Med Safety & Quality Improvement Flashcards
An error of omission is when…
something was left out that is needed for safety
An error of commission is when…
something was done incorrectly
Error investigations need to take place quickly, often as soon as…
within 48 hours of the incident
The ISMP National Medication Errors Reporting Program (MERP) is…
a confidential, voluntary reporting system. It provides expert analysis of the system causes of medication errors and provides recommendations for prevention.
Medication errors and close calls can be reported on…
the ISMP website
Failure mode and effects analysis (FMEA) is a proactive or prospective method used to…
reduce the frequency and consequences of errors
A root cause analysis (RCA) is a retrospective investigation of an event that already occurred, which includes…
reviewing the sequence of events that led to the error
Continuous quality improvement (CQI) is the goal for most health care settings. Examples include…
Lean (focuses on minimizing waste) and Six Sigma (focuses on reducing defects)
Six Sigma uses the DMAIC process, which stands for…
define, measure, analyze, improve, control
The Joint Commission on Accreditation of Healthcare organizations (TJC) is…
an independent, not-for-profit organization that accredits and certifies more than 17,000 healthcare organizations and programs in the U.S.
An accredited organization must undergo an on-site survey at least…
every 3 years (can be unannounced)
The TJC sets the…
national patient safety goals (NPSGs) annually for different types of healthcare settings. Each goal includes defined measures called “Elements of Performance”
2020 NPSGs for pharmacists include…
- Use at least 2 patient identifiers when providing care, treatment and services
- Reduce the likelihood of patient harm associated with the use of anticoagulant therapy
- Maintain and communicate accurate patient medication information (medication reconciliation and providing discharge counseling)
- Comply with the CDC or WHO hand hygiene guidelines
Abbreviations are unsafe and contribute to med errors. All institutions accredited by TJC are required to have a list of abbreviations that..
may not be used in the facility.
Look-alike, sound-alike drugs are a common cause of med errors. Drugs that are easily mixed up should be labeled with…
tall man letters (ex. CeleXA, CeleBREX)
