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Medication Safety

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allelipraise's version from 2018-03-13 21:12

Section 1

Question Answer
Drug Related ProblemsEvents associated with drug therapies that can or do hamper optimal patient outcomes
Medication MisadventuresIatrogenic hazards or incidents associated with indicated drug therapy resulting in patient harm
Medication ErrorsAny 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
Side EffectsAn expected, well-known reaction resulting in little or no change in patient management
Adverse Drug ReactionsDrug therapy problems that are noxious and unintended, and which occurs at doses normally used in man for the prophylaxis, diagnosis, or therapy of disease, or for the modification of physiological function
Adverse Drug EventsAdverse drug reactions that result in an injury – due to the use or lack of intended use of a drug
HarmTemporary or permanent impairment of the physical, emotional, or psychological function or structure of the body and/or pain resulting therefrom requiring intervention.
National Coordinating Council for Medication Error Reporting and Prevention (NCCMERP) Independent body comprised of 27 national organizations in the US
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Section 2

Question Answer
ACircumstances or events that have the capacity to cause error
BAn error occurred but the error did not reach the patient
CAn error occurred that reached the patient but did not cause patient harm
DAn error occurred that reached the patient and required monitoring to confirm that it resulted in no harm and/or required intervention to preclude harm Category E: An error occurred that may have contributed to or resulted in temporary harm to the patient and required intervention Category F: An error occurred that may have contributed to temporary harm to the patient and required initial or prolonged hospitalization Category G: An error occurred that may have contributed to or resulted in permanent patient harm
EAn error occurred that may have contributed to or resulted in temporary harm to the patient and required intervention
FAn error occurred that may have contributed to temporary harm to the patient and required initial or prolonged hospitalization
GAn error occurred that may have contributed to or resulted in permanent patient harm
HAn error occurred that required intervention necessary to sustain life
I An error occurred that may have contributed to or resulted in the patient’s death
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Section 3

Question Answer
Prescribing Errors • Failure to alter drug therapy in patients with impaired renal or hepatic function
Prescribing Errors • Use of an incorrect drug name, dosage form, or abbreviation • Dosage miscalculation
Dispensing Errors • Wrong drug • Wrong strength • Wrong dosage form
Dispensing Errors • Wrong quantity • Wrong label-instruction • Deteriorated drug
Dispensing Errors • Omission error • Wrong time
Administration Errors• Wrong drug error • Extra dose error • Omission error
Administration Errors• Wrong patient • Wrong dose • Wrong route • Wrong time • Wrong dosage form • Wrong technique
Self medication• May attempt to manage their illnesses themselves without seeing doctors and pharmacists • May be taking complementary medicines, such as herbal preparations, vitamins and minerals without informing health care workers
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Section 4

Question Answer
Error of OmissionNo Drug =Untreated Condition/ Failure to Receive Prescribed Drug
Error of CommisionIncorrect/ Correct Drug
Correct DrugSub-therapeutic dosage Over-dosage Adverse Drug Reaction Drug Interaction
Incorrect Drug Improper Drug Selected Drug Use Without Indication
5's of Safe Medication UseRight: Patient/Drug/Time/Dose/Route
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Section 5

Question Answer
Institute for Safety Medication PracticesISMP
Patient Information• Health care providers need readily available demographic and clinical information • Age, weight, allergies, diagnoses, and pregnancy status • Patient monitoring information such as laboratory values
Drug Information• Drug inventory must be controlled • Up-to-date drug information should be readily accessible to health care providers • References, protocols, order sets, computerized drug information systems, medication administration records • Regular clinical activities by pharmacists in patient care areas
HAM• Drugs that bear a heightened risk of causing significant patient harm when they are used in error • Limit access, use auxiliary labels • Standardize ordering, storage, preparation, and administration
Communication related to medications• Failed communication is at the heart of many errors • Enhanced collaborative teamwork • Standardize the way prescription orders and other drug information are communicated to avoid misinterpretation
Drug labeling, packaging, nomenclature Ensure that drugs are provided in clearly labeled containers • Take extra steps to prevent errors with sound-alike and look- alike drugs (SALADs), ambiguous drug packaging, and confusing or absent drug labes
Drug standardization, storage, & distribution• Minimizing the availability of medications • Restricting access to high-alert drugs and hazardous chemicals • Distributing or dispensing medications in a timely fashion • Use commercially-available products and standard concentrations
Medication delivery device acquisition, use, and monitoring• Assess a device’s safety before purchase and ensure fail-safe protections • Limit variety to promote familiarity • Require independent double checks of processes in which errors could cause serious patient harm (e.g. refilling automated dispensing equipment, setting patient-controlled analgesia pumps)
Environmental Factors• Poor lighting • Cluttered work spaces • Noise and interruptions • Ensure adequate staffing and workload assignments
Staff competency and education• Ongoing assessment of health care providers’ baseline competencies and education about new medications, non- formulary medications, high-alert medications, and error prevention
Patient education• Educating patients about their medications and encouraging them to ask questions
Quality process and risk management• Systems for identifying, analyzing, and reducing the risk of medication errors • Nonpunitive culture of safety • Strategically-placed quality control checks
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Section 6

Question Answer
AntiretroviralCarbamazepine
Chemotherapeutic agents Chloral hydrate Liquid
Hypoglycemic Agents Heprain
Immunosuppressant Agents Metformin
InsulinMethotrexate
OpiodsMidazolam
Pediatric Liquid MedPropythiouracil
Pregnancy category X drugsWarfarin
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Section 7

Question Answer
Culture of safey key element of everyone’s job/
Information is sharedReducing potential risk is more important than concerns about disclosure
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