Week 2 - Medication Safety Flashcards
What is standard 4?
Aims to ensure that clinicians safely prescribe, dispense and administer appropriate medicines, and monitor medicine use.
What are the common errors in medication?
- Incorrect admission documentation
- Errors in prescription; incorrect dose
- Administration of medication when there is an allergy
- Errors in documentation
- Failure to recognise adverse side effects
- Lack of patient education
Why do nurses make mistakes while giving medications?
- Similar names and packaging
- Distractions on medication rounds
- Rushing the task
- Not understanding medications and their uses
- Dangerous abbreviations
- Not documenting at the time of administration
How can we prevent mistakes?
- Medication history, medication management plan, reconciliation
- National Standard Medication Chart
- Generic names
- Tall man lettering
- Terminology, abbreviations and symbols
How to improve our medication knowledge
- Valid order
- Allergy
- ask patient, check medication chart and look for arm band
- AusDI & Australian Injectable Drug Handbook
– Indication, contraindication, adverse effects,
precautions, recommended dose …
What is red in injectables medicines?
Target tissue - Intra-arterial
Route of administration - Intra-arterial
What is blue in injectables medicines?
Target tissue - Intravenous
Route of administration - Intravenous
What is yellow in injectables medicines?
Target tissue - Neural tissue
Route of administration - Epidural, intrathecal and regional
What is beige in injectables medicines?
Target tissue - Subcutaneous tissue
Route of administration - Subcutaneous
What is pink in injectables medicines?
Target tissue - Miscellaneous
Route of administration - Any other route not specified above
What are the other medication routes?
- Ophthalmic medication
- Rectal medication
- Topical medication (Transdermal patches)
- Inhaled medication (nebuliser and inhaler)
- Enteral medication (NGT)
Explain pharmacokinetics of absorption
the process by which a medication passes from the source of administration into the bloodstream.
What factors can influence absorption
It is influenced by factors such as:
* body surface area, blood flow, presence of food, ability of
medication to dissolve, lipid solubility of medication
* the route of administration, such as: oral, inhalation, topical, IM, IV
* medication form, such as: liquid, capsule, tablet, enteric coated, sustained release, suppository, transdermal patches
Explain pharmacokinetics of distribution
- is the transportation of a drug from its site of
absorption to its site of action. - blood circulation, protein binding, membrane permeability
Explain pharmacokinetics of metabolism
- the process by which a drug is transformed
into a less active or inactive form. - occurs in the liver, but also lungs, kidney, intestines
Explain pharmacokinetics of excretion
- the process by which metabolites and drugs are
eliminated from the body. - mainly via the kidneys, but also intestines, lungs, skin, breastmilk
What are some considerations when giving out medications?
Medication doses for the very young and older adult need to be adjusted due to pharmacokinetic variations such as:
* immature or age affected organs
* skin, intestine, liver & kidneys
* poor peripheral tissue perfusion
* higher (very young) or lower (older adult) water content
* composition of body fat
* lower plasma proteins (albumin)
* Weight
What are some paediatric medication consideration?
Variables impacting on the calculation of a medication dose:
* height/length, weight, age, body surface area
* Liquid forms
* Use disposable syringe to prepare dose < 10 mL
What are some geriatric medication consideration?
Precautions associated with comorbidities
* Polypharmacy – prescription, over the counter drugs, ‘sharing’
* Interactions between drugs
* Higher rate adverse effects
and mortality
* Increase risk falls, frailty
and disability
What is the meaning of the following abbreviation - CD
- CD Controlled Dose
What is the meaning of the following abbreviation - EC
- EC Enteric Coated
What is the meaning of the following abbreviation - SR
- SR Slow Release
What is the meaning of the following abbreviation - LA
- LA Long Acting
What is the meaning of the following abbreviation - ER/XR
- ER/XR Extended Release
What is the meaning of the following abbreviation - MR
- MR Modified Release
What is the meaning of the following abbreviation - CR
- CR Controlled Release
Where should medications be stored?
All medications must be stored in a locked cupboard, room, drawer or trolley when not in immediate use
1 Except for emergency trolley medications
2 All medications must be stored in same container as received from Pharmacy
3 Medications must be stored in manner that minimizes medication error
4 Medication keys must be kept separate from other ward keys
Where should Schedule 8 and
Schedule 4 Appendix D Medication be stored?
- Drugs of addiction
- Stock levels of S8 and S4D/R medications should be kept to lowest level practicable
- Must be stored in separate medication storage unit:
– Metal safe
– Securely attached to floor or wall
– Kept locked
– Lock should be five lever lock
– Close to CCTV monitoring
What is the cold chain management?
- System of transporting and storing vaccines within the temperature range of +20C to +80C
- Ideal is + 50C
- Staff in hospitals/clinics responsible for:
– receiving
– stocking
– storing
– administering - Must ensure cold chain is maintained at all stages
