The lecture for undergraduate students

1. By:
Seragaldin M. Abdulqader
Clinical pharmacology for nurses
University of Raparin/school of nursing
The lecture for undergraduate students:
2015 -20169/11/2015 1

2. Medication Errors
10% to 18% of hospital injuries
attributed to medication errors
44,000 to 98,000 people die in U.S.
hospitals annually due to medication
errors
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3. Medication Errors
Effects of medication errors
 Increase length of stay
 Increased cost
 Patient disability
 Death
So nurse’s personal and professional status,
confidence, and practice
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4. Nursing Responsibilities
Legal and Ethical
 Nurses are liable for their actions,
omissions, and for those duties
they may delegate to others.
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• They are personally
responsible…legally, morally and
ethically…for every drug they
administer.

5. Nursing Responsibilities
 Know Information about the medication
Action – side effects – appropriate dose- Age specific
considerations – and routes
 Know Information about the client what other medications
are they taking;
- Age
- Vital signs
- Genetic factors
- Pregnant/breast feeding
- ALLERGIES or other problems
- Gag reflex – Impaired swallowing
- Dietary and/or Fluid restrictions
- Cultural and/or religious influences
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- Lab values – renal & liver function / protein & albumin

6. Nursing Responsibilities
Using correct techniques of preparation
and administration to deliver medications
safely.
Monitoring the client for therapeutic and
non-therapeutic effects of the drug
Client education for safe and accurate
self-administration of the drug.
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7. Drug Information Resources
 Agency pharmacists.
 Nursing drug handbooks.
 Physician's Desk Reference (PDR).
 Package Inserts: Required by law for insertion
with each new drug and must include a description,
indications, precautions, dosage, and contraindications.
 Electronic databases and Internet
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8. Adverse Drug Reaction
Adverse Effects:
-Expected side effects (stomach upset)
-Dose-related reactions (liver or renal impairment)
-Drug/Drug or Drug/Food interactions (potentiation
of drugs by another drug, or drug not absorbed well
with food)
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9. Adverse Drug Reaction
Allergic Reaction:
-Hypersensitivity (rash, anaphylaxis)
Idiosyncratic Reaction:
-abnormal and unpredicted response specific
to an individual (ie: confusion)
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10. Nursing Measures to
Prevent Medication Errors
 Never assume anything about a drug order. CLARIFY,
CLARIFY, CLARIFY
 Make sure medication orders contain all (7) parts
 Minimize use of verbal or telephone orders. If used,
 spell all drug names and repeat to confirm
 Check Medication Administration Records to the
original prescriber order as per agency protocol.
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11. Nursing Measures to
Prevent Medication Errors
Safe Medication Administration
USE THE SIX RIGHTS
 Right drug
 Right route
 Right patient
 Right dose
 Right time
 Right documentation
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12. Right Patient
Correctly identify patient prior to
medication administration using
Tell patient at time of administration
what medication and dosage is being
administered. Briefly explain
therapeutic use of each medication
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13. Right Drug the (3) Checks
Check medication label 3X
 On first contact with drug; when removing
from medication box
 Prior to measuring
 Pouring, counting, or withdrawing
 Just prior to administration; when returning
to medication box
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14. Right Drug
 Be aware of distractions
 Do not multitask during drug administration
 Use bar-coding scanning when available
 Be knowledgeable about the drug’s actions,
indications, and contraindications
 Be extremely vigilant about known
HIGH ALERT MEDICATIONS
 Be alert to Look-a-like , Sound-a-like medications
 Do not accept Drug Name Abbreviations
(MS for Morphine Sulfate )
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15. Right Route
Consult a drug information source to
confirm correct route
Do not accept incorrect abbreviations:
sq or sc – WHAT IS PREFERRED?
May need to change or clarify forms or
routes of the drug for safe medication
administration
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16. Right Time
Order should include frequency of
administration
Administer medications within 1 hr of
prescribed time ( or per facility guidelines)
Use safe abbreviations
Do not accept: QD or QOD
WHAT IS PREFERRED???
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17. Right Dose
Carefully read and clarify drug orders
Do not accept illegible handwriting
Do not accept leading or trailing zeroes
Do not accept U or IU
WHAT IS PREFERRED?
Recheck the labels 3 times!
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18. Right Documentation
Document IMMEDIATELY after administration
(NEVER DOCUMENT BEFORE!)
Omitting documentation can result in over or
under medication
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19. Thank you
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