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Medication Safety
PP4 Medication Safety Lecture
| Question | Answer |
|---|---|
| The NSQHS has 10 standards. Which standard relates to medication safety? | Standard 4 |
| What is the aim of the standard? | Improve safety and quality medicine use Reduce occurrence of medication incidents by ensuring safe standards for prescribing, dispensing, administration & monitoring. Ensure patients/carers are told why, what and how to take their meds |
| What are the three types of errors that can results in a medication related error? | Skill based error and lapses Rule based mistakes Knowledge based errors |
| When are each of the types of errors likely to occur? | When you know what you're doing, but something goes sideways (slip, lapse) You think you know what you're doing, but don't notice a sign of a potential problem (Rule based error) You're not really sure what you're doing (knowledge error) |
| What does the high risk medicine acronym APINCH stand for? | A Anti-infectives/antibiotics P Potassium I Insulin N Narcotics/opioids, neuromuscular blockers C Chemotherapy H Heparin and other anticoags |
| What does the pharmacist need to consider with anti-infectives/antibiotics? | Appropriateness of agent Timeliness of administration Clear Documentation of starting/stopping Minimise ADR's especially: resistance, unnecessary/prolonged treatment, prescribing an agent in someone with a recorded allergy |
| Which medications are time critical? | Anticoags Anticonvulsants Antidotes Antimicrobials Corticosteroids Cytotoxic agents Hypoglycaemic agents/insulin Immunosuppressants Antiparkinsons agents |
| A 15 minute delay to a patient taking an antiparkinsons med can cause what? | Pain increased falls risk difficulty swallowing and speaking significant distress for patient and family |
| Potassium comes in a concentrated electrolyte solution and is given if patient is hypokalaemic. How can a patient die of hyperkalaemia when given this solution? | If it is given too rapidly, in too high a dose or is excretion is impaired |
| Why was potassium the medication most commonly implicated in fatal incidents in acute settings? | Concentrated potassium chloride ampoules were available as ward stock. Removing the ampoules and replacing with pre mixed solution has resolved many of these issues. |
| How has safety been improved with potassium? | Concentrated ampoules removed from most clinical areas Prescribe in mmol not grams Promote oral therapy Introduced pre-mixed bags |
| How is the risk of mix ups reduced with look a like and sound a like medicines? | Separate and label clearly |
| With regards to insulin, how should the dose be recorded on the chart? | Write units not U. U isn't safe |
| What is the most serious adverse effect of narcotics and opioids? | Respiratory depression |
| How should the dose for narcotics and neuroblockers be recorded | Grams not ml's |
| Which medicines are often given incorrectly due to misreading the name on a chart? | Oxycodone Oxycontin MS Contin Hydromorphone Morphine Methadone |
| What strategies can be implemented so these medicines narcotics and opioids aren't mixed up? | Challenge the script if written in mL Check small details each time Use TALLman letters |
Created by:
LDM
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