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Medication error, nursing responsibility

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RAHIMA M . SALENDAB
NQMC,MGH, MADINA
Meeqat Hospital,Madinah

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Medication error, nursing responsibility

  1. 1. RAHIMA M . SALENDAB NQMC,MGH, MADINA
  2. 2. Medication Error: It is any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the health care professional, patient or consumer. Such events may be related to professional practice, health care products and systems, including: prescribing, order communication, product labeling, packaging and nomenclature, compounding, dispensing, distribution, administration, education, monitoring and use. DEFINITION:
  3. 3. PROCEDURES:
  4. 4. MEDICATION ERROR REPORT PROCESS STAFF DISCOVERED - Inform Head/Charge nurse - Incident report (OVR) to be made - Complete EMERF through alert system -Assess & Monitor the patient - Inform MRP/SOD - Take action to solve the error - Must be aware of: *No disciplinary action to be taken for the staff reported within 24 hours Head/Charge Nurse SOD (Supervisor on Duty) - Must be aware of the incident - Complete OVR - Insure EMERF is done - Inform Pharmacy MRP (Most Responsible Physician) - To take Appropriate action - Fills in the designated area of EMERF the appropriate action taken - Inform Pharmacy immediately if the error reach the patient and have necessitated monitoring Pharmacy - Investigate the case - Submit the written report to QPSD/Risk management QPSD/Risk Management - Do RCA - Provide recommendation to resolve the problem Medical Director - Approve the learned action plan - Disseminated learned action to all unit
  5. 5. Causes for errors:
  6. 6. TYPE OF MEDICATION ERROR 1. PRESCRIBING ERRORS . 2. OMISSION ERRORS. 3. WRONG TIME ERRORS. 4. UNAUTHORIZED DRUG ERRORS. 5. IMPROPER DRUG ERRORS . 6. WRONG DOSE FORM ERRORS. 7. WRONG DOSE PREPARATION ERRORS. 8. WRONG ADMINISTRATION TECHNIQUE ERRORS . 9. DETERIORATED DRUG ERRORS . 10.MONITORING ERRORS . 11.COMPLIANCE ERRORS .
  7. 7. 1. PRESCRIBING ERRORS  Occurs when prescriber orders drug for specific patient drug dose dosage form route of administration length of therapy number of doses administration drug concentration inadequate or incorrect instructions for use illegible handwriting
  8. 8. 2. OMISSION ERRORS Failure to administer an ordered dose (not late dose). Omitted dose is not an error when: cannot take anything by mouth (NPO). providers are waiting for drug level results. patient refuses.
  9. 9. 3. WRONG TIME ERRORS  Standardized administration times  Acceptable interval surrounding scheduled time.  Occasionally unavoidable: patient is away care area for test. medication is not available at time it is due.
  10. 10. 4. UNAUTHORIZED DRUG ERRORS  Administration of medication to patient without proper authorization by prescriber.  Medication for patient given to another patient.  Nurse gives medication without prescriber order.  Patients “share” prescriptions.
  11. 11. 5. IMPROPER DOSE ERRORS  Dose that is greater or less than prescribed dose.  Can occur when additional dose is administered Delay in documenting dose Absence of documentation  Inaccurate measurement of oral liquid Exclusions from this error type
  12. 12. 6. WRONG DOSAGE FORM ERRORS  Doses administered as different form than ordered.
  13. 13. Example:
  14. 14. 8. WRONG ADMIN TECHNIQUE ERRORS  Examples: Subcutaneous injection that is given too deep Intravenous (IV) drug is allowed to infuse via gravity instead of using an IV pump. Instilling eye drops in wrong eye.
  15. 15. 9. DETERIORATED DRUG ERRORS  Monitoring expiration dates is very important.  Refrigerated drugs stored at room temperature may decompose & lose efficacy.
  16. 16. 10. MONITORING ERRORS  Inadequate drug therapy review.  Examples: Ordering serum drug levels but not reviewing them. Not ordering drug levels when required. Prescribing antihypertensive agent & then failing to check blood pressure.
  17. 17. 11. COMPLIANCE ERRORS  Failure to adhere to prescribed drug regimen. Example: Patient does not complete antibiotics therapy-saves a few doses.
  18. 18. OTHER ERRORS  Errors that cannot be placed into category. Examples: Medication dispensed without adequate patient education.
  19. 19. UNAPPROVED ABBREVIATIONS LEADING TO MEDICATION ERRORS:
  20. 20. Types of Verbal Order Errors
  21. 21. NURSING RESPONSIBILITIES
  22. 22. STANDARD PRECAUTION
  23. 23. LOOK ALIKE MEDICINE
  24. 24. SAMPLE OF ILLEGIBLE HAND WRITING
  25. 25. Folinic Acid Folic Acid Amidaron Amlor Zinnat Zantac Concor Zocor Tazocin Prazocin Kafocid Keflex Lasix Losec Aldactone Aldomet Ranitidine Loratidine voltarin ventolin SOUND ALIKE
  26. 26. HOW TO PREVENT MEDICATION ERROR?????
  27. 27. Just because you cannot do it TODAY Does NOT mean you will not do it SOMEDAY ‫اليوم‬ ‫ذلك‬ ‫تفعل‬ ‫لم‬ ‫ألنك‬ ‫فقط‬ , ‫ينب‬ ‫ال‬ ‫هذا‬ ‫غي‬ ‫ما‬ ً‫ا‬‫يوم‬ ‫ذلك‬ ‫تفعل‬ ‫لن‬ ‫انك‬ If you are not willing to learn, No one can help you. If you are determined to learn, No one can stop you …!! ‫ان‬ ‫احد‬ ‫يستطيع‬ ‫لن‬ ‫تتعلم‬ ‫ان‬ ‫على‬ ً‫ا‬‫عازم‬ ‫تكن‬ ‫لم‬ ‫ان‬ ‫يساعدك‬ ‫سيوقفك‬ ‫من‬ ‫اليوجد‬ ‫فإنه‬ ‫تتعلم‬ ‫أن‬ ‫قررت‬ ‫إذا‬ NO ONE CAN MOTIVATE…. IF YOU ARE NOT WILLING TO DO YOUR SELF…
  • LindaLookWalley

    Sep. 22, 2021

RAHIMA M . SALENDAB NQMC,MGH, MADINA Meeqat Hospital,Madinah

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