Podcast
Questions and Answers
A state's nurse practice act is most likely to define which aspects of medication administration?
A state's nurse practice act is most likely to define which aspects of medication administration?
- Protocols for handling and disposing of hazardous medications.
- Specific dosage calculations that nurses must use.
- The scope of medication-related tasks that registered nurses can legally perform. (correct)
- Formularies of medications that are approved for use in hospitals.
Policy statements related to medication administration within a healthcare facility most commonly address what educational requirement?
Policy statements related to medication administration within a healthcare facility most commonly address what educational requirement?
- Specific competencies required for professionals authorized to administer medications. (correct)
- The number of continuing education hours on pharmacology required for all licensed staff.
- Certification requirements for advanced practice nurses prescribing medications.
- The process for pharmacists to educate nurses on new medications.
Which action is considered essential before a nurse administers medication, aligning with legal and ethical standards?
Which action is considered essential before a nurse administers medication, aligning with legal and ethical standards?
- Possessing a current license to practice and a signed medication order. (correct)
- Having a detailed understanding of all possible off-label uses of the medication.
- Confirming the patient's insurance coverage for the prescribed medication.
- Consulting with the charge nurse to validate the medication's appropriateness.
A medical order specifies a drug, dose, route, and frequency. What critical element must the nurse understand regarding this order?
A medical order specifies a drug, dose, route, and frequency. What critical element must the nurse understand regarding this order?
A patient's chart contains various sections. Which section would a nurse consult to review a patient's medication history and current prescriptions?
A patient's chart contains various sections. Which section would a nurse consult to review a patient's medication history and current prescriptions?
In electronic health records, documentation standards are implemented. What is a key consideration for healthcare facilities?
In electronic health records, documentation standards are implemented. What is a key consideration for healthcare facilities?
What is a key characteristic that differentiates the 'floor or ward stock system' from other medication dispensing systems?
What is a key characteristic that differentiates the 'floor or ward stock system' from other medication dispensing systems?
What is a primary advantage of using a unit-dose drug distribution system in healthcare settings?
What is a primary advantage of using a unit-dose drug distribution system in healthcare settings?
Which feature is the Computer-Controlled Dispensing System is most significant for preventing medication errors?
Which feature is the Computer-Controlled Dispensing System is most significant for preventing medication errors?
What is a standard protocol specific to Long-Term Care Unit-Dose System?
What is a standard protocol specific to Long-Term Care Unit-Dose System?
How do computer-controlled medication dispensing systems enhance patient safety?
How do computer-controlled medication dispensing systems enhance patient safety?
What is the major advantage of using bar code scanning devices in medication administration?
What is the major advantage of using bar code scanning devices in medication administration?
A nurse discovers a discrepancy while counting narcotics at shift change. What is the most appropriate initial action?
A nurse discovers a discrepancy while counting narcotics at shift change. What is the most appropriate initial action?
What is the primary environmental concern driving guidelines for the disposal of unused medications?
What is the primary environmental concern driving guidelines for the disposal of unused medications?
A physician orders immediate administration of intravenous antibiotics for a patient experiencing anaphylaxis. Which type of medication order is this?
A physician orders immediate administration of intravenous antibiotics for a patient experiencing anaphylaxis. Which type of medication order is this?
A doctor gives a verbal order for a routine medication. Aside from administering the treatment, what must a nurse immediately do next?
A doctor gives a verbal order for a routine medication. Aside from administering the treatment, what must a nurse immediately do next?
Which practice is most important for a nurse to implement freedom from accidental injury from medications?
Which practice is most important for a nurse to implement freedom from accidental injury from medications?
Which of the following is considered a 'high-alert' medication, requiring extra precautions during administration because of its potential for significant patient harm?
Which of the following is considered a 'high-alert' medication, requiring extra precautions during administration because of its potential for significant patient harm?
What strategy is most effective in reducing medication errors related to similar drug names?
What strategy is most effective in reducing medication errors related to similar drug names?
What is a nurse's responsibility regarding medication orders?
What is a nurse's responsibility regarding medication orders?
A nurse working on a busy unit is passing the medication room when another nurse approaches and hands the first nurse two syringes and three unit-dose tablets who states she needs to help another patient but that the medications in the first nurse's hands are for the patient in room 386. What does the nurse do next?
A nurse working on a busy unit is passing the medication room when another nurse approaches and hands the first nurse two syringes and three unit-dose tablets who states she needs to help another patient but that the medications in the first nurse's hands are for the patient in room 386. What does the nurse do next?
The nurse receives the following order: Tylenol #3 1 tablet as needed for incisional pain. This is an example of which kind of order?
The nurse receives the following order: Tylenol #3 1 tablet as needed for incisional pain. This is an example of which kind of order?
In medication administration, what does 'Right time' entail?
In medication administration, what does 'Right time' entail?
What considerations need to be made when administering accurate dosage of medication?
What considerations need to be made when administering accurate dosage of medication?
When identifying the 'Right patient' before medication administration, what action will best improve medication safety?
When identifying the 'Right patient' before medication administration, what action will best improve medication safety?
What is the most important component for Right documentation of a medication after it is administered?
What is the most important component for Right documentation of a medication after it is administered?
What are some major aspects of providing medication discharge teaching?
What are some major aspects of providing medication discharge teaching?
When performing medication reconciliation, comparing the patient's current medication orders to the medications the patient is actually taking should be done at these times:
When performing medication reconciliation, comparing the patient's current medication orders to the medications the patient is actually taking should be done at these times:
When working with children and providing medication/treatment, what is a helpful action?
When working with children and providing medication/treatment, what is a helpful action?
After a medication error occurs, what steps should be taken to facilitate the prevention of future errors?
After a medication error occurs, what steps should be taken to facilitate the prevention of future errors?
What is a major component of implementing disposal of unused medicines?
What is a major component of implementing disposal of unused medicines?
A medication reconciliation involves five steps, one of the steps includes determining if there are any discrepancies between the lists. What is the next action the nurse should take?
A medication reconciliation involves five steps, one of the steps includes determining if there are any discrepancies between the lists. What is the next action the nurse should take?
To aid in prevention, how could nurses follow specific methods of aid?
To aid in prevention, how could nurses follow specific methods of aid?
Which of the following is considered a dispensing error?
Which of the following is considered a dispensing error?
A nurse is preparing to administer a medication and notes that the medication label has both the generic and brand names listed. Why is it essential for the nurse to be aware of both names?
A nurse is preparing to administer a medication and notes that the medication label has both the generic and brand names listed. Why is it essential for the nurse to be aware of both names?
A nurse is preparing to administer medication in a long-term care facility where residents are not required to wear identification bands. What is the most appropriate method to ensure the 'Right patient'?
A nurse is preparing to administer medication in a long-term care facility where residents are not required to wear identification bands. What is the most appropriate method to ensure the 'Right patient'?
In a healthcare facility transitioning to electronic medication administration records (eMAR), which strategy would be the MOST effective in minimizing potential transcription errors during medication order entry?
In a healthcare facility transitioning to electronic medication administration records (eMAR), which strategy would be the MOST effective in minimizing potential transcription errors during medication order entry?
Following a reported medication error involving an opioid analgesic, what is the MOST effective strategy a healthcare facility can implement system-wide to prevent similar occurrences in the future?
Following a reported medication error involving an opioid analgesic, what is the MOST effective strategy a healthcare facility can implement system-wide to prevent similar occurrences in the future?
A nurse is preparing to administer intravenous medication using a smart pump. What strategy demonstrates the MOST effective use of this technology to prevent medication errors?
A nurse is preparing to administer intravenous medication using a smart pump. What strategy demonstrates the MOST effective use of this technology to prevent medication errors?
Flashcards
Nurse Practice Act
Nurse Practice Act
Understanding of nurse practice act and rules/regulations is necessary for medication administration.
Standards of Care
Standards of Care
Standards developed by each state's nurse practice act, state and federal law, The Joint Commission, professional organizations.
Policy Statements
Policy Statements
Educational requirements, approved IV lists, restricted medication lists, abbreviation restrictions.
Nurse's Requirements
Nurse's Requirements
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Patient Chart
Patient Chart
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Patient Chart Sections
Patient Chart Sections
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Kardex
Kardex
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Charting Standards
Charting Standards
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Team Approach
Team Approach
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Drug Distribution
Drug Distribution
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Floor/Ward Stock
Floor/Ward Stock
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Unit-Dose System
Unit-Dose System
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Computer Dispensing
Computer Dispensing
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Long-Term Unit-Dose
Long-Term Unit-Dose
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Narcotics Control
Narcotics Control
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Unused Meds Disposal
Unused Meds Disposal
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Medication order types
Medication order types
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Medication Safety
Medication Safety
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Medication errors
Medication errors
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High Alert Medications
High Alert Medications
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Error Prevention
Error Prevention
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Medication reconciliation
Medication reconciliation
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Five-Step Process
Five-Step Process
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Sound-Alike Medications
Sound-Alike Medications
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Nurse Verification
Nurse Verification
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Seven Rights
Seven Rights
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Right Drug Verification
Right Drug Verification
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Right Indication
Right Indication
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Confirm Drug Test parameters
Confirm Drug Test parameters
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Right Dose
Right Dose
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Right Patient
Right Patient
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Right Route
Right Route
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Right Documentation
Right Documentation
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Study Notes
Principles of Medication Administration and Medication Safety
- Legal and ethical factors, dispensing systems, narcotic control, and common medication errors are all key aspects
- Identifying precautions for medication preparation and administration, plus proper documentation, is crucial
Legal and Ethical Considerations
- Understanding state nurse practice acts and board regulations are important
- Standards of care are set by state nurse practice acts, laws, and organizations like The Joint Commission
- Policy statements cover professional education, approved IV solutions, restricted meds, and prohibited abbreviations
- Nurses require a current license, policy authorization, signed order, rationale, and drug knowledge before administering medication
Contents of Patient Charts
- Charts contain summary, consent, and order sections, along with history, physical exam, progress, and nurses' notes
- Charts include lab test records and graphic records, plus flow sheets, consultation reports, and diagnostic reports
- Charts document medication administration, PRN medications, patient education, additional records, and nursing care plans
Drug Distribution Systems
- Floor/ward stock, individual prescription order, unit-dose, computer-controlled, and long-term care unit-dose systems exist
- Computer-controlled dispensing is a safer way to dispense controlled medications
Unit-Dose Distribution System
- In this system single-unit drug packages go into labeled drawers assigned to patients
- This results in less prep time for the nurses and less wastage
- The pharmacy, not a nurse, is responsible for preparing some medications in this system
Computer-Controlled Dispensing System
- The pharmacy stocks this system with single-unit medication packages
- Nurses use security credentials to access a patient's profile and select drugs for administration
- This system has automatic documentation and is economical
Long-Term Care Unit-Dose System
- In this system each resident's medications are prepared for a week in individual containers
- Medication aides/nurses administer the medications, after checking the medication order
- Residents may not wear an ID band, but their picture is used
Narcotic Control Systems
- Controlled substances must be locked
- Records document medication dispensing
- Discarded narcotics must be accounted for by two nurses
- Pharmacy and nursing services are alerted if there are any discrepancies with the patient's chart
Medication Orders
- Stat orders are used for emergency situations
- Single orders are for one-time use
- Standing orders are given for a specific number of doses
- PRN orders are administered as needed - always consider allergies
- Verbal orders should be avoided if possible, but must be signed and dated by the physician within 24 hours
- Also consider an Electronic transmission for patient orders
Types of Medication Safety
- Medication safety is promoting freedom from accidental injury from medications
- A nurse should know how to handle certain medications
- The nurse needs to understand how to correctly prepare and administer them to avoid injury
Medication Errors
- Common medication errors include: prescribing, transcription, dispensing, administration, monitoring, as well as adverse drug events (ADEs)
- Costly errors can be prevented through the use of CPOE, bar coding, smart pumps, and other technologies
- A five-step process is used during medication reconciliation
High-Alert Medications
- Examples of high-alert medications: insulin, heparin, opiods, potassium injectable, neuromuscular blocking agents & Chemotherapeutic agents
Practices to Aid in Prevention
- There are several: Standardizing practices, developing processes to stand out errors, methods to minimize errors, use of tech, restricting certain meds, Using checklists with high-alert drugs
- Continue by: Using both generic and brand names, avoiding orders of high-alert drugs, standardizing drug concentrations & Performing double-checks
Medication Reconciliation
- Compare current orders to medications a patient is actually taking during patient transfers or changes in practitioner
- A list of current medications is developed and compared with a list of prescribed medications
- Make clinical decisions based on the comparisons, and communicate the new list to caregivers
Sound-Alike Medications
- Most products with sound-alike names are used for different purposes
- Knowing the diagnosis of the patients is imporant
- Manufacturers should avoid using brand names similar to other medications to avoid errors
Nurse Responsibilities
- Nurses make professional judgement regarding medication orders; this includes drug type, usual dose, therapeutic intent, and potential allergic reactions
- Nurse must verify orders transcribed by other
- Report variance to maintain safe medication practice and provide information to improve the system and prevent future occurrences
- Also consider transcription
The Seven Rights
- Rights include: right drug, right dose, right time, right route, right patient, right documentation & Right indication
- Review exact spelling and concentration of drug with medication card and drug container
- Verify for patient condition, liver, kidney function, nausea or vontimiting
- Children should never be asked their name as a means of positive ID
- Dosages are double checked
Clinical Goldmines (Checks)
- When checking the medication, review the label of container for drug name, concentration, and appropriate administration route Patient’s chart, Kardex, medication profile, and identification bracelet for allergies and rotation schedules Medications that can be mixed in one syringe with an approved list, Patient's identity using two identifiers
Clinical Goldmines (Do's)
- Approach the patient in firm, but kind, manner
- Adjust the patient to the most appropriate position and continue with medication regiment
- Remain with child to be certain that all medications have been swallowed, Give simple and honest answersexplanations
- Use a plastic container, a medicine cup, a medicine dropper, an oral syringe, or a nipple to administer oral medications to an infant or small child
- Reward the child who has been cooperative by giving praise; and comfort and hold the uncooperative child after medication
Discharge Medication Teaching
- Explain the method of taking prescribed medications. Stress the need for punctuality & show the correct methods for medicine taking
- Teach the patient to store medications separately
- Provide the patient with written instructions and identify the anticipated therapeutic response
- Family members should be instructed or others, on how to collect/record data and list a point-of-contact for reporting signs or symptoms
- Stress measures to minimize or prevent anticipated adverse effects of prescribed medications
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