Module 8: Principals of Safe Medication Administration Flashcards

1
Q

Stock Supply System

A
  • Medications are available in quantity, in large, multi-dose containers
  • Is time consuming and costly
  • High rate of medication errors
  • Not commonly used today
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2
Q

Unit-Dose System

A
  • Uses portable carts containing a drawer with a 24-hour supply of medications for each patient
  • Each drawer is labelled with the patients name
  • Each tablet or capsule is wrapped in a foil or paper container
  • At a designated time each day the pharmacy refills the drawers
  • Also contains limited amounts of PRN medications
  • Controlled substances are not kept in the individual drawers
  • Designed to reduce medication errors and save steps when dispensing medication
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3
Q

Automated Dispensing System (AMDS)

A
  • Use computerized controls to dispense narcotics and unit-dose medication
  • Each nurse accesses with a security code
  • Are controlled electronically via pt’s profile
  • PTs name and drug profile must be accessed before AMDS will dispense the medication
  • COW (Computer on wheels)
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4
Q

Information contained on a MAR

A

-Patient name, DOB, hospital #
-Date/time
-Medication ordered
-Dose ordered
-Frequency
-Route
-Scheduled medications
-PRN medications
-
-

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5
Q

Forms of Medication

A
  • Oral
  • Topical
  • Parenteral
  • Instillation
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6
Q

Routes of Medication Administration

A

-Oral routes (SL, Buccal)
-Parenteral routes (ID, IV, IM, SC)
Epidural, Intrathecal, Intraosseous.
-Topical administration
Transdermal disc aka patch
-Inhalation
-Intraocular

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7
Q

High-Alert Medications

A

Medications that present a risk of causing serious injury or death if used incorrectly

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8
Q

Additional precautions to prevent errors with High-Alert Medications

A
  • Independent double checks are required
  • Two health care professionals shall independently verify:
    a) the most current prescriber order or medication administration record
    b) the patient’s relevant laboratory values and/or diagnostic results
    c) medication dosage calculations
    d) 7 medication rights
    e) pump programming
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9
Q

Seven Rights of Safe Medication Delivery

A
  1. RIGHT Client (Name, DOB, ID #)
  2. RIGHT Medication
  3. RIGHT Dose
  4. RIGHT Route
  5. RIGHT Time
  6. RIGHT Reason
  7. RIGHT Documentation
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10
Q

Three Additional Rights of Medication Delivery

A
  1. RIGHT to refuse
  2. RIGHT Patient education
  3. RIGHT Evaluation
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11
Q

Forms of Oral Medication

A
Solid
-Tablet
-Capsule
-Enteric-coated
Liquid
-Extract
-Syrup
-Elixir
Other
-Aerosol
-Lozenges
-Sustained release
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12
Q

Forms of Topical Medication

A
  • Ointment
  • Liniment
  • Lotion
  • Paste
  • Transdermal disc or patch
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13
Q

Forms of Parenteral Medication

A
  • Solution

- Powder

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14
Q

Forms of Instillation Medication

A
  • Solution
  • Intraocular disc
  • Suppository
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15
Q

Process of Medication Reconciliation (4)

A
  1. Verify
  2. Clarify
  3. Reconcile
  4. Transmit
    - When a patient is admitted into any health care setting, the nurse should compare the medications the patient took in the previous setting with the current ordered medications.
    - Upon discharge, the nurse reviews the patient’s current medications with the health care providers in the new setting
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16
Q

Benefits of Medication Reconcilliation

A

-Essential step in ensuring medication safety

17
Q

Common Causes of Medication Errors

A
  • Preparing drugs on multiple patients
  • Nonstandard times
  • Documentation
  • MAR’s unavailable
  • Held/discontinued meds
  • Nonspecific doses
  • Monitoring issues
18
Q

Typed of Orders

A
  • Routine or scheduled – carried out until the prescriber cancels it by writing a new order or until a prescribed number of days have elapsed
  • As needed (“PRN”) – given when the patient requires it
  • Single or one-time dose – given one time only for a specific reason (e.g. before surgery)
  • STAT – given immediately such as in an emergency
19
Q

How to Reduce Med Errors Associated with Verbal Orders/Rx

A
  • Read labels at least 3 times; compare label with MAR before, during, and after
  • Use at lease two patient identifiers
  • Double check all calculations and verify with another nurse
  • Don’t interpret illegible handwriting; clarify with prescriber
  • Questions unusually large or small doses
  • Document as soon as meds are given
  • Avoid abbreviations
20
Q

Common Dosage Administration Schedules

A

am: 0800
pm: 1700
hs: 2200
bid: 0800, 1700
tid: 0800, 1200, 1700
qid: 0800, 1200, 1700, 2200
am ac: 0700
bid ac: 0700 1600
qid ac: 0700, 1100, 1600. 2200
q6h: 0600, 1200, 1800, 2400
q8h: 0600, 1400, 2200
q12h: 1000, 2200

21
Q

Guidelines for Safe Narcotic Administration and Control

A
  • Store all narcotics in a locked, secure cabinet or container
  • Count narcotics frequently and record inventories
  • Report discrepancies immediately
  • Use a special narcotic record every time a narcotic is dispensed
  • If you only administer part of a premeasured dose another nurse must witness the disposal of the remaining amount
  • Meds are not to be disposed of in the sink,toilet or garbage. But returned to pharmacy in designated container