Medication Errors: - PowerPoint Presentation

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Medication Errors: - PPT Presentation

Preventing and Responding DSN Kevin Dobi MS APrn Copyright 2014 by Mosby an imprint of Elsevier Inc C hapter 5 Medication errors Institute of Medicine studies 1999 2006 Adverse drug reactions ID: 311992

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Slide1

Medication Errors:Preventing and RespondingDSN Kevin Dobi, MS, APrn

hapter

5Slide2

Medication errorsInstitute of Medicine studies (1999, 2006)Adverse drug reactionsAllergic reactionIdiosyncratic reactionAdverse Drug Event

2Slide3

In the 2006 Institute of Medicine Study, it was estimated that some form of medication error resulted in harm to how many patients?

400,000

800,000

1 million

1.5 millionSlide5

PreventableCommon cause of adverse health care outcomesMore potential for harm with “high-alert” medicationsMedication Errors

5Slide6

Errors can occur during any step of medication process:ProcuringPrescribingTranscribingDispensingAdministeringMonitoring

Issues Contributing to Errors

6Slide7

Organizational issuesEducational system issuesSociologic factorsIssues Contributing to Errors (cont’d)

7Slide8

No error, although circumstances or events occurred that could have led to an errorMedication error that causes no harmMedication error that causes harmMedication error that results in deathTypes of Medication Errors

8Slide9

Multiple systems of checks and balancesLegible and correct ordersAppropriate consultationCheck medication order three times“Six Rights” of medication administrationPreventing Medication Errors

9Slide10

Minimize verbal or telephone ordersRepeat order to prescriberSpell drug name aloudSpeak slowly and clearlyList indication next to each orderAvoid medical shorthand, including abbreviations and acronyms

Preventing Medication Errors (cont’d)

10Slide11

Never assume anything about items not specified in a drug order (e.g., route)Do not hesitate to question a medication order for any reason when in doubtDo not try to decipher illegibly written orders; contact prescriber for clarificationPreventing Medication Errors (cont’d)

11Slide12

NEVER use a “trailing zero” with medication ordersDo not use 1.0 mg; use 1 mg1.0 mg could be misread as 10 mg, resulting in a tenfold dose increasePreventing Medication Errors (cont’d)

12Slide13

ALWAYS use a “leading zero” for decimal dosagesDo not use .25 mg; use 0.25 mg.25 mg may be misread as 25 mgPreventing Medication Errors (cont’d)

13Slide14

Take time to learn special administration techniques of certain dosage formsAlways verify new medication administration recordsPreventing Medication Errors (cont’d)

14Slide15

Always listen to and honor any concerns expressed by patients regarding medicationsCheck patient allergies and identificationPreventing Medication Errors (cont’d)

15Slide16

The nurse is administering a drug that has been ordered as follows: “Give 10 mg on odd-numbered days and 5 mg on even-numbered days.” When the date changes from May 31 to June 1, what should the nurse do?

Give 10 mg because June 1 is an odd-numbered day

Hold the dose until the next odd-numbered day

Change the order to read “Give 10 mg on even-numbered days and 5 mg on odd-numbered days”

Consult the prescriber to verify that the dose should alternate each day, no matter whether the day is odd- or even-numberedSlide17

Report to prescriber and nursing managementDocument error per policy and procedureFactual documentation onlyMedication administeredActual doseObserved changes in patient conditionPrescriber notified/follow-up orders

Reporting Medication Errors

17Slide18

External reporting of errorsUSP MERP (United States Pharmacopeia Medication Errors Reporting Program)MedWatch, sponsored by the FDAInstitute for Safe Medication Practices (ISMP)The Joint Commission

Reporting Medication Errors (cont’d)

18Slide19

The nursing student realizes that she has given a patient a double dose of an antihypertensive medication. The tablet was supposed to be cut in half, but the student forgot and administered the entire tablet. The patient’s blood pressure just before the dose was 146/98 mm Hg. What should the student nurse do first?

Notify the patient’s physician

Notify the clinical faculty

Take the patient’s blood pressure

Continue to monitor the patientSlide20

Continuous assessment and updating of patient medication informationVerificationClarificationReconciliationMedication Reconciliation

20Slide21

Should be done at each stage of health care delivery:AdmissionStatus changePatient transfer within or between facilities/provider teamsDischargeMedication Reconciliation (cont’d)

21Slide22

Medication Errors: - PowerPoint Presentation

Medication Errors: - PPT Presentation

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