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Lecture 6
Medication Safety & Literacy and Prescription Writing
| Question | Answer |
|---|---|
| Medication Error Definition: failure in treatment process leading to or potential to lead to, ____ | harm to the patient |
| Prescribing Errors (5): subset of ____. failure in ____leading to or potentially leading to patient harm. irrational, inappropriate, ineffective ____. Under prescribing. Over prescribing | medication error. decision-making process. prescribing. |
| Prescription Error: failure in ____ resulting in wrong instruction in one or more of the normal features of a prescription. Identity of patient, drug, formulation, dose, route, timing, frequency, duration | Rx writing process |
| Medication Error (ME): national coordinating council for medication error reporting and prevention definition = "any ___ event that may cause or lead to inappropriate medication use or patient harm while the medication is int he control of the healthcare" | preventable |
| Medication Error (ME): may occur at any point during the ____. Does not always cause patient harm if caught prior to ____ | medication-use process. reaching patient |
| Medication Use Process | selection and procurement, storage, ordering and transcribing (errors common), preparing and dispensing, administration (errors common), monitoring |
| Medications Errors: ME that are most likely to cause harm to the patient include | incorrect administration of medication, delivering drugs through the wrong route, dispensing wrong medications |
| Medications Errors: _____are cited as being agents frequently involved in errors resulting in patient harm | insulin, morphine, and heparin |
| Adverse Drug Event (ADE): ___from a medication or a missed or inappropriately dosed medication can be attributed to preventable and non preventable causes | injury |
| Adverse Drug Event (ADE): patients can experience an ADE even if the correct medication was prescribed and administered because an ADE refers to _____ | the effect the drug had on the patient, not necessarily that an error occurred in the medication process. cause patient harm but are not necessarily preventable. MEs are preventable but do not necessarily cause patient harm |
| Prescribing Error Examples | incorrect drug selection, dose, dosage form, quantity, route, concentration, rate of administration, instructions for use of a drug product ordered or authorized; illegible prescriptions or medication orders that lead to errors that reach the pt |
| 7 Rights | right patient, drug, dose, time, route, reason, documentation |
| Medication Use Process (6) | selection and procurement, storage, ordering and transcribing, preparing and dispensing, administration, monitoring |
| 1. Selection and Procurement(pharmacy related): MEs include = failing to order adequate stock of ___to meet patient needs. Expired or ____meds. Confusion with ____during product shortage and recalls. Ordering incorrect product, strength, ____ | medication, adulterated, substituions, dilution |
| 2. Storage: MEs include = any medication stored ____and subsequently given to patient. failing to ____a medication. Failing to protect medication from ___ | improperly, refrigerate, light |
| 3. Ordering and Transcribing (error prone step)**: ordering MEs include=when drug selected and/or its dose frequency, or dosing duration is not appropriate for ____or ____. Transcribing MEs include=failure to correctly interpret the ____ | disease or physiologic condition. medication order |
| 4. Preparing and Dispensing: Correct: obtaining and packaging the correct drug, dose, or dilution of a product. Medication dispensing errors are defined as____ | any discrepancy between the medication dispensed and the original prescriber's order |
| 5. Administration (error prone step)**: MEs are=any discrepancy between how the medication is given to the patient and the ____ | administration directions from the physician or hospital guidelines. E.g. wrong dose administered or incorrect drug adminstration technique |
| 6. Monitoring: ME's include=not ensuring proper ___of the therapeutic effect of a medication or failing to recognize an adverse effect of a medication | follow-up |
| Medication Reconciliation: pair hospital/discharge meds with at home meds. inadequate reconciliation is a cause of medication errors and adverse drug events | comparing and reconciling hospital admission and discharge medication orders with patients' home medications, or comparing medication when patients are moved among different areas in a hospital |
| Medication Literacy: communication failure has been reported to be the underlying cause of 10% of ____. patients with limited health literacy are significantly ____to ask questions of their providers. | ADEs(adverse drug effects). less likely |
| Addressing Limited Health Literacy: take the time to ____. create a ____environment. Use ____. show the patient ____when counseling | counsel. relaxed and nonthreatening. plain language. each med |
| Addressing Limited Health Literacy: focus on one to three key points and ____. have patients repeat instructions. encourage patients to ___. use pictures or illustrated medication schedules | repeat frequently. ask questions |
| Overview of Prescribing Process | patient evaluation and diagnosis, select therapeutic approach, written prescription |
| Types of Prescriptions | pre-compounded prescription=already manufactured drugs from drug companies. Compounded=medication prepared by pharmacist according to directions/recipe on rx, magic mouthwash |
| Elements of Prescription: first 4 identify the ___ | prescriber. preprinted on standard prescription form |
| Elements of Prescription: 5 is the ____the prescription was written | date |
| Elements of Prescription: 6 and 7 identify the patient by ____ | name and address |
| Elements of Prescription: 8-11 are the body of prescription = ___ | medication, formulation, strength, dispensed quantity or drugs supply, complete directions for use |
| Conversions | 2.2 pounds = 1 kilogram. 1 tsp=5mL. 1 tb=15mL |
| Quantity Prescribed Factors | duration of therapy, cost, need for followup visits, abuse potential, toxicity/overdose potential, standard sizes of products (birth control) |
| Direction considerations | simpler directions, fewer number of daily doses, instructions on how/when to take medication, length of therapy, purpose of medication, directions should be clear and concise |
| Elements of Prescriptions: 12-14= | refill information, waiver of requirement for childproof containers, additional labeling instructions |
| Elements of Prescriptions: 15-17= | prescriber's signature, NPI number, DEA number, or state license number. DEA authentication method (controlled substances) |
| Common types of prescribing errors | omission of necessary information, poor writing, prescribing drugs inappropriate for specific situation |
| Omission of Information | common in hospital orders. Examples: resume pre-op meds, continue present IV fluids, continue eye drops, failure to discontinue prior med when new one is started |
| Poor Prescription Writing ** | illegible writing, misplaced or ambiguous decimal point, U for units should not be used, acronyms and abbreviations should not be used (ASA) |
| Controlled Substances Prescribing**: controlled drug act requires prescribers and dispensers to register with DEA, pay fee, receive a personal registration number, keep records of ______. Said DEA number must be on ____ | controlled drugs prescribed or dispensed. prescriptions for controlled substances |
| Controlled Substances Prescribing**: schedule II drugs cannot be ____without a new Rx. Schedule III-V prescriptions can be refilled up to a ___maximum (6 months from written date). Schedule II drugs cannot be ____ | refilled. 5-refill. phoned in |
Created by:
bluedolphin7
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