Medication safety (not complete)

Question 1

How are some ways that pharmacists provide medication safety?

Answer 1

• 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

Question 2

What system should we use in written orders?

Answer 2

the metric system

Question 3

Should we use decimals in written orders?

Answer 3

no if that is possible

Question 4

Should we use a leading zero when we do use decimal points?

Answer 4

yes always

Question 5

should we use trailing zeros after the decimal?

Answer 5

no

Question 6

Should we abbreviate medication names?

Answer 6

not unless they are approved (when it doubt, write it out)

Question 7

What is FDA/ISMP-recommended Tall Man Lettering?

Answer 7

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.

Question 8

What are the 5 governmentally controlled organizations that focus on medication safety?

Answer 8

AHRQ, NCQA, FDA, CMS, DEA know these and then know that any others besides these are Independent

Question 9

What is the Medication Management System? what are the steps in order?

Answer 9

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

Question 10

What does MUP stand for?

Answer 10

Medication Use Process

Question 11

What are the 5 nodes in MUP

Answer 11

-prescribing
order entry
dispensing
administration
monitoring

Question 12

What has to happen in order for a medication error to occur?

Answer 12

The problem/error has to slip through everyone of the safety checks and never get caught before it reaches the patient

Question 13

What is a medication error?

Answer 13

This is a preventable event/mistake in the MUP that may cause inappropriate medication use or patient harm

Question 14

What are the three categories of Medication errors?

Answer 14

• potential
• prevented
• actual

Question 15

What is a potential medication error?

Answer 15

a situation that proposes hazard and might turn into an error

Question 16

What is a prevented medication error?

Answer 16

A mistake that has been made and IS DETECTED and corrected prior to administration tot he patient

Question 17

What is an actual medication error?

Answer 17

this is a mistake that is not detected or corrected prior to administration to the patient (a mistake reached the patient)

Question 18

What is an actual medication error?

Answer 18

this is a mistake that is not detected or corrected prior to administration to the patient (a mistake reached the patient)

Question 19

Is the absence of errors evidence of safety?

Answer 19

No, because over half of the errors made go unnoticed

Question 20

Where do most MUP errors occur?

Answer 20

administration

Question 21

What are all the types of errors that can occur in MUP?

Answer 21

• prescribing
• order entry
• dispensing
• administration
• monitoring

Question 22

What are “high alert” patient groups?

Answer 22

• pediatrics
• geriatrics
• polypharmacy
• pregnant or breastfeeding women
• renally/hepatically/physically impaired patients
• chrinically sick patients or patients with cancer

Question 23

What are characteristics of medications that are “high-alert”?

Answer 23

• administered parenterally
• concentrated formulations
• complex measurement or complex dosing schedules?
• drugs with a narrow therapeutic index
• drugs that require close monitoring

Question 24

What are examples of high-alert medications? (APINCH)

Answer 24

anti-invectives, potassium (and other electrolytes), insulin, narcotics, chemotherapy drugs, heparin (and other anti-coagulants)

Question 25

what is a system-oriented approach to medication errors?

Answer 25

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

Question 26

what is the difference between the medication management system and the MUP?

Answer 26

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.

Question 27

how does an error occur in MUP?

Answer 27

it has to slip through the cracks in all 5 categories in order to make it to the patient.

Question 28

what is a medication error?

Answer 28

any preventable event or mistake that may cause the patient harm

Question 29

what are the three types of medication errors?

Answer 29

potential, prevented, and actual

Question 30

what is a potential error?

Answer 30

this is an error that could have happened, but didn’t it just had the potential to occur

Question 31

what is a prevented error

Answer 31

this is an error that did happen, but there was an intervention before it reached the patient

Question 32

what is an actual error?

Answer 32

this is an error that got to the patient and caused the patient harm

Question 33

what are the two most common medication errors?

Answer 33

ordering and administration tot he patient

Question 34

what are common causes fo med errors?

Answer 34

• human factors
• environmental factors
• communication errors (abbreviations etc)
• name of the lable confusion
• high-risk populations
• hazardous medications
• drug dosing calculations

Question 35

what are high risk populations?

Answer 35

• pediatrics
• polypharmacy
• pregnant or breastfeeding women
• physically impaired patients
• geriatrics
• chronically ill patients
• infected patients
• cancer patients

Question 36

what are characteristics of high risk medications?

Answer 36

• administered parenterally
• concentrated formulations
• complex measurement/dosing
• narrow therapeutic index

Question 37

what are the “A PINCH” drugs?

Answer 37

anti-infectives, potassium and other electrolytes, insulin, narcotics, chemotherapy drugs, heparin and other anticoagulants

Question 38

what is an adverse event?

Answer 38

this is an event where the patient was harmed but not necessarily because of the drug

Question 39

what is an adverse drug event?

Answer 39

this is an event where the patient is caused harm caused by the drug

Question 40

what is an adverse drug reaction?

Answer 40

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.

Question 41

What are the steps to classifying a drug error?

Answer 41

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?

Question 42

what is mild harm?

Answer 42

this is harm where the patients vital signs may have changed but no intervention was done and the problem resolved itself

Question 43

what is moderate harm?

Answer 43

this is harm where the patients vital signs changed and medical/surgical intervention was needed to correct it

Question 44

what is severe harm?

Answer 44

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

Question 45

what is a type A adverse drug reaction?

Answer 45

this is a drug reaction that occurred because of a pharmacological error

Question 46

what is a type B adverse drug reaction?

Answer 46

this is a drug reaction that occurred because of hypersensitivity in the patient

Question 47

What is a SADR?

Answer 47

this is a serious adverse drug reaction that caused hospitalization, disability, birth defects, and even death