PTCB Prt 3- Patient Safety and Quality Assurance

There are different types of balances. Name 3 different kinds…

1) Class III Torsion Balance

2) Electric balance

3) Analytical balance

What is an Infusion Pump? What is a Syringe Pump?

• Infusion Pump- are machines that are used by healthcare workers to administer set large volumes of IV fluids to a patient. This includes IV fluids/medications and TPNs. (also referred to as volumetric infusion pumps because they move a set volume of fluid along the tubing)

• Syringe Pump- deliver small volumes of fluid to a patient directly from a compatible, disposable syringe. Unlike infusion pumps that are driven by volume, syringe pumps are calibrated to move the syringe plunger a set distance over time.

Infusion pumps must undergo What periodically?

• Periodic maintenance

• Calibration and performance testing for infusion pumps are completed during initial inspection when the machine is first purchased, after any repairs and as part of their annual preventative maintenance.

Why is calibration testing important?

Calibration involves verifying that the pump is administering the correct flow or volume that is stated

What needs to be consulted to determine how to operate and calibrate pumps?

Hospital protocols or guidelines from the manufacturer since there are many different types of pumps available on the market.

Medication information leaflets must be written at or below _____ grade reading level

a 6th grade reading level

Manufacturers of branded medications usually offer copay assistance cards for patients with private insurance. However, manufacturer copay cards are not allowed to be used for patients with ______?

government insurance, including Medicare, Medicaid and Tricare.

Bulk Medications can be repacked by pharmacies into unit dose or individual packaging. The repackaging log must contain the following information each time a medication is repackaged:

1. Date of repackaging

2. Drug name (including the generic), strength, and dosage form

3. Quantity of drug repackaged

4. Manufacturers name

5. Lot number and manufacturer’s expiration date

6. Beyond use date (expiration date of the medication now that it's been repackaged)

7. Initials of the pharmacy technician who repackaged the product

8. Initials of the pharmacist who checked or verified the repackaged product

Each repackaged medication must be labeled with the following information:

1. Generic name of the drug

2. Drug strength and dosage form

3. Manufacturers name and lot number

4. Expiration date of repackaged product

5. Special handling instructions (ex: refrigerate, shake well)

What is a Medication Error?

• is any preventable medication event that has the potential to lead to medication misuse or patient harm.

What is a Near Miss?

• is a medication error that is caught before the medication leaves the pharmacy.

What is Alert fatigue?

• occurs when the computer system constantly prompts the user with too many alerts, so the user becomes less responsive to the alerts and misses an important one.

White plastic bottles contain the ingredient ________ that prevents light from entering the bottle.

titanium dioxide

Brown, orange or amber bottles contain the ingredient ________ that prevents light from entering the bottle.

Iron oxide

What can be found on blister dose packs to protect the medication from light damage?

Aluminum

Glass is an excellent form of packaging because it is impervious to water, oxygen, in carbon dioxide. However, the weakest part of the glass is …?

is the packaging cap since metal and plastic do not seal well against glass.

____________ is a commonly used for rigid plastic packaging because it is impervious to water and gases.

Polypropylene

• What material can be used to package IV fluids because it is lightweight, flexible and can also be frozen, then defrosted in the microwave?

• Some medications are incompatible with the above material so what can be used as an alternative? T

• Polyvinyl chloride PVC

• Polyethylene

It is necessary to document and record pharmacy activity so management can provide the pharmacy with adequate resources and staff. One of the most popular ways to measure the productivity of the pharmacy is

is with prescription counts

• What is a quality improvement plan?

• The four main steps to a quality improvement plan are:

• Quality improvement plans in the pharmacy mainly aim to….

• is a plan or set of standards developed by the management of an organization to improve processes and ensure high-quality patient care.

• 1) creation of a plan 2) Do 3) check and 4) act.

• to reduce medication errors and improve the quality of patient care.

Pharmacy technicians are NOT legally allowed to perform the following roles in a pharmacy:

1. Provide medical advice or OTC recommendations to patients

2. Receive a new verbal or telephone prescription order

3. Perform a clinical review of a prescription order or medication summary

4. Discuss clinical interventions with the prescriber (ex: drug interactions, prescription changes)

5. Perform a drug utilization review

6. Counsel a patient regarding adverse event, drug interactions or medication adherence

7. Perform accuracy checks and final verifications or prescription orders

8. Administer immunizations

9. Transfer prescriptions to another pharmacy

In hospitals or other facilities, drugs are prescribed using medication orders rather than prescriptions. What is an automatic stop order in relation to a medication order?

An automatic stop order occurs when a prescriber does not specify a duration of therapy on the medication order. Instead, the order is automatically stopped or inactivated after a specified date/time, number of days, or number of doses

• When it comes to errors, all pharmacies should have ______ _______ logbook.

• Each pharmacy will have a policy that states who's responsible for…

• Why is it important to keep this type of logbook in the pharmacy?

• medication error logbook

• reviewing medication errors and how often the log should be reviewed.

• Medication Error logbooks are important because they help establish trends in the type of errors that occur and they help come up with ideas for how to prevent the reoccurrence of common errors.

What is MedWatch? Can it be used to report medication errors?

How can reports be made to MedWatch?

• is the FDA's online voluntary reporting system for adverse drug reactions associated with any human drug whether OTC or prescription only. This includes biologics, medical devices, vaccines, dietary supplements, infant formula, cosmetics, food or beverages.

• Yes, Med Watch can also be used to report medication Errors and medication safety concerns

• Reports can be made online, by phone, by mail or by fax.

What is the Vaccine Adverse Event Reporting System (VAERS ?

is an FDA program specifically designed to monitor adverse reactions associated with vaccinations.

What is the National Drug Code (NDC) ?

is a unique 10-digit or 11-digit, 3-segment number, and a universal product identifier for human drugs in the United States.

• During the drug dispensing process, the bar code of each stock bottle is scanned to ensure that it matches the NDC number.

• Drug bar codes are also scanned when they are loaded into automated dispensing robots AKA Pyxis machines.

What is Root cause analysis ?

What triggers a Root cause analysis?

How long does a Root cause analysis take to complete?

• is a problem-solving method used by pharmacies to determine the causes of medication errors and suggests methods for error prevention.

• Root cause analysis is triggered by a sentinel event, medication error or an undesirable event.

• Root cause analysis can take days to weeks to complete. Every pharmacy should have multidisciplinary team in which in place that is trained on how to analyze Sentinel events using root cause analysis

What is a perscription Error?

is a mix up or mistake that occurs anytime during the prescribing, dispensing, or administration process and has the potential to cause patient harm

What are Near misses?

are prescription errors that are caught before the medication reaches the patient.

• Equipment such as counting trays and spatulas should be cleaned and disinfected before and after use with….?

• Certain medications should be prepared using designated in the labeled counting trays and spatulas which includes…?

• 70% isopropyl alcohol.

• This includes antibiotics and other agents that have allergy potential, warfarin, chemotherapy agents and other hazardous medications

Error Prone Abbreviations

U ; instead use…

Unit

• can be mistaken for 0

Error Prone Abbreviations

IU ; instead use…

international unit

• can be mistaken for IV or 10

Error Prone Abbreviations

Q.D. or q.d. ; instead use…

Daily

• can be mistaken for drops or every other day

Error Prone Abbreviations

Q.O.D. or q.o.d. ; instead use…

Every other day

• can be mistaken for daily or four times a day

Error Prone Abbreviations: for whole numbers, do not….

• put a decimal and a trailing zero

• The decimal can be missed ex: 1.0 might look like 10

Error Prone Abbreviations: for number less than 1, you should….

• place a zero in front of the decimal so the decimal is not mistaken as a one digit whole number

• ex: .5 should be 0.5

Error Prone Abbreviations: for a specific chemical…

• write out the full name and NOT the chemical abbreviation so it is not confused for anohter chemical

Error Prone Abbreviations: for a specific medication, do not use the abbreviation for the name instead….

• write out the full name of the medication, so the medicine is not confused for another drug or chemical