored drug)
- compliance (not given the way it was supposed to be given can be patient or RN fault)
- wrong documentation.
What factors could a provider/pharmacist/nurse run into that could cause a medication error?
- Distractions
- Poor communication
- Lack of training
- Inadequate knowledge of a patient
- Inadequate knowledge of drug
- Overworked or fatigued/lack of sleep
- physical/emotional health issue/stress
- Administration technique
- Lack of knowledge of drug-drug inte
- Miscalculation of dosage
- Drug preparation
- Computer error
- Stocking error
- Transcription error
What factors with the patient could cause a medication errors?
- Personality
- Literacy
- Language barriers
- Multiple health conditions
- Polypharmacy
- Inconsistent method
What communication factors are associated with medication errors.
- Name confusion
- Illegible handwriting
- Verbal order
- Brand name confusion
- Generic name confusion
- Labeling
What are ways to reduce medication errors?
- Patient and patient families take an active role and be informed
- Give healthcare workers tools and information needed to prescribe dispense and administer
-Computerized order entry system- Having a clinical pharmacist accompanying physicians in high risk area
- Bar-code systems
-Medication reconcilliation - Not using error prone abbreviations
- Medication education for new and existing staff
- Limitations and safeguards for verbal orders
What are ways to reduce medication errors?
- Patient and patient families take an active role and be informed
- Give healthcare workers tools and information needed to prescribe dispense and administer
-Computerized order entry system- Having a clinical pharmacist accompanying physicians in high risk area
- Bar-code systems
-Medication reconciliation - Not using error prone abbreviations
- Medication education for new and existing staff
- Limitations and safeguards for verbal orders
What is complacently in the workplace?
Is when you become so secure in your work that you take potentially dangerous shortcuts in your tasks, don’t perform to the same quality as you once did or become unaware of deficiencies
The TALL man system helps us do what?
Helps us differentiate meds and prevent med errors
What is a black box warning?
- Strictest labeling requirements FDA can mandate for prescription drugs
- Alert of increased risk- may result in death or serious injury
When a med error occurs what happens and who is the priority?
- Assess/monitor patient continuously for adverse reactions, notify the charge nurse and contact physician
- Complete and incident report
- Evaluate the patient
- The patient is the PRIORITY
“Every step of safe medication administration requires a discipled attitude and a comprehensive, systemic approach”
Nurses need to know
- Medication knowledge – pros & cons
- Patient allergies
- How to calculate medication dosages
- Factors affecting the patients response
- Nursing process
- Nurse practice act (NPA)
The role of the nurse in med admin is…..
- Having an up-to-date database of drugs.
-knowing the medication- known/new
- Dose(s)
- route
- frequency
- reason
- instructions/considerations/precautions/drug-on-drug interactions
- Know how to give meds correctly/know the skills
- know your patient.
- Implement nursing care plan
- assessments
- problems
- desired outcome/goal
- intervention(s)
- Evaluation(s)
- Patient teaching from admission to D/C
- Advocate by protecting the patient
How can we advocate for the patient when it comes to med admin
- Question/clarify incorrect or incomplete medication orders
- Know when to hold medications or request alternate route, if needed
- Know if meds are compatible
- Never leave meds unattended or at the bed side
Who is held accountable for a med admin error?
Nurse
What is the role of a patient during med admin?
- Understand their responsibilities
- Understand the treatment and question what they do not understand
- adhere to the regimen (take medication correctly)
- Avoid misuse or abuse of medications
- Report adverse effects of medications or changes in medical condition
- Store medications safely
- Received a qualified nursing assessment
- be informed of the name, dosage, reason, frequency, route, potential undesired effects
The patient has the right to (med admin)
- Receive labeled mediation(s) & opened in their presence
- Received mediation admin correctly
- NOT to receive unnecessary medication
- Refuse to take a medication - always double check if patient questions you.
What are the components of a medication order
- Patient name
- Date and time
- Name of medication
- Dosage
- Route of administration
- Time/frequency of admin
- signature/verification of prescriber
What is a standing or route order
Administered until the dosage is changed or another medication is prescribed
What is a single (one-time) order?
Given one time only for specific reason
What is a NOW order?
- When a medication is needed right away but not STAT.
What is a range order?
Medication order is written with dosage having a range
What is PRN/Contingency order?
Given when the patient requires it
What is a STAT order?
- Given immediately in an emergency
What is a prescription?
Medication to be taken outside of the hospital
What information should you obtain during a verbal/telephone order? (med admin)
- Patients name
- Date and time
- Medication
- Dosage
- Route
- time and frequency
- signature of prescriber
What should we avoid using during verbal/telephone orders?
DNU abbreviations
What must a charge nurse/RN do when taking a verbal/telephone order
must document “read back” “spell back”
How long does the provider have to approve and verify a telephone/verbal order?
24 hours
What are the 7 rights of medication administration?
- Right patient
- Right medication
- Right dose
- Right Time
- Right route
- Right reason
- Right documentation
RIght ___ - use two identifiers –
Right patient
Right ___- check label!!
Medication
Right ______- know what the appropriate dose ranges are based on the route and patient
dose
Right ____- know how the drug can and cannot be given; order determines route
Route
