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Medication errors
1. By:
Seragaldin M. Abdulqader
Clinical pharmacology for nurses
University of Raparin/school of nursing
The lecture for undergraduate students:
2015 -20169/11/2015 1
2. Medication Errors
10% to 18% of hospital injuries
attributed to medication errors
44,000 to 98,000 people die in U.S.
hospitals annually due to medication
errors
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3. Medication Errors
Effects of medication errors
Increase length of stay
Increased cost
Patient disability
Death
So nurse’s personal and professional status,
confidence, and practice
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4. Nursing Responsibilities
Legal and Ethical
Nurses are liable for their actions,
omissions, and for those duties
they may delegate to others.
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• They are personally
responsible…legally, morally and
ethically…for every drug they
administer.
5. Nursing Responsibilities
Know Information about the medication
Action – side effects – appropriate dose- Age specific
considerations – and routes
Know Information about the client what other medications
are they taking;
- Age
- Vital signs
- Genetic factors
- Pregnant/breast feeding
- ALLERGIES or other problems
- Gag reflex – Impaired swallowing
- Dietary and/or Fluid restrictions
- Cultural and/or religious influences
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- Lab values – renal & liver function / protein & albumin
6. Nursing Responsibilities
Using correct techniques of preparation
and administration to deliver medications
safely.
Monitoring the client for therapeutic and
non-therapeutic effects of the drug
Client education for safe and accurate
self-administration of the drug.
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7. Drug Information Resources
Agency pharmacists.
Nursing drug handbooks.
Physician's Desk Reference (PDR).
Package Inserts: Required by law for insertion
with each new drug and must include a description,
indications, precautions, dosage, and contraindications.
Electronic databases and Internet
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8. Adverse Drug Reaction
Adverse Effects:
-Expected side effects (stomach upset)
-Dose-related reactions (liver or renal impairment)
-Drug/Drug or Drug/Food interactions (potentiation
of drugs by another drug, or drug not absorbed well
with food)
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9. Adverse Drug Reaction
Allergic Reaction:
-Hypersensitivity (rash, anaphylaxis)
Idiosyncratic Reaction:
-abnormal and unpredicted response specific
to an individual (ie: confusion)
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10. Nursing Measures to
Prevent Medication Errors
Never assume anything about a drug order. CLARIFY,
CLARIFY, CLARIFY
Make sure medication orders contain all (7) parts
Minimize use of verbal or telephone orders. If used,
spell all drug names and repeat to confirm
Check Medication Administration Records to the
original prescriber order as per agency protocol.
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11. Nursing Measures to
Prevent Medication Errors
Safe Medication Administration
USE THE SIX RIGHTS
Right drug
Right route
Right patient
Right dose
Right time
Right documentation
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12. Right Patient
Correctly identify patient prior to
medication administration using
Tell patient at time of administration
what medication and dosage is being
administered. Briefly explain
therapeutic use of each medication
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13. Right Drug the (3) Checks
Check medication label 3X
On first contact with drug; when removing
from medication box
Prior to measuring
Pouring, counting, or withdrawing
Just prior to administration; when returning
to medication box
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14. Right Drug
Be aware of distractions
Do not multitask during drug administration
Use bar-coding scanning when available
Be knowledgeable about the drug’s actions,
indications, and contraindications
Be extremely vigilant about known
HIGH ALERT MEDICATIONS
Be alert to Look-a-like , Sound-a-like medications
Do not accept Drug Name Abbreviations
(MS for Morphine Sulfate )
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15. Right Route
Consult a drug information source to
confirm correct route
Do not accept incorrect abbreviations:
sq or sc – WHAT IS PREFERRED?
May need to change or clarify forms or
routes of the drug for safe medication
administration
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16. Right Time
Order should include frequency of
administration
Administer medications within 1 hr of
prescribed time ( or per facility guidelines)
Use safe abbreviations
Do not accept: QD or QOD
WHAT IS PREFERRED???
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17. Right Dose
Carefully read and clarify drug orders
Do not accept illegible handwriting
Do not accept leading or trailing zeroes
Do not accept U or IU
WHAT IS PREFERRED?
Recheck the labels 3 times!
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