Transcript Medication Error - Bethlehem University

Medication
Error
Nasha’at Jawabreh And yousef
What is the
definition of
medication
error ?
“..any preventable event that may cause or
lead to in inappropriate medication use or
patient harm , while the medication is in the
control of health care professional, patient,
or consumer, Such events may be related to
professional practice, health care products,
procedures, and systems including :
prescribing; order communication; product
labeling; packaging and nomenclature;
compounding; dispensing; distribution;
administration; education; monitoring; and
use”.
(NCCMERP)
The safe and accurate
administration of medications is
one of the nurses most important
responsibilities.
Drugs are the primary means of
therapy for clients with health
problems, but a drug may have the
potential for causing harmful
effects when administered
improperly.
How mistakes are made ?
Medication errors fall into these categories :
• Omission : the patient fails to receive unordered drug
dose.
• Wrong dose : the patient receives a dose that’s at
least 5% more or less than the dose ordered.
• Extra dose : the patient receives more doses tan the
doctor ordered.
• Unordered drug : the patient receives a drug that
wasn’t ordered for him.
• Wrong root
• Wrong time: the patient receives a drug too early or
too late.
The nurse is responsible for
understanding a drugs action and
it’s side effects, administering it
correctly, monitoring the client’s
response and helping the client
self administer drugs correctly and
knowledgably (Proulx, 1993).
Ways to Prevent Medication
Errors
Despite repeated emphasis
on the “five Rights of Drug”
administration, too many
patients receive the wrong
medication. So the ways to
prevent these errors are:
1. Don’t administer any drug-including over the
counter drug, without a doctor’s order.
2. Always check the label to identify a drug. Don’t
rely on the drugs color, shape, or location in the
medication cassette.
3. Check the label against the doctors order and the
patient’s medication administration record (MAR)
three times: when obtaining the drug, when
preparing the dose, and when returning the
container to storage or discarding it.
4. When you check the drug name, pay particular
attention to the spelling many drugs have similar
names. If you have any doubts about the drug you
are giving, call the doctor or pharmacist.
5. Check expiration dates, and return out dated
drugs to the pharmacy.
6.Prepare drugs in a quiet , well-lit area where
you will not be distracted.
7.Ask another nurse or a pharmacist to
double check your dosage calculations.
8.Don’t give drugs another nurse has
prepared.
9.The nurse should have verified the dosage
before giving the drug-and she should to
followed a basic administration rule, “If you
don’t know a drug and it’s dosage, don’t
give it until you find out (Martha, 1995)
10.Don’t try to interpret illegible handwriting
even in ask the physician.
11.Identify the patient by his ID band- don’t
just ask his name or check his bed number.
12.Use appropriate documentation system
Documentation on the MAR (Medication
Administration record helped prevent
errors. That’s because the nurse have the
chance to check previous therapy, read any
notes that apply to a specific patient, and
see what occurred the last time the drug
was given.
13.Store preparations meant for external use
separately from other medications, and
make sure they are labeled for external use
only (Carr, 1996).
Errors in medication administration
often arise due to combination of
factors that are :
1. Poor communication between pharmacists and
nurses.
2. Lack of knowledge in drug administration.
3. Multiple interruptions the nurse have during preparing
medication.
4. Stress an fatigue.
5. Poor working conditions.
6. Carelessness from nurse.
Medication errors should not
happen. But they occur due to
the fact that every human
being is capable to doing
mistake here and those that
happen where you work- can
add to your knowledge and
skill.
yousef
Gender Of Respondents
29
28
27
26
25
24
Count
23
22
21
male
gender
f emale
Type of Error
30
20
Percent
10
0
w rong Name
w rong rout
w rong dose
type of error
all of the above
w rong Patient
MD .E and Incident Report
yes
No
Incident reported To Adminsration
50
40
30
Percent
20
Hospital type
govermental
10
non-govermental
yes
No
when the error Hapined an incident report was wretten to the hosp. admin
Educational levels and MD.E
30
20
10
Count
Medication Erro
yes
0
No
Practical nurse
educational level
Regesterd nurse
TYPE OF HOSP AND MD E
30
20
10
Count
Medication Errors ex
yes
No
0
govermental
Hospital type
non-govermental
Experience and MD.E
20
10
Count
Medication Errors ex
yes
0
No
1-5
Experience
6-10
11-15
+15
Complication Happened And Treated
yes
No