Medication Safety and Quality Flashcards

Flashcards on Medication Safety and Quality

Six Rights of Medication Administration

Right patient, right drug, right dose, right time, right route, right documentation.

Right Patient Verification

Verify patient with two forms of identification, compare patient's stated name and birthdate with patient's ID band and MAR, scan patient's barcode on their ID band, check color coding, verify with family, check for name-alert sticker.

Right Drug Verification

Scan medication label, check order is prescribed, read drug label three times, be familiar with patient's health record, know why the patient is receiving medication, check dose calculations, know beginning and ending date.

Right Dose Verification

Verify dosage calculation, verify drug is safe, weigh patient if dose is dependent on weight, validate dose of certain drugs with 2 RNs.

Right Time Considerations

Use healthcare agency policy, use military time, consider drug-food interactions, check for scheduled procedures, check expiration date, administer antibiotics at even intervals, hold antihypertensives prior to dialysis if ordered.

Right Route Considerations

Necessary for adequate absorption. Assess patient's ability to swallow. Do not crush without validation. Offer water (not juice, except iron with orange juice). Use aseptic technique.

Right Documentation

Record drug administration immediately with drug name, dose, route, time, date, and nurse's signature/initials. Document patient's response, especially for analgesics, sedatives, and antiemetics.

Culture of Safety

ANA encourages reporting drug errors to improve the system. Risk management departments.

The Joint Commission (TJC)

Developed National Patient Safety Goals, focuses on healthcare safety problems and resolutions, established standards for abbreviations, FDA established 'black box warnings'.

Drug Reconciliation

Develop accurate list, advise patient to carry list, update drug list, and bring to appointments.

Disposal of Medications

Follow label instructions, transfer drug to undesirable substance, place mixture in container, remove identifying information, do not flush unless instructed, return to 'drug take-back' program, consult pharmacist.

OSHA Needlestick Safety and Prevention Act

Requires safer medical devices, safe workplace with education, and written policies to prevent sharps injuries.

Safety Risks in Medication Administration

Tablet splitting, buying drugs over the internet.

Counterfeit Drugs

May look like desired drug but may have no active ingredient, wrong ingredient/dose, or may be improperly packaged/contaminated. Purchase only from licensed pharmacies.

Dosage Forms - Crushing

Consult pharmacist before crushing. Do not crush extended- or sustained-release drugs.

High-Alert Medications

Can cause significant harm if given in error. Examples: Epinephrine, insulin, nitroprusside, potassium chloride injection.

Look-Alike and Sound-Alike Drugs

Examples: Ephedrine-Epinephrine, Captopril-Carvedilol, Depo-medrol-SoluMedrol. Be aware of correct drug spelling.

Preventing Medication Errors

Distraction-free environment, medication safety zone.

Nursing Process: Medication Safety - Assessment & Planning

Use critical thinking skills to determine if medication is safe. Calculate dose accurately and verify if necessary, avoid distractions.

Nursing Process: Medication Safety - Interventions

Use relevant sources, calculate doses correctly, avoid skin contamination, always use hand hygiene, never administer medications prepared by another nurse, use two forms of identification.

Medication Administration Resources

Provides accurate medication safety info. FDA database helps identify, implement, and evaluate strategies to prevent errors. Drug reference book, pharmacist, or acceptable technology resource. FDA Pregnancy Categories

Take one multivitamin qod

call the prescriber to clarify the order.