Chapter 9 - Safety and Quality

Chapter 9: Safety and Quality

Page 1: Introduction

N275 Introduction to Pharmacology

Instructor: Ariana Twyman, MSN, RN

Page 2: Quality and Safety Education for Nurses

• Patient- and family-centered care: Focuses on understanding the needs of patients and their families.

• Collaboration and teamwork: Working together with other healthcare professionals.

• Evidence-based practice: Using the best available research to make decisions about patient care.

• Quality improvement: Continuous efforts to make healthcare services better.

• Safety: Ensuring that patients are not harmed during their care.

• Informatics: Using technology and information systems in healthcare to improve care and safety.

Page 3: The "Six Rights" of Medication Administration

1. Right Patient: Make sure you have the correct patient receiving the medication.

2. Right Drug: Ensure the correct medication is given.

3. Right Dose: Check that the correct amount of medicine is prescribed.

4. Right Time: Administer the medication at the right time.

5. Right Route: Give the medication through the correct method (oral, injection, etc.).

6. Right Documentation: Write down all details about the medication given to the patient.

Page 4: Right Patient

Verification

• Always use two forms of identification to confirm who the patient is.

• Compare the name and birthdate the patient says with their ID band and the Medication Administration Record (MAR).

• Check for a “name-alert” sticker if there are other patients with the same name.

Page 5: Prescribing Authority

Question: Who can prescribe medication?

• A. Medical doctor (MD)

• B. Licensed practical nurse (LPN)

• C. Certified nursing assistant (CNA)

• D. Dentist (DD)

• E. Advanced practice registered nurse (APRN)

Page 6: Right Drug

Verification Steps

• Scan the medication label and check it against what is written on the MAR.

• Read the drug label three times for accuracy.

• Get to know the patient’s medical history, including allergies and lab results.

• Confirm dosage calculations and understand how long the medication needs to be taken.

Page 7: Prescription Example

Central City Hospital:

• Patient details: Name, address, age, and date.

• Rx: Amoxicillin 500 mg tablet, three times a day for ten days, total of 30 tablets.

• Ensure the prescriber’s DEA number is included for controlled drugs.

• Signature should include instructions on how the patient should take the medication.

Page 8: Right Dose

Verification Steps

• Check that the dosage is safe for the patient.

• Weigh the patient if the dose depends on weight.

• Confirm high-alert drugs with two registered nurses (RNs).

Page 9: Right Time

Policy Compliance

• Follow healthcare agency rules, using military time if required.

• Schedule medications while considering if they should be taken with food or around procedures.

• Keep an eye on expiration dates and ensure antibiotics are given on time.

Page 10: Right Route

Administration Techniques

• The route is important for how well the medication works; make sure the patient can swallow if required.

• Don’t crush or mix medications without following safety protocols.

• Use water when giving medications instead of juice, unless otherwise directed.

Page 11: Right Documentation

Documentation Practices

• Record the medication administration right away, noting all important details.

• Document how the patient responds to the medication, especially if it’s for pain relief (analgesics).

Page 12: Just and Safe Culture

Definition of Medication Error:

• Any preventable event that leads to the wrong use of medication or causes harm while under healthcare supervision (NCCMERP, 2020).

Page 13: The Joint Commission (TJC) National Patient Safety Goals

Focus Points

• Resolving safety issues in healthcare.

• Standardizing how abbreviations are used.

• FDA Drug Reconciliation helps make sure that the list of medicines a patient is taking is correct when they move from one level of care to another, like going from hospital to home or from one doctor to another.

Page 14: TJC "Do Not Use" Abbreviation List

Examples Include:

• U (unit)

• IU (International Unit)

• Q.D. (daily)

• It's better to write these out to avoid misunderstandings.

Page 15: Medication Disposal

Disposal Guidelines

• Mix medication with substances like dirt or coffee grounds before throwing it away.

• Remove personal info from containers before disposal.

• Follow instructions if medicines need to be flushed down the toilet.

Page 16: Sharps Safety Practices

OSHA Requirements

• Use safer medical devices as required.

• Develop written policies to prevent injuries from sharp objects.

Page 17: Safety Risks with Medication Administration

Common Risks

• Risks like splitting tablets or purchasing medications online from unverified sources.

Page 18: Counterfeit Drugs

Risks

• Counterfeit drugs may have incorrect ingredients or dosages.

• Only buy medications from licensed pharmacies to ensure their safety.

Page 19: Dosage Forms

Identifying Drugs

• Learn about different kinds of medications and their labeling requirements.

Page 20: High-Alert Medications

Definition

• Medications that can cause serious risk to patients if given improperly.

• Examples include drugs that look or sound alike.

Page 21: Clinical Judgment in Medication Safety

Key Actions

• Use critical thinking when calculating doses.

• Stay focused and make sure to identify the patient correctly.

• Assess how the patient responds to and understands their medication.

Page 22: Application of Safety Concepts

Critical Thinking Skills

• Identify and analyze important cues.

• Create solutions as needed to ensure safety.

Page 23: Acceptable Drug Orders

Question

• Evaluate examples of acceptable drug orders based on specified criteria.

DRUGS WITH THIS ABBREVIATION/ LABELS SHOULD NOT BE CRUSHED