Medication Administration in Healthcare Settings

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Questions and Answers

What is a primary concern when administering medications in a hospital environment?

Cost of medications

Availability of nursing staff

The time of administration may not be feasible (correct)

Patients being allergic to medications

What do most BCMA systems provide when medication administration times are outside defined parameters?

An automatic adjustment of the medication schedule

An alert to the patient

A warning to the user (correct)

Permission to skip the dose

How might healthcare institutions define the timing of medication administration?

Based solely on nurse discretion

By the time the pharmacy receives orders

Through patient feedback on timing

By internal guidelines on early or late dosing (correct)

What role does the pharmacy have in retiming medication administration?

The pharmacy might need to be notified of time changes Signup and view all the answers

What has enhanced chronic disease management and improved the quality of care?

Patient registries in electronic health records Signup and view all the answers

How do pharmacists contribute to preventing adverse drug events after hospital discharge?

Through patient counseling Signup and view all the answers

What should be considered when placing a bar code on medications for BCMA?

The packaging of the medication Signup and view all the answers

What impact has the current pharmacist shortage had on medication errors?

It has increased medication errors Signup and view all the answers

What is an essential analysis focus in the dispensing of medications?

Activities from procurement to patient administration Signup and view all the answers

What challenge do pharmacies face when implementing BCMA systems?

Achieving bar coding on all medications Signup and view all the answers

What role does informatics technology play in medication safety?

It supports the development of decision-making tools Signup and view all the answers

What can be included in the structured methodology for retiming medication orders?

Instructions for notifying the pharmacy of time changes Signup and view all the answers

What percentage of potentially harmful prescribing errors were intercepted by pediatric pharmacists using CPOE in one study?

78% Signup and view all the answers

How have clinical decision support systems impacted medication errors?

They have been developed to enhance medication safety Signup and view all the answers

Which of the following is an example of how pharmacists enhance patient care?

Identifying drug-related problems through medical record review Signup and view all the answers

What is one of the main functions of pharmacists with regards to healthcare informatics tools?

Designing tools with medication safety features Signup and view all the answers

What type of information is NOT typically included in a patient file?

Provider's NPI number Signup and view all the answers

What role does the insurance file play in a pharmacy information system?

Lists supported insurance companies Signup and view all the answers

What function does an automated dispensing equipment interface serve in a pharmacy?

Sending completed prescription data for filling Signup and view all the answers

What is the primary purpose of monitoring in the medication use process?

To assess the efficacy and safety of medications Signup and view all the answers

Which file contains demographic data about the prescriber?

Prescriber file Signup and view all the answers

Which of the following is NOT included in a drug file?

Patient demographics Signup and view all the answers

Which statement accurately describes the difference between hospital and outpatient prescription processing?

Prescriptions in outpatient settings may be faxed or called in. Signup and view all the answers

What is typically required from pharmacy staff once a prescription is received?

Transcribing the prescription into the system Signup and view all the answers

What is e-prescribing primarily designed to enhance?

Patient safety Signup and view all the answers

Which of the following is an example of forced documentation in a BCMA system?

Prompting nurses to check a patient's blood pressure before administration Signup and view all the answers

How does BCMA systems enhance documentation for nurses?

By translating recorded information into the electronic health record Signup and view all the answers

What role does a BCMA system play in managing a patient's pain medication?

It requires nurses to document pain scores before and after medication administration Signup and view all the answers

What are the benefits of computerized decision support tools embedded within CPOE?

They can effectively reduce both hospital-based and outpatient medication errors. Signup and view all the answers

What is a benefit of using BCMA and eMAR in pharmacokinetic monitoring?

They facilitate quick access to medication administration times in relation to serum drug concentrations Signup and view all the answers

In the context of BCMA systems, what does passive documentation entail?

Capturing data automatically without direct input from the nurse Signup and view all the answers

What issue arose with early CPOE systems?

They allowed for free text typing which caused spelling errors. Signup and view all the answers

In what situations do CPOE systems seem to be more effective?

Pediatric or neonatal critical care. Signup and view all the answers

How can BCMA systems support nurses in providing patient education?

By serving as the primary source of information for patients about their medications Signup and view all the answers

What was the impact on medication error rates after the implementation of CPOE in one hospital?

The medication error rate fell by 81% and serious medication errors fell by 86%. Signup and view all the answers

Which of the following is NOT a function of the monitoring components in a BCMA system?

Automatically dispensing medications to patients Signup and view all the answers

What can contribute to 'alert fatigue' in physicians and pharmacists?

Alerts triggered at excessively low thresholds. Signup and view all the answers

What is a potential consequence of alert fatigue?

Missed important alerts. Signup and view all the answers

What element is essential for improving medication safety in CPOE systems?

Standardized alerts and electronic prescribing standards. Signup and view all the answers

What impact did computerized signals related to medication safety have in a multispecialty group practice?

They identified 53% of potential incidents. Signup and view all the answers

What are nonpreventable adverse drug events (ADEs) also known as?

Adverse drug reactions (ADRs) Signup and view all the answers

Which scenario best describes a preventable ADE?

A patient known to be allergic to a medication receives it and suffers a reaction. Signup and view all the answers

What characterizes a potential ADE?

An ADE that could have occurred but did not. Signup and view all the answers

What percentage of adverse drug events are caused by medication errors?

28% Signup and view all the answers

Where do more than half of medication errors typically occur?

Drug ordering stage Signup and view all the answers

Which statement is true about medication errors?

Medication errors can occur without causing any injuries. Signup and view all the answers

What role do pharmacists have in relation to clinical decision support systems?

Pharmacists have a crucial role in designing and maintaining these systems. Signup and view all the answers

Which of the following best defines medication errors?

Mistakes in ordering, transcribing, dispensing, administering, or monitoring medication. Signup and view all the answers

Study Notes

Overview of Information

The provided images are single digits (1,2,3,4,5)

Page 78

State-of-the-art healthcare functionality is becoming more commercially available as products
The computer is now seen as a tool equivalent to a stethoscope, enabling providers' diagnostic and therapeutic processes.
Electronic Health Records (EHRs) are still adjusting to best practices and implementations.
The record now has a focus on communication between healthcare providers.
Patient-provider communications are increasingly important, facilitated by secure web-based portals for messaging.
This allows for secure messaging, symptom evaluation, medication queries, and result review.
EHRs are improving the efficiency of healthcare maintenance by allowing for personalized immunization schedules and age-appropriate screenings.

Page 97

Outpatient pharmacies are increasingly integrating into hospital information systems.
Prescriptions can be transmitted directly to the pharmacy from the prescriber in outpatient settings.
Most community pharmacies are stand-alone systems.
The selection of the best system for the pharmacy depends on the type of pharmacy (chain or independent)
Over 50% of chains in US use their own or third party software
Independent pharmacies often use stand alone systems
Key components of outpatient pharmacy systems are patient files, prescriber files, drug files, insurance information files, billing interfaces, e-prescribing interfaces, and dispensing automation interfaces

Page 98

Patient files include details like name, date of birth, sex, address, insurance information, medication allergies & conditions.
Prescriber files include provider's name, contact information, DEA/NPI.
Drug files list all the drugs dispensed by the pharmacy, details including product name, dosage, route of administration, etc.
Insurance files have all the insurance details and billing interface.

Page 100

Technologies automate many parts of the medication process. Examples of automation tools include automated dispensing systems
Automated Dispensing Cabinets(ADCs) store unit-dose medications in locked cabinets.
Smart pumps for intravenous medication are now also computerized.

Page 112

BCMA (Bar Code Medication Administration) systems rely on how an order was input into the system.
The system anticipates the type of data linked to the bar code, such as NDC or a custom drug code for compounded medications.
A forced entry can occur if the bar code data can't be recognized by the system.
Patient specific barcodes are also used as a source of data for BCMA systems.
Medication orders can cause unintended entries in the electronic medication administration record(eMAR)
Errors in order entry can lead to errors in dispensing, and these errors can cause disruption or necessitate additional manual intervention.

Page 116

Nurses often act as the last line of defense against medication errors, however, many errors still occur during the administration phase
Medication errors can significantly impact patient safety.
BCMA Implementation has demonstrated success in reducing medication errors.
Many nursing procedures need to be reviewed and adjusted due to the implementation of BCMA systems.
Time and motion studies indicate that implementing BCMA has not necessarily increased the time spent on medication administration tasks for nurses.

Page 117

Monitoring medication effects is crucial in medication use processes.
BCMA systems frequently integrate passive and active documentation features.
Examples of monitoring components include blood sugar checks before insulin administration or blood pressure checks prior to administering anti-hypertensives.

Page 138

Medication errors occur frequently in home healthcare, particularly with the use of medication lists in home health care.
Patients and families not adhering to their medication regimen also lead to errors in medication practices.
Use of technology to improve communication between healthcare professionals and patients can greatly improve medication administration in home care.

Page 139

Three technologies, CPOE, bar coding, and ePrescribing, are being researched to reduce medication risks.
Technology has the potential to significantly decrease the rate of medication errors.

Page 218

A medication error is any mistake in ordering, transcribing, dispensing, administering, or monitoring of a medication.
Medication errors and adverse drug events (ADEs) are very common and costly.
Potential and Preventable ADEs are types of medication errors.

Page 219

Use of Decision Support Systems can assist healthcare providers and decrease potential medication errors.
Patient records can have pre-existing conditions or drug allergies.
The use of technology is important for appropriate drug selection

Page 220

Data and Knowledge are essential terms in pharmacy informatics.
Data is a single observation and describes the relationship between factors.
Knowledge is the result of analyses of data.
Databases store individual observations
Systems with knowledge bases can help solve problems by linking patient information to rules and algorithms

Page 221

The Institute of Medicine report "Crossing the Quality Chasm" highlights inconsistencies between what medical professionals know and their everyday practice.
Misuse of medications (errors in administration) is the most frequently studied form of medication discrepancies.
Increased use of readily available research has led to a greater need for efficient systems & protocols that incorporate patient-specific information.

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Description

This quiz addresses key concerns and practices surrounding medication administration in hospital environments. It covers topics like barcode medication administration (BCMA) systems, the role of pharmacists, and methods to enhance medication safety. Test your knowledge on how informatics and pharmacy practices contribute to patient care.