Medication Administration Flashcards
what is a near miss?
when a Pt. is exposed but not harmed due to d/t detection or luck
does a near miss have to be reported?
yes
what contributes to medication errors?
-system processes
-workload
-lack of communication and collaboration
-inadequate education
-workarounds
technology eliminates potential medication errors. true or false?
false. (do not assume correct and question any issues)
what are the stages of the medication process?
- prescribing
- transcribing
- dispensing
- administering
- monitoring
what % of pts. experience a medication error?
3-6.9%
what phases of the medication process is the nurse involved in?
transcribing
administering
monitoring
who is involved in the prescribing phase?
HCP, pharmacist
what is involved in the prescribing phase? (5 steps)
-clinical decision making→ -drug choice→
-drug regimen determination→
-medical record documentation→
-order (written, verbal, electronic)
who is involved in the transcribing phase?
the nurse
who is involved in the dispensing phase?
the pharmacist
what is involved in the transcribing phase? (2 steps)
-receive order from eMAR→
-check if correct (acknowledge is all we do)
what is involved in the dispensing phase? (4 steps)
-data entry and screening→
-preparing, mixing, -compounding→
-pharmacist double-check→
-dispensing to unit
who is involved in the administering phase?
the nurse
what is involved in the administration phase? (4 steps)
-drug preparation for administering→
-nurse verifies orders→
-drug administered→
-documented in eMAR
who is involved in the monitoring phase?
nurse
physician
pharmacist
what is involved in the monitoring phase? (4 steps)
- assess for therapeutic and adverse effects→
-review laboratory results if necessary→
-treat adverse drug event if occurring→
-medical record documentation
what happens after the monitoring stage?
quality improvement activities (as needed)
-voluntary safety reporting
-mandatory safety reporting for serious events w/in organization
-outcomes measurement for certain populations
what are the 9 rights of medication administration?
- right drug
- right dose
- right time
- right route and form
- right patient
- right documentation
- right reason
- right response
- right to refuse
how is the right patient identified?
ask pt. name and DOB
verify with eMAR
verify with ID band
what are the 7 components of a medication order?
- patients name
- medication name
- dose with unit measurement
- frequency
- route
- prescribers signature w/ date and time
- indication
when is “indication” not used?
in PRN meds in acute care (req. in LTC)
what is missing?
acetaminophen 650mg q6h prn pain
route
what is missing?
hydrocodone/acetaminophen tabs PO q4h prn
dose
what is missing?
morphine sulfate 2 q2h prn pain
measurement
route
what is missing?
furosemide 40mg one tab PO
frequency
what does SALAD stand for?
sound-alike, look-alike drugs
what is the point of TALLman lettering?
FDA and ISMP have drawn attention to sound-alike, look-alike drugs by using distinctive tall lettering on drugs that are often confused
Ex oxyCODONE and oxyCONTIN
What are the four umbrellas under Adverse Drug Reactions (ADRs)?
-drug-drug interactions
-allergic
-adverse reactions (side effects)
-idiosyncratic
what is the difference between ADRs and medication errors?
one is preventable (med errors)
what are adverse drug events (ADEs)
any injuries resulting from medication use. can result in prolonged hospitalization, disability, life-threatening problems or death
what are the (2) characteristics of drug-drug interaction?
-2 or more drugs
-enhances or diminish effects of another drug
what are three points under adverse reactions (side effects)?
-predictable
-may need symptom management (stool softener)
-resolves with discontinuation
what are the two points under allergic reactions?
-hypersensitivity
-immune response
what are the two points under idiosyncratic reactions?
-unpredictable, unexpected
-rare and peculiar
how are medication errors different from the other Adverse Drug reactions?
they are preventable
what is the definition of adverse drug reactions?
unexpected, unintended or excessive reaction that occurs at therapeutic doses
what are the bullet points under medication errors?
-error in the med process
-may/may not cause harm
-“rights” compromised
-known allergies
what are the 7 steps that need to be taken if a medication error occurs?
- assess pt. first
- report to the instructor/charge nurse
- monitor changes in condition
- document follow-up assessments using factual information (no using word “error”)
- notify physician and follow-up orders
- provide full discloure to the pt.
- file incident report to hospital
what are (8) common kinds of medication errors?
-not doing 3 checks
-giving meds to the wrong pt.
-confusing sound-alike drugs
-not obtaining a full medical history
-lack of knowledge
-dosing miscalculations
-work-arounds
-environmental factors
what is a recommended way to avoid dosing miscalculations?
ask another nurse to calculate the dosage to verify (without knowing what answer you got)
