PTCB PREP: SECTION 3 - Patient Safety & Quality Assurance

what are high-alert meds (HAMs)?

meds that have increased risk of causing significant harm/injury to patient when misused/used wrong

what is the Institute for Safe Medication Practices (ISMP)?

organization for preventing med errors and providing medication safety info

which 3 specific pharmacy settings does ISMP provide “High-Alert Medication Lists?”

• community/ambulatory care (retail pharms)

• long-term care (LTC - nursing homes)

• acute care (hospitals)

what is the Joint Commission on Accreditation of Healthcare Organizations (JCAHO or JC)?

organization that informs and evaluates health care organizations/facilities like hospitals about safe and effective patient care

what are the 5 HAMs identified by JCAHO/JC?

• insulin

  • i inject now

• opiates and narcotics

  • its so OP that the pain hurts so much

• injectable potassium concentrates (electrolyte)

  • keep potassium

• intravenous anticoagulants like heparin

  • inhibit clots

• sodium chloride solutions above 0.9% (electrolyte)

  • high salt concentration

why is insulin a HAM?

i inject now

• dangerously lowers blood sugar → coma → death

why are opiates and narcotics HAMs?

its so OP that the pain hurts so much

• causes respiratory depression (stop breathing) → death

why are intravenous anticoagulants HAMs?

inhibit clots

• increases risk of bleeding → serious adverse effects/death

why are injectable potassium concentrates HAMs?

keep potassium

• causes hyperkalemia (high potassium) → increases heart rate → death

why are NaCl solutions above 0.9% (hypertonic) HAMs?

high salt concentrations

• causes hypernatremia (high Na) → brain damage → death

can pharmacy technicians perform Drug Utilization Reviews (DURs)?

no, they assist pharmacists w/ them

what are Drug Utilization Reviews (DURs)?

evaluating the use and dispensing of meds

can pharmacy technicians make recommendations for OTC therapy or therapeutic substitution?

no, they do it under the supervision of pharmacists

what components of LASA (Look Alike Sound Alike) Drugs?

• similar brand, generic or both names

• similar names, but different characteristics

are including trailing zeros & leading decimals ways to ensure med safety?

no

• trailing zeros:

  ex: 0.5% may be read as 5%

• leading decimals:

  ex: 1.0% may be read as 1%

which organizations have created the Tall Man Lettering list?

• FDA

• ISMP

what is Tall Man Lettering?

using bold, uppercase letters to emphasize the different parts of look-alike drug names

• qh

• q_h

• qAM

• qPM

• qHS

• qD

• qOD

• qWK

• qMO

• BID

• TID

• QID

• PRN

• every hour

• every _ hour(s)

• every morning

• every evening

• every night at bedtime

• every day

• every other day

• every week

• every month

• two times a day

• three times a day

• four times a day

• as needed

• AC

• PC

• CF

• HS

• STAT

• UD

• WA

• TAT, UAT

• AUD

• AAA

• per

• C

• S

• d/c

• TUD

• x_D

• before meals

• after meals

• with food

• at bedtime

• immediately, now

• as directed

• while awake

• until all taken

• apply as directed

• apply to affected area

• by, through

• with

• without

• discontinue

• take as directed

• for _ days

• PO

• SL

• IV

• IM

• SC, SQ

• OU

• OD

• OS

• AU

• AD

• AS

• PV

• PR

• ID

• TD

• IA

• by mouth

• under the tongue (sublingual)

• into a vein (intravenously)

• into a muscle (intramuscularly)

• under the skin (subcutaneously)

• both eyes

• right eye

• left eye

• both ears

• right ear

• left ear

• vaginally (per vagina)

• rectally (per rectum)

• into the skin (intradermal)

• onto the skin (transdermal)

• into an artery (intraarterial)

• tab

• cap

• cr, cre

• oint, ung

• lot

• inh

• inj

• qtt

• syr

• sol, soln

• supp

• susp

• ODT

• ER

• DR

• EC

• tablet

• capsule

• cream

• ointment

• lotion

• inhalation

• injection

• drop

• syrup

• solution

• suppository

• suspension

• orally disintegrating tablet

• extended release

• delayed release

• enteric coated

• QS

• DAW

• NR

• R x __, R __

• quantity sufficient (give the amount needed)

• dispense as written

• no refill

• refill __ times

• tsp

• TBSP

• mL

• oz

• mcg

• mg

• g

• U

• teaspoon

• tablespoon

• milliliter

• ounce

• microgram

• milligram

• gram

• units

• ss

• I or i

• V

• X

• L

• C

• D

• M

• II or ii

• III or iii

• IV or iv

• V

• VI

• VII

• VIII

• IX

• ½

• 1

• 5

• 10

• 50

• 100

• 500

• 1000

• 2

• 3

• 4

• 5

• 6

• 7

• 8

• 9

what does donning PPE mean?

putting on PPE

what does doffing mean?

taking off PPE

how long should you wash your hands with soap and water?

at least 30 seconds