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
Right Patient: Make sure you have the correct patient receiving the medication.
Right Drug: Ensure the correct medication is given.
Right Dose: Check that the correct amount of medicine is prescribed.
Right Time: Administer the medication at the right time.
Right Route: Give the medication through the correct method (oral, injection, etc.).
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
