Medication Administration Safety in Anesthesia

The FDA (Food and Drug Administration) was established to regulate the safety and effectiveness of drugs in the United States.

This amendment expanded the FDA's power to regulate drugs, requiring manufacturers to prove both the safety and effectiveness of new drugs before they can be marketed.

This act establishes regulations for dietary supplements, treating them more like food than drugs. While health claims are allowed, they must be 'qualified' and supported by scientific evidence.

These are therapeutic products derived from living organisms, used to treat diseases or conditions. They are regulated to ensure similar outcomes with no increased risks.

Clinicians have a responsibility to report any significant abnormalities, quality issues, or potential product defects to the FDA. This reporting helps to monitor drug safety and identify potential problems.

This term encompasses any product designed to treat illness or alter the body's structure or function. It could include drugs, devices, or supplements.

The USP (United States Pharmacopeia) is an official compendium that sets standards and establishes regulations for pharmaceuticals, supplements, and other health-related products.

A type of error that occurs before, during, or after a surgical procedure, involving the wrong medication, incorrect dosage, or improper administration.

The act of giving medication in a controlled setting, such as a hospital or operating room, often by a healthcare professional.

A set of rules and guidelines aimed at ensuring that medication administration is carried out in a safe and effective manner.

A method for reducing the chance of medication errors by identifying and preventing potential problems before they can happen.

A record of legal cases against healthcare providers, often including details about errors and their consequences.

Adverse drug events (ADEs) are preventable injuries that occur due to medication errors. They contribute significantly to healthcare costs.

Medication errors occur when a medication is given in the wrong dosage, to the wrong patient, or at the wrong time. They can have serious consequences.

Common medications that often lead to medication errors include opioids, sedatives, antibiotics, vasoactive medications, and muscle relaxants.

Risk factors for medication errors include the absence of or improper use of safety checks, poor implementation of prevention strategies, and long procedures.

Intravenous medication errors are common and can occur during various stages of the medication process, including preparing, administering, and monitoring.

Calculation errors, wrong concentrations, incorrect infusion rates, extra doses, missed doses, and syringe or ampule swaps contribute to medication errors.

Medication errors can be classified into various types, including calculation errors, repetition, omission, substitution, labeling errors, administering medications despite allergies, and failing to flush a line after drug administration.

A prospective, observational study evaluating drug dilution samples showed a significant deviation from target concentration, raising concerns about unnoticed medication errors.

The Closed Claim Example #1 highlights a case where the patient experienced a cardiac arrest during a cataract procedure due to medication administration errors.

The Closed Claim Example #2 involves a surgical fire during facial surgery, demonstrating the importance of appropriate anesthesia planning to prevent medication errors.

Strategies for preventing medication errors include barcode scanning, computerized read-back of medication names, standardized cart organization, and clear medication labeling.

Technology plays a vital role in medication error prevention. Smart infusion pumps, barcode assistance, controlled substance tracking software, and unique device connections contribute to safer medication administration.

Pharmacy plays a crucial role in medication error prevention by providing prefilled syringes, premixed solutions, avoiding multi-use vials, and acting as clinical consultants.

Recommendations for preventing medication errors include error detection mechanisms, medication reconciliation, standardization, technology utilization, pharmacy involvement, and minimizing distractions during care.