Patient Safety and Quality Assurance

High Alert/Risk medications

Medications that are most likely to cause harm to a patient if used incorrectly

Institute for Safety Medication Practice (ISMP)

Primary resource for indetifying high-alert medications

5 “Rights” of Medicine Administration

Right drug

Right dose

Right time

Right route

Right patient

Verification steps to reduce risk of a dispensing error

1. Verify name and date of birth

2. Verify street address

3. Briefly mention what you have for the patient

Inventory management

1. Ordering and receiving products

2. Identify specific storage requirements

3. Removing expired or recalled medications

When should a pharmacist conduct Drug Utilization Review (DUR)?

Prior to dispensing a new medication or refilling an existing order

What should a Drug Utilization Review (DUR) include

Comprehensive review of the patient’s prescription and OTC medications, with a special focus on drug-drug interaction and potential adverse drug events

Drug-Disease interaction

Inappropriate prescribing (age, gender, pregnancy)

Recommendation for substitution and therapeutic interchange allergies

OBRA-90 mandated for medicaid prescriptions

Adverse Drug Event (ADE)

1. Unwanted reactions that occur from the normal use or potential misuse of a medication

2. Can be due to medication error or adverse reaction from practical use

3. Should always be documented

4. Always report to the FDA Adverse Event Reporting System (FAERS)

Therapeutic substitution

Allows for a medication to be switched to a different medication in the same drug class (not same drug) without first checking with prescriber

Generic substitution

Allowd for brand name drug to be substituted with generic version

What errors should be reporting and documenting both internally and externally for quality assurance purposes

Adverse events and medication error

MedWatch

A program run by the FDA for healthcare providers and patients to report an adverse reaction to a medication

Information required when reporting through MedWatch

1. Name of drug

2. Description of adverse event

3. Any concomitant medication use or disease history

4. Date event occured and when medication was started/stopped

5. Dosage and directions for use

6. Outcome of event

What can compromise a product’s integrity

Storage, temperature changes, moisture levels, etc.