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PHAR 102 Ch 14
Chapter 14 Medication Safety
| Term | Definition |
|---|---|
| wrong amount error | a medication error that occurs when a dose is either above or below the correct amount by more than 5% |
| teratogenicity | high potential of a drug to cause harm to a fetus |
| psychological dependence | when the patient takes a drug on a regular basis because it produces a sense of well-being that the patient does not want to consider doing without |
| wrong time error | a medication error that occurs when a drug is given 30 minutes or more before or after it was prescribed, up to the time of the next dose, not including “as needed” orders |
| RxPatrol | a collaborative effort between industry and law enforcement designed to collect, collate, analyze, and disseminate pharmacy theft information |
| Institute for Safe Medication Practices (ISMP) | a nonprofit healthcare agency whose primary mission is to understand the causes of medication errors and to provide time-critical error-reduction strategies to the healthcare community, policy makers, and the public |
| Medication Errors Reporting Program (MERP) | a national program designed to allow healthcare professionals to report medication errors directly to the Institute for Safe Medication Practices (ISMP) |
| root-cause analysis | a logical and systematic process used to help identify what, how, and why something happened to prevent recurrence |
| capture error | a medication error that occurs when focus on a task is diverted elsewhere and, therefore, the error goes undetected |
| Vaccine Errors Reporting Program (VERP) | a national program designed to allow healthcare professionals to report vaccine errors directly to the Institute for Safe Medication Practices (ISMP) |
| extra dose error | a medication error that occurs when more doses are received by a patient than were prescribed by the physician |
| mislabeling error | a medication error that occurs when a medication has incorrect information on it leading to the wrong use of it, or the wrong patient receiving it |
| right of refusal | the ability of a pharmacist to decline with cause to fill any prescription, especially those for controlled substances |
| addiction | compulsive and uncontrollable use of a drug substance for reasons other than prescribed |
| SPEAK UP | an acronym for advice for hospital patients to get the safest, best health care, promoted by the Joint Commission and Centers for Medicare and Medicaid Services |
| quality related events (QREs) | medication errors that reach the patient; this includes “near misses” and unsafe conditions |
| rushed error | a medication error that occurs because of the pressure of meeting corporate or self-imposed time constraints, resulting in not fully checking and double-checking information by the technician and pharmacist |
| Vaccine Adverse Event Reporting System (VAERS) | a postmarketing surveillance system operated by the FDA and CDC that collects information on adverse events that occur after immunization |
| drug tolerance | when the body adapts to a drug so that higher doses are needed to produce the same pharmacological effect |
| accountable care organizations (ACOs) | groups of physicians, pharmacists, and other providers, hospitals, and healthcare facilities that join together in a coordinated and transparent way to seek out measurable improvements in patient health outcomes |
| drug seeker | a patient who is dependent on or addicted to drugs, who may receive prescriptions for the same or similar controlled drugs from several physicians and pharmacies; often requests early refills |
| tell back | a collaborative approach that uses patient-centered, open-ended questions to encourage the patient to tell back what he or she understands; an especially useful method for new patients and/or new prescriptions |
| wrong formulation error | a medication error that occurs when the dosage form or formulation is not the accepted interpretation of the physician order |
| sentinel event | an unexpected occurrence involving death or serious physical or psychological injury or the potential for such events to occur |
| adverse drug reaction (ADR) | a negative consequence to a patient from taking a particular drug, due to the nature of the drug itself, for certain vulnerable populations |
| wrong drug error | a medication error that occurs when the incorrect drug is substituted for the one prescribed |
| narrow therapeutic index drugs | medications where small differences in dose or blood concentration may lead to adverse reactions or therapeutic failures |
| contaminated product error | a medication error that occurs when aseptic technique is not followed in compounding, and the drug is no longer sterile and causes a microorganism infection |
| tall man lettering | enhanced lettering on the stock labels of similar-sounding high-risk medications, or other labeling changes to help better differentiate products and dosages and reduce medication errors |
| MEDMARX | an international internet-based program of the USP for use by hospitals and healthcare systems for documenting, tracking, and identifying trends for adverse events and medication errors |
| omission error | an administration error in which a prescribed dose is not given |
| technical failure | an error generated by failure of equipment |
| adverse drug error | a medication error that occurs when the prescribed drug initiates an allergy or an adverse drug interaction because a flag was missed |
| REACT | an acronym for what to do in the case of a robbery: Remain calm, Eyewitness, Activate alarm, Call police, Take charge |
| human failure | a medication error generated by failure that occurs at an individual level |
| alert fatigue | fatigue that arises and causes the technician and/or the pharmacist to have a relaxed attitude and bypass drug utilization warnings |
| physical dependence | taking a drug continuously so that when the medication is stopped, physical withdrawal symptoms occur |
| medication error | any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the healthcare professional, patient, or consumer |
| medication nonadherence | failure to take medication therapy as the physician instructs; may also be called noncompliance |
| documentation error | a medication error that occurs when essential information is not properly noted, such as a prescription, allergy, patient request, or other information in the medication profile, or when insurance or billing claims are not properly processed |
| product line extension | a marketing strategy by which a brand-name product is brought to market with different combinations of active ingredients and different indications, leading to potential consumer errors |
| selection error | a medication error that occurs when two or more options exist, and the incorrect option is chosen |
| Failure Mode Effects Analysis (FMEA) | an analysis procedure that breaks larger processes down into levels and tasks to find the root causes of failures (problems) and the rate or probability of failure occurrences, the consequences, and ways to fix the failures |
| Prescription Drug Monitoring Program (PDMP) | a program, generally state-sponsored, to gather data to monitor controlled drug dispensing |
| Pharmacists Recovery Network (PRN) | an organization to provide assistance and treatment for impaired colleagues who seek help without the risk of losing their license or registration |
| risk evaluation and mitigation strategy (REMS) | a program designed by the FDA for prescribers, pharmacies, and patients to more closely monitor selected high-risk drugs |
| incorrect assumption error | a medication error that occurs when an essential piece of information cannot be verified, and an assumption is made |
| medication education error | a medication error that occurs when the proper medication education materials and counsel are not passed on to the patient or medication administrator |
| fear error | a medication error that occurs when a technician fears the consequences of speaking up and asking the pharmacist or the prescriber to double-check an element of the prescription |
| distraction error | a medication error that occurs when a technician or pharmacist is interrupted in the middle of a filling process and forgets a portion of key information or train of thought, and some information or a safety decision gets missed |
| iPLEDGE program | a specific risk assessment program for isotretinoin, which can cause a high incidence of birth defects if not properly monitored |
| High-Alert Medication Modeling and Error-Reduction Scorecards (HAMMERS) | a free tool from ISMP designed to help community pharmacies identify the unique set of system and behavioral risks associated with dispensing certain high-alert medications and to estimate how often an error or adverse drug event reaches a patient |
| patient safety organizations (PSOs) | groups designed to collect and analyze error data from more than one health provider and to offer quality improvement counsel |
| Medication Guide | printed information in which the FDA communicates side effects, adverse reactions, and blackbox warnings for high-risk drugs |
| Patient Safety and Quality Improvement (PSQI) Act | a federal law passed in 2005 dedicated to promoting a culture of patient safety and quality assurance; created a network of safety databases and the ability to create PSOs |
| organizational failure | an error generated by failure of organizational rules, policies, or procedures |
| marijuana | a Schedule I controlled drug that cannot be dispensed in pharmacies due to federal law restrictions though it is legal for prescribed medical and/or recreational use in multiple states |
| MedWatch | a voluntary program by the ISMP that allows any healthcare professional or consumer to report a serious adverse event associated with the use of any drug, biological device, or dietary supplement |
| incomplete information error | a medication error that a medication error that occurs when full information is not available because the patient was not asked sufficient or proper questions, or the answers were somehow not recorded in the profile, or the patient withheld information deliberately or by accident of memory |
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