MEDICATION SAFETY AND QUALITY IMPROVEMENT

Question 1

WHICH COMMITTEES SHOULD BE INFORMED IN THE HOSPITAL SYSTEM REGARDING ERRORS?

Answer 1

P&T COMMITTEE

MEDICATION SAFETY COMMITTEE

Question 2

MEDICATION ERRORS REPORTING PROGRAM

Answer 2

CONFIDENTIAL, VOLUNTARY REPORTING PROGRAM

ANALYZES CAUSE OF ERROR AND PROVIDES RECOMMENDATIONS FOR PREVENTION

Question 3

MEDICATION ERRORS AND CLOSE CALLS CAN BE REPORTED ON THIS WEBSITE…

Answer 3

ISMP WEBSITE

Question 4

PROSPECTIVE EVALUATION AND QUALITY IMPROVEMENT

Answer 4

FAILURE MODE AND EFFECTS ANALYSIS (FMEA)
REDUCES THE FREQUENCY AND CONSEQUENCES OF ERRORS.
USED TO ANALYZE THE POTENTIAL FOR ERRORS AND DETERMINE POTENTIAL EFFECTS OF SYSTEM CHANGES

Question 5

RETROPECTIVE EVALUATION AND QUALITY IMPROVEMENT

Answer 5

ROOT CAUSE ANALYSIS (RCA)

AFTER EVENT HAS OCCURRED, REVIEW THE SEQUENCE OF EVENTS THAT LED TO THE ERROR

Question 6

CONTINUOUS EVALUATION AND QUALITY IMPROVEMENT

Answer 6

CONTINUOUS QUALITY OF IMPROVEMENT (CQI)
GOAL FOR ALL SETTINGS
EXAMPLES INCLUDE “LEAN” AND “SIX SIGMA”

Question 7

FOCUSES OF “LEAN”

Answer 7

MINIMIZING WASTE

Question 8

FOCUS OF “SIX SIGMA”

Answer 8

REDUCING DEFECTS

Question 9

THE JOINT COMMISSION

Answer 9

INDEPENDENT, NOT-FOR- PROFIT ORGANIZATION THAT ACCREDITS AND CERTIFIES HEALTH CARE ORGANIZATIONS IN THE US

Question 10

HOW OFTEN ARE NATIONAL PATIENT SAFETY GOALS SET?

Answer 10

ANNUALLY BY TJC

Question 11

HIGH ALERT MEDICATIONS

Answer 11

ANTIARRHYTHMIAS
ANTICOAG/ANTITHROMBOTICS
CHEMO
EPIDURAL/INTRATHECAL
HYPERTONIC SALINE
IMMUNOSUPPRESSANTS
INOTROPICS
INSULINS, HYPOGLYCEMICS
MG SULFATE
NEUROMUSCULAR BLOCKING
OPIOIDS/SEDATIVES/ANESTHESIA
PARENTAL NUTRITION
POTASSIUM CHLORIDES AND PHOSPHATES
STERILE WATER FOR INJECTION

Question 12

PRECAUTION EXAMPLE FOR INSULIN

Answer 12

DO NOT PLACE INSULIN IN ADDC

ALL INSULIN ORDERS SHOULD BE REVIEWED BY A PHARMACIST PRIOR TO DISPENSING

Question 13

PRECAUTION EXAMPLE FOR POTASSIUM CHLORIDE

Answer 13

REMOVE ALL KCL VIALS FROM FLOOR STOCK (ONLY PREPARE IN PHARMACY)
ONLY USE PREMIXED CONTAINERS
SPECIFIY PROTOCOLS FOR DELIVERY
ALLOW FOR AUTOMATIC ORAL SUBSTITUTION FOR IV
LABEL ALL FLUIDS WITH “POTASSIUM CONTAINING” STICKER IF INCLUDED

Question 14

WHY ARE PATIENTS WITH MULTIPLE MEDICAL CONDITIONS TARGETED FOR MTMS

Answer 14

THESE PATIENTS ARE LIKELY TO INCUR ANNUAL COST FOR DRUGS THAT EXCEED PREDETERMINED LEVEL

Question 15

MOST COMMON ERROR ASSOCIATED WITH ADC USE.

HOW IS THIS AVOIDED?

Answer 15

WRONG DRUG OR DOSE TO A PATIENT

AVOIDED BY USING BARCODE SCANNING

Question 16

WHICH MEDICATIONS SHOULD NOT BE INCLUDED IN THE ADC

Answer 16

INSULIN
WARFARIN
HIGH DOSE NARCOTICS

Question 17

METHOD TO ENSURE ADC SAFETY:

LOOK-ALIKE, SOUND-ALIKE MEDICATIONS SHOULD BE STORED IN…

Answer 17

DIFFERENT LOCATIONS WITHIN THE ADC

Question 18

METHOD TO ENSURE ADC SAFETY:

WHAT SHOULD BE DONE WITH UNUSED MEDICATIONS BY NURSE?

Answer 18

SHOULD NOT BE PLACED BACK INTO THE ADC

Question 19

METHOD TO ENSURE ADC SAFETY:

MACHINES IN THESE ENVIRONMENTS ARE MORE PRONE TO ERRORS

Answer 19

BUSY NOISY ENVIRONMENT

POOR LIGHTING

Question 20

METHOD TO ENSURE ADC SAFETY:

TJC REQUIRES THIS TO OCCUR BEFORE ANY MEDICATION IS REMOVED FROM THE ADC

Answer 20

PHARMACIST REVIEW

Question 21

METHOD TO ENSURE PCA SAFETY:

CAN PCAS BE IN ANY HOSPITAL?

Answer 21

IT SHOULD ONLY BEUSED IN WELL-COORDINATED HEALTHCARE TEAMS

Question 22

METHOD TO ENSURE PCA SAFETY:

TJC REQUIRES THESE PEOPLE TO NOT BE TAUGHT OR NOT BE ABLE TO USE PCAS

Answer 22

FRIENDS AND FAMILY MEMBERS SHOULD NOT ADMINISTER PCA DOSES

Question 23

METHOD TO ENSURE PCA SAFETY:

WHAT SHOULD BE CREATED IN ORDER TO LIMIT AGENTS

Answer 23

STANDARDIZED ORDER SETS TO LIMIT OPIOIDS AVAILABLE OUTSIDE OF ADCS

Question 24

METHOD TO ENSURE PCA SAFETY:

STAFF SHOULD BE EDUCATED REGARDING THESE DRUG MIX UPS

Answer 24

HYDROMORPHONE AND MORPHINE

Question 25

METHOD TO ENSURE PCA SAFETY:

WOULD BARCODING HELP IN THESE SITUATIONS?

Answer 25

YES

Question 26

COMMON TYPES OF NOSOCOMIAL INFECTIONS:

UTIS ARE COMMONLY CAUSED BY

Answer 26

INDWELLING CATHETERS

REMOVE CATHETER AS SOON AS POSSIBLE

Question 27

COMMON TYPES OF NOSOCOMIAL INFECTIONS:

BLOODSTREAM INFECTIONS ARE COMMONLY CAUSED BY

Answer 27

IV LINES (HIGHEST RISK WITH CENTRAL LINES)
CATHETERS

Question 28

COMMON TYPES OF NOSOCOMIAL INFECTIONS:

WHAT IS THE MOST COMMON BACTERIAL INFECTIONS

Answer 28

CLOSTRIDIOIDES (C.DIFF)

Question 29

COMMON TYPES OF NOSOCOMIAL INFECTIONS:

PNEUMONIA CAUSED BY

Answer 29

VENTILATOR USE

Question 30

CONTACT PRECAUTIONS ARE RECOMMENDED FOR PATIETNS WITH

Answer 30

MRSA
VRE
C. DIFFICILE INFECTION

Question 31

AIRBORNE PRECAUTIONS ARE RECOMMENDED FOR PATIENTS WITH

Answer 31

TUBERCULOSIS
MEASLES
VARICELLA VIRUS

Question 32

METHODS TO AVOID CATHETER RELATED BLOODSTREAM INFECTIONS

Answer 32

ASEPTIC TECHNIQUE (INCLUDINE HANDWASHING)
SKIN ANTISEPTICS (2% CHLORHEXIDINE)
ANTIBIOTIC IMPREGNANTED CENTRAL VENOUS CATHETERS

Question 33

WHEN SHOULD SOAP AND WATER USED INSTEAD OF ALCOHOL BASED RUBS

Answer 33

BEFORE EATING
AFTER RESTROOM
AFTER CARING FOR PT WITH C. DIFF
BEFORE CARING FOR PT WITH FOOD ALLERGIES

Question 34

WHAT IS THE DEFINITION OF HIGH ALERT MEDICATION BY ISMP

Answer 34

DRUGS WITH HEIGHTENED RISK OF CAUSING HARM IF USED INCORRECTLY

Question 35

IF ABBREVIATIONS ARE USED, WHAT SHOULD BE CREATED IN THE INSTITUTION TO AVOID ANY CONFUSION

Answer 35

APPROVED LIST OF ABBREVIATIONS

BUT REALLY SHOULD AVOID IF POSSIBLE