Medication Administration II

Question 1

Category A

Answer 1

actual error did not occur, almost did

Question 2

Category B

Answer 2

error did not reach patient

Question 3

Category C

Answer 3

error did not harm patient and there was no intervention needed to preclude harm nor was extra monitoring needed

Question 4

Category D

Answer 4

Error did not harm patient and interventions were made to preclude harm and extra monitoring was required

Question 5

Category E

Answer 5

Patient was harmed. Required interventions to sustain life. Harm was temporary and required prolonged hospitalization

Question 6

Category F

Answer 6

Patient was harmed. Required interventions to sustain life. Harm was temporary and did not require prolonged hospitalization

Question 7

Category G

Answer 7

patient was harmed, required interventions to sustain life, harm was not temporary- harm was permenant

Question 8

Category I

Answer 8

error contributed or resulted in patient death

Question 9

Category II

Answer 9

patient was harmed, which required interventions to sustain life, but harm was not permentant

Question 10

Near Misses

Answer 10

Error did not reach patient

Question 11

Adverse Events

Answer 11

any undesirable experience associated with the use of a medical product in a patient. Sometimes preventable sometimes not. Rarely reported

Question 12

Sentinel Events

Answer 12

Reportable to Joint Commission. Errors that did harm or caused patient death. Investigation done to determine root cause to determine cause and required interventions

Question 13

Medication Error Definition

Answer 13

any preventable event that may cause or lead to inappropriate medication use or patient harm during Medication Administration Process

Question 14

Factors contributing to Med. Errors (11)

Answer 14

6 Rights, Agency checks, Client variables, verbal/phone orders, illegible/incomplete orders, stress/fatigue, short-term memory, being late or in a hurry, multitasking, interruptions, environment

Question 15

Patient’s Impact of Med Errors

Answer 15

prolonged hospitalization, increased cost and time, harm to patient, loss of trust in healthcare team

Question 16

Staff Nurse’s Impact of Med errors

Answer 16

self-doubt, traumatized, poor reputation

Question 17

Administrative Personnel Impact

Answer 17

may be penalized b/c of errors in their dept. Investigations

Question 18

Hospital’s Impact

Answer 18

Poor reputation, perceived as unsafe, penalization, financial costs

Question 19

Med Error Prevention- Assessment (5)

Answer 19

Ask patient: Allergies, concerns, OTC meds/herbal supp, Med taken prior
Assess: Kidney/liver functions for impairments and pharmacotherapeutic effects

Question 20

Med Error Prevention- Planning (5)

Answer 20

Minimize Contributing Factors: abbreviations, question orders, don’t accept verbal orders, follow policies/procedures, ensure patient can demonstrate/understands goals of therapy

Question 21

Med Error Prevention- Implementation Pre-Admin (6)

Answer 21

Eliminate distractions, 6 Rights, verify patient ID, correct route techniques, calculate doses correctly, double check

Question 22

Med Error Prevention- Implementation Post-Admin (5)

Answer 22

record meds on MAR immediately, confirm patient swallowed, be alert for long-acting oral dose forms, medication reconciliation, Patient education

Question 23

Med Error Prevention- Evaluation

Answer 23

expected outcomes, adverse events, quality improvement

Question 24

First step once Error is recognized

Answer 24

Assess patient’s reactions, document findings, notify PCP

Question 25

Documentation of Error- Incident report

Answer 25

factual/objective, avoid blame or judgement.
Must record specific nursing interventions implemented to protect patients safety
Document all individuals who were notified

Question 26

Purpose of Incident Report

Answer 26

ID contributing factors, assist in identifying performance improvements to prevent
Risk management use for quality improvements
Education/administrative purposes to ID common errors

Question 27

Failure Mode and Effect Analysis (FMEA)

Answer 27

systems that anticipate error. same as RCA but error never occured