MEDICATION ERRORS

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medication errors

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MANAGEMENT OF MEDICATIONS:

MANAGEMENT OF MEDICATIONS DR.MAHIRA MAIDEEN (PHARM D) CLINICAL PHARMACIST 1 Dr. Mahira Maideen, Pharm D

Medicine is a double edged sword:

Medicine is a double edged sword 2 Dr. Mahira Maideen, Pharm D

MEDICATION ERRORS:

MEDICATION ERRORS 3 Dr. Mahira Maideen, Pharm D

DEFINITION:

DEFINITION “ A medication error is a preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the health care professional, patient, or consumer.” 4 Dr. Mahira Maideen, Pharm D

NCCMERP CATEGORY OF ERRORS A B C D E F G H I:

NCCMERP CATEGORY OF ERRORS A B C D E F G H I No error A Circumstances or events that have the capacity to cause error Error, no harm B An error occurred, but the medication did not reach the patient C An error occurred that reached the patient but did not cause patient harm D An error occurred that resulted in the need for increased patient monitoring but no patient harm 5 Dr. Mahira Maideen, Pharm D

Slide6:

Error, harm E An error occurred that resulted in the need for treatment or intervention and caused temporary patient harm F An error occurred that resulted in initial or prolonged hospitalization and caused temporary patient harm G An error occurred that resulted in permanent patient harm H An error occurred that resulted in a near-death event (e.g., anaphylaxis, cardiac arrest) Error, death I An error occurred that resulted in patient death 6 Dr. Mahira Maideen, Pharm D

DEFINITION:

DEFINITION Medication errors , defined as any error in the prescribing, dispensing or administration of a drug whether there are adverse consequences or not . 7 Dr. Mahira Maideen, Pharm D

Slide8:

DISPENSING PRESCRIBING ADMINISTRATION COMPLIANCE 8 Dr. Mahira Maideen, Pharm D

PRESCRIBING ERRORS:

PRESCRIBING ERRORS Wrong drug Wrong dose Wrong time Wrong indication Illegible handwriting Drug name confusion Inappropriate use of decimal points 9 Dr. Mahira Maideen, Pharm D

DISPENSING ERRORS:

DISPENSING ERRORS Wrong patient Wrong medication Wrong selection (Sound alike- look alike –SALA) Wrong mixing Dispensing expired drugs Inappropriate substitute 10 Dr. Mahira Maideen, Pharm D

PATIENT COMPLIANCE ERRORS:

PATIENT COMPLIANCE ERRORS Wrong time Wrong number/ quantity Wrong medication omission 11 Dr. Mahira Maideen, Pharm D

ADMINISTRATION ERRORS:

ADMINISTRATION ERRORS Wrong patient Wrong dose Wrong time Dose omission Drug overused Wrong administration technique Wrong drug preparation Improper recording after drug administration. 12 Dr. Mahira Maideen, Pharm D

Slide13:

TRANSCRIPTION ERRORS MEDICATION RECONCILIATION ERRORS 13 Dr. Mahira Maideen, Pharm D

10 RIGHTS OF MEDICATION SAFETY:

10 RIGHTS OF MEDICATION SAFETY “ TO ERR IS HUMAN” Here’s how to prevent them . 14 Dr. Mahira Maideen, Pharm D

#1 RIGHT PATIENT :

#1 RIGHT PATIENT 15 Dr. Mahira Maideen, Pharm D

Slide16:

Always check patient’s identification . Name, place, room no: Verify patient’s allergies with chart and with patient. 16 Dr. Mahira Maideen, Pharm D

#2 RIGHT MEDICATION:

#2 RIGHT MEDICATION 17 Dr. Mahira Maideen, Pharm D

Slide18:

Perform a triple check of the medication’s label When retrieving the medication. When preparing the medication. Before administering medication to patient. Always check the medication label with the physician’s orders. Never administer medication prepared by another person Never administer medication that is not labeled. 18 Dr. Mahira Maideen, Pharm D

#3 RIGHT DOSE:

#3 RIGHT DOSE 19 Dr. Mahira Maideen, Pharm D

Slide20:

Check label for medication concentration. Compare prepared dose with medication order. Triple all medication calculations. Check all medication calculations with another nurse. Verify that dosage is within appropriate dose range for patient and medication. 20 Dr. Mahira Maideen, Pharm D

#4 RIGHT TIME:

#4 RIGHT TIME 21 Dr. Mahira Maideen, Pharm D

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22 Dr. Mahira Maideen, Pharm D

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Verify schedule of medication with order. 1. Date 2. Time 3. Specified period of time Check last dose of medication given to patient. Administer medication within 30 minutes of schedule. 23 Dr. Mahira Maideen, Pharm D

#5 RIGHT ROUTE:

#5 RIGHT ROUTE 24 Dr. Mahira Maideen, Pharm D

Slide25:

Verify medication route with medication order before administering. Medication may only be administered via route specified in order. 25 Dr. Mahira Maideen, Pharm D

# 6 RIGHT EDUCATION:

# 6 RIGHT EDUCATION 26 Dr. Mahira Maideen, Pharm D

Slide27:

Inform patient of medication being administered. Inform patient of desired effects of medication. Ask patient if they have any known allergies to medication. 27 Dr. Mahira Maideen, Pharm D

#7 RIGHT TO REFUSE:

#7 RIGHT TO REFUSE 28 Dr. Mahira Maideen, Pharm D

Slide29:

The legally responsible party (patient, parent, family member, guardian, etc.) for patient’s care has the right to refuse any medication. Inform responsible party of consequences of refusing medication. Verify that responsible party understands all of these consequences. Notify physician that ordered medication and document notification. Document refusal of medication and that responsible party understands consequences. 29 Dr. Mahira Maideen, Pharm D

#8 RIGHT ASSESSMENT:

#8 RIGHT ASSESSMENT 30 Dr. Mahira Maideen, Pharm D

Slide31:

Properly assess patient and tests to determine if medication is safe and appropriate. If deemed unsafe or inappropriate, notify ordering physician and document notification. Document that medication was not administered and the reason that dose was skipped. 31 Dr. Mahira Maideen, Pharm D

#9 RIGHT EVALUATION:

#9 RIGHT EVALUATION 32 Dr. Mahira Maideen, Pharm D

Slide33:

Assess patient for any adverse side effects. Assess patient for effectiveness of medication. Compare patient’s prior status with post medication status. Document patient’s response to medication 33 Dr. Mahira Maideen, Pharm D

#10 RIGHT DOCUMENTATION:

#10 RIGHT DOCUMENTATION 34 Dr. Mahira Maideen, Pharm D

Slide35:

Never document before medication is administered. Document Medication Dosage Route Date and Time Signature and credentials 35 Dr. Mahira Maideen, Pharm D

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Keep these tips in mind: • Have the patient’s chart available when calling the prescriber, and write down the order while you’re still on the phone. • Verify the patient’s name. • Read back and confirm the medication. If you’re unfamiliar with the drug, ask the prescriber to spell the drug name. 36 Dr. Mahira Maideen, Pharm D

Slide37:

Confirm the medication dosage by stating each number individually. • To help prevent sound-alike errors, verify with the prescriber the condition that the medication is being used to treat. 37 Dr. Mahira Maideen, Pharm D

Slide38:

Having the prescription, the drug and the patient in the same place so they can be checked against one another. To prevent Transcribing errors: Double checks and documentation. 38 Dr. Mahira Maideen, Pharm D

Slide39:

Focus on one patient at a time. Engage patient or family member in medication administration process. Minimizing interruptions during drug rounds . 39 Dr. Mahira Maideen, Pharm D

Nutshell……:

Nutshell…… 10 RIGHTZZZZ…. RIGHT PATIENT RIGHT DRUG RIGHT DOSE RIGHT TIME RIGHT ROUTE RIGHT EDUCATION RIGHT TO REFUSE RIGHT ASSESSMENT RIGHT EVALUATION RIGHT DOCUMENTATION 40 Dr. Mahira Maideen, Pharm D

Slide41:

As a responsible Healthcare professional, “ I will follow the 10 RIGHTS of medication safety ” 41 Dr. Mahira Maideen, Pharm D

Slide42:

THANK YOU 42 Dr. Mahira Maideen, Pharm D

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