med admin part 1 Flashcards
__________ ________ is the 3rd leading cause of death in the USA
medical error
medication errors (5)
-death
-life threatening situation
-hospitalization
-disability
-birth defect
medication errors - who
-preventable event : inappropriate medication use may cause harm
provider order
prescribes and monitors
pharmacist (resource/dispenses)
verification and preparation
nurse administers
administers and monitors
points of medication error - when (5)
-ordering / prescribing
-transcribing
-dispensing
-administering
-monitoring
types of medication errors - what (10)
error types
- wrong patient
- wrong drug
- wrong route
- wrong time
- wrong dose/omitted dose
- wrong dosage form
- wrong technique
- deteriorated drug error
- compliance
- wrong documentation
factors associated with med error - why
provide / pharmacist / nurse (12)
-distractions
-poor communication
-lack of training
-inadequate knowledge of pt
-inadequate knowledge of drug
-overworked or fatigued / lack of sleep
-physical / emotional health issues / stress
-lack of knowledge drug-drug interactions
-miscalculation of dosage
-drug preparation
-computer error
-stocking error ***
factors associated with med error - why
patients (6)
-personality
-literacy
-language barriers
-multiple health conditions
-polypharmacy
-inconsistent method
factors associated with med error - why
communication (6)
-name confusion
-illegible handwriting
-verbal order
-brand name confusion
-generic name confusion
-labeling
ways to reduce medication errors
patients and families take an ________ role and be informed
__________ the patient
active
educating
ways to reduce medication errors
give healthcare workers _______ and _______ needed to prescribe, dispense, and administer
tools
information
prevention
cause for HIGH alert
look-alike or sound-alike medications
prevention
TALL man system
capitalization of certain letters in words so you can see exactly what meds you are supposed to be giving
prevention
black box warning
-alert of increased risk - may result in death or serious injury
-strictest labeling requirements FDA can mandate for prescription drugs
prevention
when an error occurs, the priority is who ?
the PATIENT
prevention
when an error occurs, what do we do? (5)
- assess and monitor pt continuously for adverse reactions
-notify charge nurse
-contact physician
-complete an incident report
-reflect
relevance
nurses need to know : (6)
-med knowledge : pros and cons
-pt allergies
-how to calculate medication dosages
-factors affecting the pt response
-nursing process
-nursing practice act (NPA)
role of nurse
up to date __________ base
knowledge
role of nurse
the nurse needs to know what about the medication when administering ? (6)
-known/new
-dose(s)
-route
-frequency
-reason
-instructions/considerations/precautions/drug-drug interactions
role of nurse
nursing care plan (APDIE)
Assessments
Problem
Desired outcomes/goal
Intervention(S)
Evaluation(S)
role of nurse
patient teaching from __________ to ___________
admission to discharge
role of nurse
__________ by protecting the patient
advocate
role of nurse
question / clarify incorrect or incomplete _________ ________
medication orders
role of nurse
know when to ______ medications or request alternate ______, if needed
hold
route
role of nurse
know if meds are ________
compatible
role of nurse
never leave meds ____________ or at the _______
unattended
bedside
role of nurse
who is hold accountable? why?
nurse
roles - patient rights
receive a qualified __________ _____________
nursing assessment
roles - patient rights
pt should be informed of … (6)
-the drug name
-the drug dosage
-reason for receiving the drug
-frequency or how often they will receive the drug
-the route
-potential underside effects
roles
patient has the right to receive ________ medications and opened in their presence
labeled
roles
patient has right to receive medications administered ___________
correctly
roles
pt has right to not to receive ____________ medications
unnecessary
roles
patient has right to _________ to take a medication. always ___________ ________ if pt questions you
refuse
double check
roles
components of a medication order (7)
-pt name
-date and time
-name of medication
-dosage
-route of administration
-time/frequency of administration
-signature/verification of prescriber
orders
standing or routine
administered until the dosage is changed or another medication is prescribed
orders
single (one-time)
given one time only for a specific reason
orders
now
when a medication is needed right away, but not STAT
orders
range order
medication order is written with dosage having a range
orders
PRN/contingency
given when the pt requires it
orders
STAT
given immediately in an emergency
orders
prescriptions
medications to taken outside of the hospital
roles - verbal / telephone orders
avoid ________ abbreviations
DNU
roles - verbal / telephone orders
CN/RN must document “_____________” “____________”
read back
spell back
roles - verbal / telephone orders
provider must approve and verify within _____hrs
24
roles - verbal / telephone orders
things included in telephone order (7)
-pt name
-date and time
-medication
-dosage
-route
-time and frequency
-signature of prescriber
students may NOT (4)
-admin meds alone
-chemo,blood,etc
-verbal/telephpne orders
-perform any procedures alone
7 rights
1.
2.
3.
4.
5.
6.
7.
right
use 2 identifiers - what are they ? what else if needed?
right
check label!!! for spelling, expiration date
right
know what the appropriate dose ranges are based on the route and pt
right
know how the drug can and cannot be given : order determines route
right and
know medication schedules
right - is the order/medication appropriate
-pt history
-thorough assessment
right - in the eMAR (3)
-may always require co-signature/updated info
-always document delays, omissions/refusals,reassessments/responses
-NEVER
ethics and legal
diversion (defined by DEA)
use of prescription drugs for alternative purposes from the original intent
ethics and legal
diversion : +/- ______% of healthcare workers divert narcotics
15%
ethics and legal - diversion
______ and _______ _________ are contributing factors leading to abuse
stress and chronic illness
ethics and legal - diversion
hospital narcotics are (DOC) drug of choice for _________
abusers
ethics and legal
diversion (defined by DEA)
any employee who has knowledge a co-worker is stealing drugs has an obligation to __________ to immediate supervisor or employer
report
ethics and legal
every time a narcotic is pulled a _________/________ count of that narcotic is reported
before/after
ethics and legal
wastage of narcotics is always ___________ and immediately __________ by another license nurse
witnessed
documented
ethics and legal
diversion - consequences (7)
-drug screening w 3 day suspension for + findings of narcotics
-immediate terminated if deemed necessary
-report to Peer Review to establish treatment
-report to BNE of violation and treatment
-police are notified, report filed, CEO involved, etc.
-can lose nursing license
-TPAPN
TPAPN
Texas Peer Assistance Program for Nurses
ethics and legal
if convicted for personal use … (3)
-state jail felony (180 days to 2 years)
-fine up to 10,000
-suspension or revocation of license
ethics and legal
if convicted for benefit of others.. (3)
-2-10 years
-fine up to 10,000
-suspension of revocation of license
