Ch. 12 - Safety & Quality in Medication Administration Flashcards Preview

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Flashcards in Ch. 12 - Safety & Quality in Medication Administration Deck (33)
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Quality & Safety Education for Nurses (QSEN):

Focus --->
*Safe = medication administration
*Prevent = med-related errors
Six competencies


Avoid Medication Errors:

*Traditional 5 rights of Medication Admin.

*5+5 Rights of Drug Admin.


1.) Right Client

2 forms of ID:
1.) Check wrist (identification band)
2.) Ask (client name, birth date)
Check for drug allergies


2.) Right Drug

Who may write a drug order?:
1.) Physician
2.) Dentist
3.) Podiatrist
4.) Advanced Practice Registered Nurse


Components of a Drug Order (1):

Verify order -->
-Date, time
-Drug name, dosage, route
-Frequency, duration
-Signature of prescriber


Components of a Drug Order (2):

Order --> always written
Telephone Order (T.O) or Verbal Order (V.O)
RN --> writes order -- "TO (or VO) per Dr. Smith/V. Odell, RN"
Prescriber signs order


To Avoid Drug Error:

Read label 3 times:
1.) Taking container from its location
2.) Before pouring the med
3.) After pouring the med


4 Main Categories of Drug Orders:

1.) Standing (routine)
2.) One-time (single dose)
3.) PRN (as needed)
4.) STAT (immediately) *technically a one time order as well


3.) Right Dose (1):

*Unit dose method --- drugs indiv wrapped & labeled for single doses
Automated / computerized medication -- management system ==> most common


3.) Right Dose (2):

Do not use: unlabeled/illegible label
Keep unit does med in packet until administering
NEVER administer med that someone else prepared


4.) Right Time:

How many times / day: PRN
*Bid (2x day)
*Tid (3x day)
Qid, qd --> Write out! ---- Qid (4x day)
Q 4hrs, Q 6hrs = (every 4/6 hrs)
May give 1/2hr before or after ordered time know before and after meal abbreviations


5.) Right Route:

Oral (po) = tablet, liquid
Sublingual = under tongue
Buccal = between teeth & tongue
Feeding Tube
Topical ---> Inhalation, Installation, Suppository,


Nursing Implications:

(a): Assess ability to swallow for oral meds
(b): Aseptic technique when admin
(c): Stay with client until orals meds are swallowed


6.) Right Assessment:

Obtain appropriate data before you admin


7.) Right Documentation (1):

-Signature (initials)


Right Documentation (2):

PRN meds
-Nurses notes --> need for med and clients response
*DO NOT pre-chart any information


8.) Right to Education:

Clients should receive accurate info regarding their meds


9.) Right Evaluation:

(a):Evaluate effectiveness of med
(b): Determine client's response


10.) Right to Refuse:

Ask: Why is client refusing?


Six Nurses Rights When Administering Medication (1):

1.) Right to complete and clear order
2.) Right to have the correct drug, route, and dose dispensed
3.) Right to have access to information


Six Nurses Rights When Administering Medication (2):

4.) Right to have policies to guide safe medication administration
5.) Right to administer meds safely and to identify system problems
6.) Right to stop, think, and be vigilant


Culture of Safety:

Medication Error:
"Any Preventable event that may cause or lead to inappropriate medication use or to harm a patient"


Bar Code Label Requirements for Human Drug Products & Blood:

Bar code method of medication admin.
-wristband has a scanner that organizes info about pt and reinforces pt safety with admin.


To Prevent Drug Errors:

The Joint Commission (TJC)
-May not use certain abbreviations, acronyms, & symbols d/t misinterpretation ("DO NOT USE" list)


Disposal of Medication (1):

(a): Follow specific info on drug label/insert
(b): Do not flush meds down the toilet unless instructed
(c): Remove drug from original container


Disposal of Medication (2):

(d): Dispose in a sealed bag with kitty litter / coffee grounds
(e): Remove all identifying information on container


Sharps Safely (1):

Occupational Safety & Health Administration (OSHA) Needlestick Safety & Prevention Act of 2000
- d/t ANA Campaign Safe Needles Save Lives


Sharps Safely (2):

Employers must ensure that no preventable needle stick injuries occur


Sharps Safely (3):

Dispose of used gloves, needles/syringes

-NEVER re-cap used needle


Look-alike & Sound-alike Drug Names:

(a): Certain drug names sound alike and are spelled similsry
(b): Lightning bolt symbolizes safety concerns