Medication safety (not complete) Flashcards
How are some ways that pharmacists provide medication safety?
- ensuring the patient has access to the medications
- supplying medication information
- making sure the medication is appropriate for the patient
- improving patient medication adherence
- providing health and wellness services
- performing medication management services
- assessing the patient’s health status
- coordinating care transitions for the patient
What system should we use in written orders?
the metric system
Should we use decimals in written orders?
no if that is possible
Should we use a leading zero when we do use decimal points?
yes always
should we use trailing zeros after the decimal?
no
Should we abbreviate medication names?
not unless they are approved (when it doubt, write it out)
What is FDA/ISMP-recommended Tall Man Lettering?
This is labeling in which look alike sound alike drugs have the distinctive lettering capitalized so we do not get them confused with each other on accident.
What are the 5 governmentally controlled organizations that focus on medication safety?
AHRQ, NCQA, FDA, CMS, DEA know these and then know that any others besides these are Independent
What is the Medication Management System? what are the steps in order?
this is the process that occurs from the time the drug is selected in the order until after it has been given tot he patient:
1) selection
2) storage
3) prescribing and transcribing
4) preparing and dispensing
5) administration
6) monitoring
What does MUP stand for?
Medication Use Process
What are the 5 nodes in MUP
-prescribing order entry dispensing administration monitoring
What has to happen in order for a medication error to occur?
The problem/error has to slip through everyone of the safety checks and never get caught before it reaches the patient
What is a medication error?
This is a preventable event/mistake in the MUP that may cause inappropriate medication use or patient harm
What are the three categories of Medication errors?
- potential
- prevented
- actual
What is a potential medication error?
a situation that proposes hazard and might turn into an error
What is a prevented medication error?
A mistake that has been made and IS DETECTED and corrected prior to administration tot he patient
What is an actual medication error?
this is a mistake that is not detected or corrected prior to administration to the patient (a mistake reached the patient)
What is an actual medication error?
this is a mistake that is not detected or corrected prior to administration to the patient (a mistake reached the patient)
Is the absence of errors evidence of safety?
No, because over half of the errors made go unnoticed
Where do most MUP errors occur?
administration
What are all the types of errors that can occur in MUP?
- prescribing
- order entry
- dispensing
- administration
- monitoring
What are “high alert” patient groups?
- pediatrics
- geriatrics
- polypharmacy
- pregnant or breastfeeding women
- renally/hepatically/physically impaired patients
- chrinically sick patients or patients with cancer
What are characteristics of medications that are “high-alert”?
- administered parenterally
- concentrated formulations
- complex measurement or complex dosing schedules?
- drugs with a narrow therapeutic index
- drugs that require close monitoring
What are examples of high-alert medications? (APINCH)
anti-invectives, potassium (and other electrolytes), insulin, narcotics, chemotherapy drugs, heparin (and other anti-coagulants)
what is a system-oriented approach to medication errors?
this is a process that never blames the employee. they make the environment a place where the worker does not feel like they are going to get fired for reporting their mistake
what is the difference between the medication management system and the MUP?
The medication management system takes into account ordering and storage, and MUP does not because ti only has 5 nodes. Otherwise they are the same.
how does an error occur in MUP?
it has to slip through the cracks in all 5 categories in order to make it to the patient.
what is a medication error?
any preventable event or mistake that may cause the patient harm
what are the three types of medication errors?
potential, prevented, and actual
what is a potential error?
this is an error that could have happened, but didn’t it just had the potential to occur
what is a prevented error
this is an error that did happen, but there was an intervention before it reached the patient
what is an actual error?
this is an error that got to the patient and caused the patient harm
what are the two most common medication errors?
ordering and administration tot he patient
what are common causes fo med errors?
- human factors
- environmental factors
- communication errors (abbreviations etc)
- name of the lable confusion
- high-risk populations
- hazardous medications
- drug dosing calculations
what are high risk populations?
- pediatrics
- polypharmacy
- pregnant or breastfeeding women
- physically impaired patients
- geriatrics
- chronically ill patients
- infected patients
- cancer patients
what are characteristics of high risk medications?
- administered parenterally
- concentrated formulations
- complex measurement/dosing
- narrow therapeutic index
what are the “A PINCH” drugs?
anti-infectives, potassium and other electrolytes, insulin, narcotics, chemotherapy drugs, heparin and other anticoagulants
what is an adverse event?
this is an event where the patient was harmed but not necessarily because of the drug
what is an adverse drug event?
this is an event where the patient is caused harm caused by the drug
what is an adverse drug reaction?
this is an adverse event that occurs because of the drug, but the drug was given at normal doses the patient just was easily harmed but he medication. it is nothing that could have been controlled.
What are the steps to classifying a drug error?
1) is it potential, prevented, or actual?
2) what measure s were required to resolve it? monitoring? intervention? or intervention necessary to sustain life?
3) what degree of harm occurred? none? mild? moderate? severe?
what is mild harm?
this is harm where the patients vital signs may have changed but no intervention was done and the problem resolved itself
what is moderate harm?
this is harm where the patients vital signs changed and medical/surgical intervention was needed to correct it
what is severe harm?
this is harm that drastically changed the patient’s vital and caused them to be in the hospital for longer than 14 days, drastically changed their life forever, or killed them
what is a type A adverse drug reaction?
this is a drug reaction that occurred because of a pharmacological error
what is a type B adverse drug reaction?
this is a drug reaction that occurred because of hypersensitivity in the patient
What is a SADR?
this is a serious adverse drug reaction that caused hospitalization, disability, birth defects, and even death
