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Medication errors

The lecture for undergraduate students

Medication errors

  1. 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. 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 9/11/2015 2
  3. 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 9/11/2015 3
  4. 4. Nursing Responsibilities Legal and Ethical  Nurses are liable for their actions, omissions, and for those duties they may delegate to others. 9/11/2015 4 • They are personally responsible…legally, morally and ethically…for every drug they administer.
  5. 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 9/11/2015 5 - Lab values – renal & liver function / protein & albumin
  6. 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. 9/11/2015 6
  7. 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 9/11/2015 7
  8. 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) 9/11/2015 8
  9. 9. Adverse Drug Reaction Allergic Reaction: -Hypersensitivity (rash, anaphylaxis) Idiosyncratic Reaction: -abnormal and unpredicted response specific to an individual (ie: confusion) 9/11/2015 9
  10. 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. 9/11/2015 10
  11. 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 9/11/2015 11
  12. 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 9/11/2015 12
  13. 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 9/11/2015 13
  14. 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 ) 9/11/2015 14
  15. 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 9/11/2015 15
  16. 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??? 9/11/2015 16
  17. 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! 9/11/2015 17
  18. 18. Right Documentation Document IMMEDIATELY after administration (NEVER DOCUMENT BEFORE!) Omitting documentation can result in over or under medication 9/11/2015 18
  19. 19. Thank you 9/11/2015 19

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