Nursing Chapter 09: Safety and Quality

Study Notes

Medication Administration Safety

The "six rights" of medication administration are critical for ensuring patient safety: right patient, right drug, right dose, right route, right time, and right documentation.
Additional rights have been established, including right assessment, right education, right evaluation, and right for patients to refuse treatment.
Determining the right patient requires at least two forms of identification as mandated by The Joint Commission (TJC).
The right drug must be verified. When using an electronic health record (EHR), scanning the patient's wristband brings up their drug profile, which must then be matched with the medication label to ensure accuracy.
Nurses are legally responsible for administering medications as ordered; incomplete orders must not be administered until verified.
The right dose must be confirmed as safe and as per the order, taking into account the patient's physical status and health conditions.
Timing of administration is governed by institutional policy, which allows for a range of acceptable times around the prescribed order.
The right route of administration is vital for effective drug absorption, defined by the healthcare provider to indicate how the medication enters the body.
Nurses should assess the safety of a drug based on pharmacodynamics and the patient's vital signs.
Current lab results, particularly renal and hepatic functions, are crucial in determining medication safety for the patient.
Documentation of medication administration must be immediate and accurate, including drug name, dose, route, time, date, and the nurse’s signature. Patient responses should also be documented.

Medication Errors and Safety Measures

A medication error is classified as a preventable event leading to inappropriate medication use or patient harm.
Organizations often have risk management teams that perform root cause analysis (RCA) to identify potential errors and implement corrective strategies.
A sentinel event refers to a patient death resulting from a medication error, highlighting the severity of such incidents.
The National Patient Safety Goals (NPSGs) focus on addressing healthcare safety issues and developing solutions.
The FDA requires black box warnings for drugs that may have serious side effects for some patients while effective for others.
Drug reconciliation is vital in ensuring safety; it involves maintaining an accurate list of all medications a patient is taking during transitions in care.
The Secure and Responsible Disposal Act promotes safe disposal methods for medications, supporting public health and safety initiatives.