Safety in Medication Administration and Drug Labels

Vocabulary practice flashcards reviewing safety protocols, mathematical rules, prescription types, and medication labels based on lecture material.

Just Culture

A nonpunitive approach within healthcare organizations that encourages reporting of errors to improve safety rather than assigning individual blame.

Institute for Safe Medication Practice (ISMP)

A nonprofit agency established in 1975 that identifies causes of medication errors, makes evidence-based prevention recommendations, and publishes lists of error-prone abbreviations, high-alert medications, and look-alike sound-alike drugs.

High-Alert Medications

Drugs that bear an increased risk of causing significant patient harm if administered in error (e.g., insulin, opioids).

Tall Man Lettering

A practice using uppercase and lowercase letters within drug names to visually highlight differences between look-alike sound-alike drugs (e.g., novoLOG vs novoLIN).

Six Rights of Safe Medication Administration

The procedural standard requiring that the right patient receives the right drug in the right dose by the right route at the right time, followed by the right documentation.

1st Check of Medication Administration

The safety check performed during retrieval of medication from a dispensing system, refrigerator, or multiple-dose container, involving checking the drug name and expiration date.

2nd Check of Medication Administration

The safety check performed while preparing the medication for administration, matching the medication label to the MAR or eMAR prior to pouring, drawing up, or placing in a medicine cup.

3rd Check of Medication Administration

The safety check performed at the bedside just prior to administration, involving barcode scanning and verifying the label against the eMAR or MAR.

Bar Code Medication Administration (BCMA)

An electronic system that scans bar codes on a patient's ID bracelet and medication label to prevent administration errors prior to giving a drug.

Time Critical Medications

Medications where early or late administration may negatively affect the patient, requiring administration within $30\,\text{minutes}$ of the scheduled time (e.g., insulin, antibiotics, cardiac medications).

Patient Observation Before, During, and After Medication Administration

A systematic assessment protocol for checking allergies and condition beforehand, observing swallow/retention during, and evaluating therapeutic effect and side effects afterward.

Leading Zero

A zero placed before a decimal point when no whole number is present (e.g., $0.58$) to prevent misreading and decimal-related medication errors.

Trailing Zero

A zero placed after a decimal point at the end of a number (e.g., $46.0$), which is prohibited by ISMP and The Joint Commission because missing the decimal point can lead to a 10-fold overdose.

Prescriptive Authority

The legal permission granted by state regulations allowing licensed independent practitioners (physicians, nurse practitioners, dentists, physician assistants) to prescribe medications.

Routine Prescription

A standard medication order that is administered continuously as scheduled until discontinued by a prescriber.

Standing Prescription

A protocol-based medication order implemented automatically under specific clinical situations predefined by an institution.

PRN Prescription

A medication order administered as needed based on specific circumstances, specifying medication, dose, route, frequency, and purpose.

Stat Prescription

A medication order that must be administered immediately and given once only.

Now Prescription

A non-emergent single-dose medication order that must be administered within $90\,\text{minutes}$.

Generic Name

The official, nonproprietary name of an active pharmaceutical substance or ingredient.

Trade Name

The proprietary name given to a medication by a specific drug manufacturer, also known as the brand name.

Dosage Strength

A two-part expression on a medication label that states the strength/concentration of active drug alongside its specific dosage form.

Single-Dose Container

A container holding enough medication for a single dose, requiring any remaining unused drug to be discarded immediately.

Multiple-Dose Container

A container holding enough medication for multiple doses, containing preservatives and specific storage guidelines for repeated use with a single patient.

Reconstitution

The process of altering a medication's form, specifically liquefying a powdered drug by mixing it with a diluent according to manufacturer directions.

Controlled Substances

Drugs regulated by state and federal laws due to their potential for abuse, physical or mental dependence, and addiction, categorized into Schedules I through V.

Schedule I Controlled Substance

Controlled substances with the highest potential for abuse and addiction and no accepted medicinal use (e.g., heroin).

Schedule II Controlled Substance

Controlled substances with accepted medical benefits but high potential for abuse and physical/psychological dependence (e.g., Oxycontin).

Schedule III Controlled Substance

Controlled substances with lower abuse potential than Schedule I or II, which may cause low/moderate physical or high psychological dependence (e.g., Vicodin).

Schedule IV Controlled Substance

Controlled substances with lower potential for abuse relative to Schedule III drugs (e.g., Valium).

Schedule V Controlled Substance

Controlled substances with the lowest abuse potential, typically consisting of combination medications containing small quantities of active drugs (e.g., Robitussin AC).

Boxed Warning

A prominent warning placed on a medication label or package insert to highlight rare but severe, life-threatening risks associated with the drug.