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FUNDAMENTALS
Study Stack Chapter 14
| Question | Answer |
|---|---|
| What is medication error ? | Is any preventable event that may cause or lead to inappropriate medication use or patient harm. One reason to use unit-dose medications in the hospital is that they can be reused if returned. |
| What are the causes of medication errors in the pharmacy ? | Stress, noise, multitasking, medication names that sound alike, prescriptions with illegible handwriting, and excessive workload. |
| How to reduce errors in the pharmacy ? | Pharmacies can use ADSs, scan the original prescription, use electronic prescribing, keep high-alert medications in a separate location in the pharmacy, maintain accurate up-to-date patient profiles that include OTC and herbal medications, designate a medication safety leader, continually review medication safety policies and procedures especially with new staff mem |
| What is the most important aspect of dealing with errors is: | Reporting process |
| What is a wrong drug preparation error ? | Occurs when a drug is incorrectly formulated (e.g., wrong calculations or wrong solution used for reconstitution) or manipulated (e.g., break in aseptic technique), and the medication is administered to the patient. |
| What is monitoring error ? | Include the failure to review a prescribed medication for proper regimen, appropriateness (e.g., not monitoring the patient's response to a prescribed medication), detection of problems in dosage (e.g., not recognizing the side effects of a drug), or failure to use laboratory results to adjust the dose correctly. |
| What is prescribing error ? | Occurred when a prescriber orders a medication that is incorrect (e.g., incorrect usage, dosage form, route, concentration, rate of infusion) or is incorrectly selected based on indications or contraindications (e.g., allergies, existing condition) and the medication reaches the patient |
| What are some ways to decreased errors? | Many physicians use E-prescribing from the physician's office to the pharmacy, or CPOE is used by the prescriber in institutional settings. If an ADS is coupled with bar-coding, then the risk of errors greatly decreases. National Coordinating Council for Medication Error Reporting and Prevention (NCCMERP),founded by the USP, is an independent council of more than 25 organizations gathered to address inter-disciplinary causes of medication errors and strategies for prevention. |
| Causes of medication errors? | Although many people are aware of the medications to which they are allergic, many allergic reactions cannot be avoided before drug administration. It is estimated that nearly one half of all Americans, age 55 years and older, are taking some type of prescription drug and approximately 40% are taking OTC medications. Many older adults mix medications on a daily basis; as the number of medications increases so does the possibility of drug-drug interactions. |
| ER | extended release |
| SR | sustained - release |
| IR | immediate- release |
| MERP error category I | Includes an error that may have contributed to or resulted in a patient's death. |
| MERP | Medication Error Reporting Program |
| ISMP | Tracks drug errors and works toward decreasing them through a Medication Error Reporting Program (MERP). Tracking systems do not focus on blame but are more interested in how the error occurred. |
| USP <797> | Addresses the problem of contamination of any type of sterile product. |
| USP <795> | Addresses non-sterile compounding and USP <800> addresses hazardous compounds. |
| Extended- release formulations | Are designed to deliver the dose over a longer interval than an immediate-release (IR) product. |
| MedCarousel | Is a vertical, automated storage and retrieval system for medications in hospital pharmacies |
| Examples of Automated dispensing machines (ADS) used in a community pharmacy. | Baker cell systems ScriptPro SP 200 Kirby Lester KL20 |
| Medication Reconciliation | The process of identifying the most up-to-date list of all the medications a patient is currently taking. |
| Bar codes | Provide the following three forms of identification of a drug: NDC number, lot number, and expiration date. |
| What are changes in labelling that drug companies are incorporating to reduce errors ? | Use of color coding and tall-man and boldface lettering, drug selection errors are less likely to occur. |
| Five safety standards outlined by TJC | (1) Leadership Process and Accountability, (2) Competent and Capable Workforce, (3) Safe Environment for Staff and Patients, (4) Clinical Care of Patients, and (5) Improving Quality and Safety. |
| Pictograms | Are standardized graphics (pictures) that depict such things as how to take medication, how to store medication, and when to take medication. |
| Why are IV heparin errors extremely dangerous? | The most frightening errors are those that quickly take effect and may not be easily reversed, which is the case for parenteral medications. Heparin is of great concern because flushing IV lines with Hep-Lock solutions is common, which may be confused with the similarly sized and labeled vials of much more concentrated heparin solutions. |
| HAI's | health care-associated infections |
| Examples of high alert IV medications according to ISMP. | Potassium chloride (KCl), Heparin, Insulin |
| ADR | Adverse drug reaction |
| Warfarin ( Coumadin ) | Administered to prevent blood clotting can interact with Aspirin and NSAIDs. |
| Medwatch | Is a program established by the FDA for reporting drug and medical product safety alerts and label changes. The program also provides a voluntary adverse-event reporting system for medications, medical products, and devices. |
| ADE | Adverse drug event |
Created by:
mparcasio