Med Administration Flashcards
Med error is the ____ leading cause of death in the US.
3rd
Nurse get approximately __ orders per shift and medication takes ____ of their time.
50; 1/3
How many Americans die as a result of med errors?
7000-9000
Med errors cause at least __ death every day in US
1
Med errors injure more than _____ ________ people every year in US
1.3 million
US spends more than __ _______ each year on pt’s affected by med errors.
40 billion
What percentage of med errors are admitted by nurses?
On the verge of med errors?
54.55%
31.37%
What are the most common types of errors?
wrong dose and infusion rate
What are the most common cause of nurse’s med errors?
lack of pharmacological knowledge
Med errors cause what?
death
disability
life-threatening situation
birth defects
hospitalization
Med errors are caused by who?
inappropriate med use
-provider’s orders (prescribes and monitors)
-resource, pharmacist, dispenses (verification and preparation)
-nurse administrators (administers and monitors)
When do medical errors occur?
ordering/prescribing
transcribing
dispensing
administering
monitoring
Type of med errors
wrong pt
wrong drug
wrong route
wrong time
wrong dose/omitted drugs
wrong form
wrong technique
deteriorating drug error
compliance
wrong doc
Providers/Pharmacist/Nurse
Factors associated with med errors
distractions
poor communication
lack of training
inadequate knowledge of pt/drug
overworked or fatigued
physical/emotional health issues/stress
Patients Factors associated with med errors
personality
literacy
multiple health conditions
polypharmacy
language barrier
inconsistent method
Where are the med errors of pharmacy/providers/nurses occur?
administration technique
lack of drug-drug interaction knowledge
miscalculation of dosage
drug preparation
computer error
stocking error
transcription error
Communication med errors occur
name confusion
illegible handwriting
verbal order
brand name confusion
generic name confusion
labeling
Ways to reduce med errors
pt and family active role and educated on meds
health care workers have the tools and info needed to prescribe, dispense, and administer
-computerized pharmacists with physicians in high-risk areas
-bar code systems
-med reconciliation
-error-prone abbreviations
-med education for new and existing staff
-limitations and safeguarding for verbal orders
No Place for complacency in nursing
when you become secure in your work that you take potentially dangerous shortcuts in your tasks, don’t perform to same quality as you once did or become unaware of deficencies
High Alert - TALL Man System
look alike/sound alike meds
Black Box Warning
alert of increased risk: result in death or serious injury
strictest labeling requirements FDA mandate for prescribing drugs
When an error occurs what priority is first?
access/monitor pt consciously for adverse reactions, notify the charge nurse, and contact the physician
-complete the incident report
-evaluate
-a culture of safety
Every step of safe med admin requires a _________ ___________ and a ____________, ______________ ____________.
disciplined attitude; comprehensive, systemic approach
The nurse needs to know
med knowledge: pros and cons
pt allergies
how to calculate med dosages
factors affecting pt’s response
nursing process
Nurse Practice Act (NPA)
Role of Nurses
=Up-to-date database
- known/new meds, dose(s), route, frequency, reasons, instructions/considerations/precautions/drug-drug interactions
=skills ensure
=know pt
=implement the nursing care plan
- assessments, problems, desired outcomes/goals, interventions, evaluations
=pt education from admission to discharge
=advocate by protecting pt
=nurse is accountable
Advocate by protecting pt
-questions/clarify incorrect or incomplete med errors
-know when to hold meds or request med orders
know if meds are incompatible
never leave meds unattended or at bedside
Role of pt
-understand their responsibilities, treatment, and question what they don’t understand
-adhere regimen
-report adverse reactions
-correct storage
Pt’s Rights
-qualifies for nursing assessments
-informed of all things drug-related
-received med admin correctly
-receive labeled meds and open in their presence
-no unnecessary meds
-refuse meds (double check)
Components of Med Order
pt name
date and time
name of meds
dosage
route administration
time-frequency of administration
signature
verify prescriber
Standing/Routine order
adminstered until dosage is changed or another med prescribed
Single (one time) order
given 1 time only for a specific reason
Now orders
needed right away but not STAT
Range order
order written with dosage having a range
PRN contingency orders
given when required
STAT orders
given immediately in emergency
Prescriptions orders
med taken outside of a hospital
Verbal/Telephone orders
document “readback, and spellback”
-provider must approve and verify within hours
-ALL components needed
DO NOT USE LIST
u
IU
q
#.0
MS
MSO4, MgSO4
Students Do Not Use List
admin meds alone
chemo, blood, etc.
verbal telephone orders
perform any procedures alone
7 Rights
Right pt: 2 identifiers
Right med: check the label (spelling, expiration)
Right dose: appropriate dose ranges based on route and pt
Right time: med schedule
Right route: given and order determines route
Right reason: appropriate for history
Right doc: eMAR, sign and updated infor
Should you pre-document med orders?
No
Diversion DEA definition
use of prescription drugs for alternate purposes from the original intention
+ 15% healthcare workers divert narcotics
_____ and _____ ______ contributing factors lead to abuse
stress
chronic illness
Hospital narcotics are _____________ for abusers
drug of choice
Pt advocacy means obligated to
report info to supervisor about a coworker
Narcotic Accountability is maintained and monitored
100% 24/7 via Pyxis system
-daily and weekly report from pharmacy
-every med is recorded
-wastage always witnessed by another nurse
Consequences of Diversion
-drug screening with 3 days suspension if found
-immediate termination
-report peer review to establish treatment
-report BNE of violation and treatment
-police notify, a report was filed, CEO involved
-TPAPN (voluntary or mandated)
= identify mental health, alcohol, or drug problem and assist treatment, and return to work
Personal Convicted
state jail felony (180 days to 2 years)
fined $10,00
suspension or revocation of license
Convicted of Drug Possession from Hospital for the benefit of others
2-10 years
-$10,000
