...Medication Errors Stephanie Stephens January 9, 2016 NU1426 ITT TECH Nurses must always follow the six rights of medication administration thoroughly to ensure patient safety. These rights include right medication, right route, right time, right client, right dosage, and right documentation. When one of these rights is not followed a medication error has occurred and must be reported immediately. Medication error prevention is vital in the role of the nurse. There were many contributing factors leading to this medication error and there are many ways to avoid medications errors. Looking at the reasons why medications occur helps the nurse understand what areas to be most vigilant. The main areas of medication errors are distractions/ interruptions, medication education, interpretation of an order and poor calculations. Patients during their time in the hospital will receive medications. Distractions will occur throughout a nurses shift, losing concentration at the task at hand can lead to serious and harmful mistakes. It is important for the nurse to let her surrounding nurses know when she/he is pulling medications so that there isn't any distractions. Also, a quiet environment when taking telephone orders so that the order can be heard clearly and dictation from the provider is understood. Another medication administration error prevention for the nurse is to allow for delegation and to not take on to much. When a nurse is in the process of administering medication...
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...to accurately set up and maintain a medication administration record – Understand that records are confidential – Know how to conduct a quantitative review of a record – Know how to conduct a qualitative review of a record – Be able to track consumer issues through a record revised 8.08 The challenge for all service providers is to understand the “whys” of documentation while also understanding the “hows”. If we are able to understand the “whys”, the mundane tasks of everyday documentation and record keeping become something that is part of the whole instead of the dreaded work we face every day. revised 8.08 Let’s Begin With A Little Chat about Program Quality You may notice that this training seems to be mostly about paper, not people. That doesn’t mean we don’t like people In fact some of our best friends are…. well, people. revised 8.08 And it’s not that we think “Good Paper Equates to Good Program” In fact, we’ve seen some very lousy programs that have really “good paper”. We call that, “doing the wrong thing, very, very well”. revised 8.08 But the thing is……….. In looking back, it’s been extremely rare that we have found really good services with really poor documentation. revised 8.08 Let’s face it……….. If we are going to keep up with all that we do to provide quality service … We’re going to have to write it down revised 8.08 So, here’s how you write it down!………… revised 8.08 Why such a big deal about...
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...paper forms containing various information from different interdisciplinary teams incorporated from a patients history of hospital stays. Often, forms are not updated to reflect current patient information, lost between departments or vital information is not correctly incorporated. It is also common practice that multiple copies of the same information exist within the hospital setting posing a risk for inconsistencies of data sources. Within a hospital setting it is imperative that procurement, management and recovery of large volumes of information be easily accessible to anyone with direct medical contact with a patient. Such information would include; patient medical and personal information, health history, staff information, medications, allergies, labs and testing results as well as physician consultations. This system will also track staff that have input, reviewed and collected information on a patient. An electronic medical record system will help the hospital run more efficiently and reduce the number of possible errors by consolidating data, standardizing data...
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...Cardiopulmonary Arrest PNCI - Learner Robert Johnson Age: 60 Weight: 70 kg Base: Stan D. Ardman Patient History Past Medical History: Hypertension well-controlled by medication, hypercholesterolemia and obesity; minor car accident three weeks ago in which he sustained whiplash Allergies: No known drug allergies Medications: Lopressor (metoprolol), Zocor (simvastatin) Code Status: Full Code Social/Family History: Married with two adult children who live locally; Does not smoke, drink or use illicit drugs Handoff Report Situation: The patient is a 60-year-old male in room 425 on the Orthopedic Unit who is recovering from an anterior-posterior interbody fusion of L4 – L5 performed two days ago. His has had an uneventful recovery. He is in his room eating breakfast. Background: Hypertension, hypercholesterolemia and obesity. The hypertension has been well controlled by his medication. He is wearing a soft neck collar for support following a minor car accident three weeks ago in which he sustained whiplash. The patient has no known drug allergies and is awake and alert. Assessment: Vital signs: HR 87, BP 128/62, RR 18, SpO2 has been 98% on room air, Temp 37.1oC Cardiovascular: No telemetry; HR regular Respiratory: Clear in both lung fields GI: Advanced to full liquid diet and tolerating it well GU: Voiding clear, yellow urine Extremities: Pink, warm and with adequate turgor; Movement is strong in all four extremities (4+) Skin: Warm and dry; No signs of infection...
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...quickly drop off their prescriptions whenever convenient for them, the pharmacists and technicians to fill the scripts near the time the customer would like to pick them up, and customers to return to the store to pick up their medications at the specified time. However, this system creates long lines and angry customers during busy pick-up times, such as around the evening meal, when the typical work day concludes. We would like to implement a system that focuses on the day’s procedures and alters the drop-off, data entry, and production steps, therefore ideally reducing the number of problems that occur and must be resolved during the pick-up stage. With some additional changes made to the pick-up procedure, we feel CVS will be able to better their customer service and increase customer satisfaction while keeping the safety of its shoppers the company’s number one priority. The following page presents a data flow diagram of the day-to-day operations of the plans we would like to implement for CVS Pharmacy. 3 Day-to-Day Operations • Constantly monitor drop-off station • Gather/check customer information • Update customer information in the system • Refill online and over telephone Drop-Off Data Entry • Drug Utilization Review • Insurance Check & Revisions • Continuous Data Entry •...
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...quickly drop off their prescriptions whenever convenient for them, the pharmacists and technicians to fill the scripts near the time the customer would like to pick them up, and customers to return to the store to pick up their medications at the specified time. However, this system creates long lines and angry customers during busy pick-up times, such as around the evening meal, when the typical work day concludes. We would like to implement a system that focuses on the day’s procedures and alters the drop-off, data entry, and production steps, therefore ideally reducing the number of problems that occur and must be resolved during the pick-up stage. With some additional changes made to the pick-up procedure, we feel CVS will be able to better their customer service and increase customer satisfaction while keeping the safety of its shoppers the company’s number one priority. The following page presents a data flow diagram of the day-to-day operations of the plans we would like to implement for CVS Pharmacy. 3 Day-to-Day Operations • Constantly monitor drop-off station • Gather/check customer information • Update customer information in the system • Refill online and over telephone Drop-Off Data Entry • Drug Utilization Review • Insurance Check & Revisions • Continuous Data Entry •...
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...Tamim Alajlan SELP 530 System Architecture and Modeling 30 April 2015 Pharmacy and PRESCRIPTION SYSTEM in Saudi Arabia Tamim Alajlan SELP 530 System Architecture and Modeling 30 April 2015 Pharmacy and PRESCRIPTION SYSTEM in Saudi Arabia 1. Introduction This report includes complete details about the background of current systems of medication implemented in Saudi Arabia and the problems rising due to implementation of this system and the solution proposed to solve these problems. The communication gap among the patients, hospitals, doctors and pharmacies have raised a lot of problems and stills citizens of Saudi Arabia are facing this problem. Treatment security is usually a worldwide problem between healthcare services. Even so, the particular problems plus the future regarding drugs security with Saudi Persia have not recently been researched. Significant variables adding to drugs security troubles included infinite public entry to medications through different doctor's offices along with group pharmacies, transmission spaces concerning healthcare institutions, restricted by using important systems for instance advanced provider get accessibility, along with the possible lack of drugs security applications with doctor's offices. Problems to present drugs security training determined simply by participants included underreporting regarding drugs mistakes along with negative medicine responses, multilingualism along with vary type of qualification regarding...
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...the medicine is having the desired affect (Dougherty et al 2004). Drug administration is an integral part of a nurse’s role and as such responsibility for correct administration of drugs rests with the nurse (O’Shea 1999). It is stated that nurses spend up to 40% of their time administrating medicine (Armitage et al 2003) In order to perform this intervention safely a nurse needs to know about the drug its immediate effect and any side effects it may cause. This role involves safe handling and administration of medicines, the role also includes the nurse being responsible for the patients knowing what medicines they are taking and why. Legal, professional and cultural boundaries are changing in health care settings, which mean that a nurse’s role is now medicines management. (Dougherty et al 2004). Medication errors can place a patients life at risk. Errors are an unavoidable subset of human behaviour, no amount of proficiency or expertise will reduce it (Reason 2000). Drug errors can be costly the results are increased hospital stay, patient harm, loss of life in some circumstances; careers ruined or fear of reprisal (Anderson et al 2002). Medication...
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...The intake form is a very important part of providing services to clients no matter the kind of services, whether it is counseling, medical, or mental health. The intake form will not only help gain better knowledge about the client, but also help set the standards and build the foundation for the services being provided. A. Does it ask all of the necessary questions to determine what the client’s presenting problem is? Please support your answer. Yes! The intake form chosen, was equip all the necessary questions to determine what the clients presenting problem is. The intake form started off by asking for the basic information such as name, DOB, primary care physician, current therapist/counselor information. And then went on to ask, what...
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...Organizational Systems and Quality Leadership Task 2 Jill Riccobono Western Governors University Organizational Systems and Quality Leadership Task 2 A. Root Cause Analysis A root cause analysis (RCA) looks at an event and considers what happened, why it happened what will be done to prevent it from happening again and how will we know that the changes made will improve the safety of the system. It takes into consideration causative factors, errors and hazards that led to a sentinel event. In this case it was a patient’s death. RCA should not look to place blame on people, but rather processes that need to be improved. The first step in a RCA is to identify what happened. In the scenario, presented in this task, the patient was over sedated and subsequently died. Step two is to identify why this happened. There were preventable causative factors, or errors, that led to this sentinel event. The hospital’s conscious sedation policy requires that the patient remains on continuous BP, ECG, and pulse oximeter throughout the procedure and there was no mention that this was performed at all throughout the procedure. It was not until after the procedure that Mr. B was placed on continuous BP and pulse oximeter, and at that time, the patient was left in the room, with only a family member while Nurse J attended to another patient. When the alarm is heard that the patient has low O2 sats, the LPN, enters the room and resets the alarm and repeats the B/P reading. His oxygen level...
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...Drug Errors Introduction Administration of medicines is a key element of nursing care. Every day some 7000 doses of medication are administered in a typical NHS hospital (Audit commission 2002). Drug administration forms a major part of the clinical nurses role. Medicines are prescribed by the doctor and dispensed by the pharmacist but responsibility for correct administration rests with the registered nurse (O'Shea 1999). Each registered nurse is accountable for his/her practice. This practice includes preparing, checking and administering medications, updating knowledge of medications, monitoring the effectiveness of treatment, reporting adverse drug reactions and teaching patients about the drugs that they receive (O'Shea 1999). The patient is expected to receive the correct medication at each drug round but several studies have shown that this is not always the case (Raju et al 1988, Ferner 1995). Medication errors do occur and are a persistent problem associated with nursing practice (O'Shea 1999). The aim of this paper is to answer the question: Why are nurses still continuing to make drug errors? In order to answer this question this paper shall examine the guidelines that nurses must adhere to when administering drugs, shall provide a definition of a drug errors, look at reasons why drug errors occur and approaches that are aimed at reducing drug errors on the ward. There are a number of pieces of legislation that relate to prescribing, supply, storage and administration...
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...From Medscape Nurses Medication Error Prevention for Healthcare Providers Faculty and Disclosures CE Information There are between 44,000 and 98,000 individuals who die every year in hospitals due to preventable medical errors.[1] It has also been reported that this is only part of the problem, as thousands of other patients are adversely affected by medical errors or barely avoid injuries that are nonfatal.[2] These medical errors not only cost the loss of lives, but carry a financial burden that is estimated to be in a range of $17 billion to $29 billion annually. Additionally, there is physical and psychological pain and suffering related to these errors.[1] Another consequence is that medical errors diminish trust and satisfaction in the healthcare system and in healthcare professionals.[1] Ginette A. Pepper, PhD, RN, FAAN, a Professor and Helen Lowe Bamberger Colby Presidential Endowed Chair and Associate Dean for Research, University of Utah College of Nursing, Salt Lake City, spoke on medication safety for the geriatric nurse practitioner (GNP).[3] Dr. Pepper was trained as a pharmacologist with a nursing focus. She was one of the first NPs to add "geriatric" to her title as well as one of the first NPs to have prescriptive authority. Safety Principles and the Medication Use Process Dr. Pepper noted that safety issues are of the utmost importance for all healthcare providers.[3] Nursing as a profession has a long history of regarding patient safety as a primary...
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...Organizational Systems RTT Task 2 Allison Vargus Western Governor’s University Organizational Systems RTT Task 2 Questions A The main goal of Root Because Analysis is to identify the policies and procedures in an agency that can be changed for the better. These changes are identified within an organization and a plan is put into place to prevent any reoccurrences of negative outcomes. RCA is defined as a “process for identifying the basic or casual factors that underlie variation in performance, including the occurrence of a sentinel event; it focuses primarily on systems and processes, not individual performance” (Cherry and Jacon, 2011, p. 442). A multidisciplinary team must assemble and pinpoint the exact causation of the problems. After the issues have been identified the next step is to determine refinements to prevent them from occurring again. Mr. B arrived at the Emergency Room after he had a fall in his home. The sixty-seven-year-old man arrived to the 6 bed, small town ER with his son and neighbor in a severe amount of pain in his left hip and leg area. There are several unfortunate reasons that lead to Mr. B’s demise. The information gathered to complete the RCA will determine the causation of this ill-fated situation. I will discuss these factors in further detail ahead. The first factor in this case I will discuss is the lack of education on hospital policies and procedures. Mr. B was placed under conscious sedation and therefore he should have...
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...process in order to address the critical thinking questions. Case Study: D.Q. is a 57-year-old male who worked in a water treatment plant for many years. He also smoked heavily for approximately 30 years. He has been diagnosed with COPD. During an extremely hot summer, he arrived at the emergency department in severe exacerbation of the COPD. The patient’s heart rate is 123, blood pressure is 163/90, respiratory rate is 34, oxygen saturation is 86% on 2 L NC, and temperature is 37.5 celsius. In preparation for discussion, consider the following process points before posting to the threaded discussion: 1. The drugs you should expect the provider to order for the patient 2. The rationale for each drug you anticipate the provider will order On the discussion boards, respond to the following: 1. What patient teaching would need to be provided for a patient taking each of these drugs: a bronchodilator, a glucocorticoid, and an expectorant? 2. What medications do you anticipate the physician ordering? Why? What are the potential side effects and/or complications of these drugs? Using the nursing process, describe your expected assessment, nursing diagnosis, plan of care, implementation, and evaluation of the patient. Compare and contrast your plan of care with that of your fellow colleagues. Why did you choose your actions and diagnosis compared to that of your colleagues? In the case of D.Q. patient teaching would be required for the following medications. Bronchodilator...
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...Collection Step 2. Patient Check-in and Payment Collection Step 3. Rooming and Measuring Vital Signs Patient Examination and Documentation Step 4. Patient Checkout Step 5. Post-Visit: Coding and Billing Post-Visit: Reviewing Test Results Coding and Reimbursement in Electronic Health Records Computer-Assisted Coding Clinical Tools in the Electronic Health Record Decision-Support Tools Tracking and Monitoring Patient Care Screening for Illness or Disease Identifying at-Risk Patients Managing Patients with Chronic Diseases Improving the Quality and Safety of Patient Care with Evidence-Based Guidelines E-Prescribing and Electronic Health Records Keeping Current with Electronic Drug Databases Increasing Prescription Safety Saving Time and Money LEARNING OUTCOMES After completing this chapter, you will be able to define key terms and: 1. 2. 3. 4. 5. 6. 7. 8. 9. List the five steps of the office visit workflow in a physician office. Discuss the advantages of pre-visit scheduling and information collection for patients and office staff. Describe the process of electronic check-in. Explain how electronic health records make documenting patient exams more efficient. Explain what occurs during patient checkout. Explain what two events take place during the post-visit step of the visit workflow. Describe the advantages of computer-assisted coding. List three decision-support tools the EHRs contain to provide patients with safe and effective health care. List four important safety checks that an EHR’s e-prescribing...
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