Med Administration

Question 1

Med error is the ____ leading cause of death in the US.

Answer 1

3rd

Question 2

Nurse get approximately __ orders per shift and medication takes ____ of their time.

Answer 2

50; 1/3

Question 3

How many Americans die as a result of med errors?

Answer 3

7000-9000

Question 4

Med errors cause at least __ death every day in US

Answer 4

1

Question 5

Med errors injure more than _____ ________ people every year in US

Answer 5

1.3 million

Question 6

US spends more than __ _______ each year on pt’s affected by med errors.

Answer 6

40 billion

Question 7

What percentage of med errors are admitted by nurses?
On the verge of med errors?

Answer 7

54.55%
31.37%

Question 8

What are the most common types of errors?

Answer 8

wrong dose and infusion rate

Question 9

What are the most common cause of nurse’s med errors?

Answer 9

lack of pharmacological knowledge

Question 10

Med errors cause what?

Answer 10

death
disability
life-threatening situation
birth defects
hospitalization

Question 11

Med errors are caused by who?

Answer 11

inappropriate med use
-provider’s orders (prescribes and monitors)
-resource, pharmacist, dispenses (verification and preparation)
-nurse administrators (administers and monitors)

Question 12

When do medical errors occur?

Answer 12

ordering/prescribing
transcribing
dispensing
administering
monitoring

Question 13

Type of med errors

Answer 13

wrong pt
wrong drug
wrong route
wrong time
wrong dose/omitted drugs
wrong form
wrong technique
deteriorating drug error
compliance
wrong doc

Question 14

Providers/Pharmacist/Nurse
Factors associated with med errors

Answer 14

distractions
poor communication
lack of training
inadequate knowledge of pt/drug
overworked or fatigued
physical/emotional health issues/stress

Question 15

Patients Factors associated with med errors

Answer 15

personality
literacy
multiple health conditions
polypharmacy
language barrier
inconsistent method

Question 16

Where are the med errors of pharmacy/providers/nurses occur?

Answer 16

administration technique
lack of drug-drug interaction knowledge
miscalculation of dosage
drug preparation
computer error
stocking error
transcription error

Question 17

Communication med errors occur

Answer 17

name confusion
illegible handwriting
verbal order
brand name confusion
generic name confusion
labeling

Question 18

Ways to reduce med errors

Answer 18

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

Question 19

No Place for complacency in nursing

Answer 19

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

Question 20

High Alert - TALL Man System

Answer 20

look alike/sound alike meds

Question 21

Black Box Warning

Answer 21

alert of increased risk: result in death or serious injury
strictest labeling requirements FDA mandate for prescribing drugs

Question 22

When an error occurs what priority is first?

Answer 22

access/monitor pt consciously for adverse reactions, notify the charge nurse, and contact the physician
-complete the incident report
-evaluate
-a culture of safety

Question 23

Every step of safe med admin requires a _________ ___________ and a ____________, ______________ ____________.

Answer 23

disciplined attitude; comprehensive, systemic approach

Question 24

The nurse needs to know

Answer 24

med knowledge: pros and cons
pt allergies
how to calculate med dosages
factors affecting pt’s response
nursing process
Nurse Practice Act (NPA)

Question 25

Role of Nurses

Answer 25

=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

Question 26

Advocate by protecting pt

Answer 26

-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

Question 27

Role of pt

Answer 27

-understand their responsibilities, treatment, and question what they don’t understand
-adhere regimen
-report adverse reactions
-correct storage

Question 28

Pt’s Rights

Answer 28

-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)

Question 29

Components of Med Order

Answer 29

pt name
date and time
name of meds
dosage
route administration
time-frequency of administration
signature
verify prescriber

Question 30

Standing/Routine order

Answer 30

adminstered until dosage is changed or another med prescribed

Question 31

Single (one time) order

Answer 31

given 1 time only for a specific reason

Question 32

Now orders

Answer 32

needed right away but not STAT

Question 33

Range order

Answer 33

order written with dosage having a range

Question 34

PRN contingency orders

Answer 34

given when required

Question 35

STAT orders

Answer 35

given immediately in emergency

Question 36

Prescriptions orders

Answer 36

med taken outside of a hospital

Question 37

Verbal/Telephone orders

Answer 37

document “readback, and spellback”
-provider must approve and verify within hours
-ALL components needed

Question 38

DO NOT USE LIST

Answer 38

u
IU
q
#.0
MS
MSO4, MgSO4

Question 39

Students Do Not Use List

Answer 39

admin meds alone
chemo, blood, etc.
verbal telephone orders
perform any procedures alone

Question 40

7 Rights

Answer 40

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

Question 41

Should you pre-document med orders?

Answer 41

No

Question 42

Diversion DEA definition

Answer 42

use of prescription drugs for alternate purposes from the original intention
+ 15% healthcare workers divert narcotics

Question 43

_____ and _____ ______ contributing factors lead to abuse

Answer 43

stress
chronic illness

Question 44

Hospital narcotics are _____________ for abusers

Answer 44

drug of choice

Question 45

Pt advocacy means obligated to

Answer 45

report info to supervisor about a coworker

Question 46

Narcotic Accountability is maintained and monitored

Answer 46

100% 24/7 via Pyxis system
-daily and weekly report from pharmacy
-every med is recorded
-wastage always witnessed by another nurse

Question 47

Consequences of Diversion

Answer 47

-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

Question 48

Personal Convicted

Answer 48

state jail felony (180 days to 2 years)
fined $10,00
suspension or revocation of license

Question 49

Convicted of Drug Possession from Hospital for the benefit of others

Answer 49

2-10 years
-$10,000