Medication Management & Safety PDF

Medication Management & Safety Learning Outcome 3.5 Work Health & Safety HSC-1123  2 Medication Errors: A medication error is any preventable event that may cause or lead to inappropriate medication use or patient harm....

Medication Management & Safety Learning Outcome 3.5 Work Health & Safety HSC-1123  2 Medication Errors: A medication error is any preventable event that may cause or lead to inappropriate medication use or patient harm. Types of Medication Errors: Prescribing errors 44,000 – 98,000 Preparation/Intervention errors deaths annually Administration errors due to medical errors Monitoring errors Education errors Product labeling, packaging, and nomenclature errors Dispensing errors Distribution errors Storage errors  3 Medication Errors in the Middle East: 1st: Prescribing (46%) 2nd: Interventions / Preparation (27%) 3rd: Administration (25%) 4th: Transcribing (2%)  4 Causes of Medical Errors: 1. Errors in Manufacturing the Drug 2. Incomplete patient information 3. Wrong choice of medications 4. Unavailable drug information 5. Miscommunication between health care providers or between healthcare provider and patients. 6. Lack of appropriate labeling of the drug 7. Environmental factors, such as lighting, heat, noise, and interruptions that can distract health professionals from their medical tasks.  5 NCC MERP Index for Categorizing Medication Errors : National Coordinating Council (NCC) Medical Error Reporting and Prevention (MERP)  6 NCC MERP Index for Categorizing Medication Errors : A: Circumstances exist for potential errors to occur B: An error occurred but DID NOT reach the patient C: Error reached the patient but DID NOT cause harm D: Patient monitoring required to determine lack of harm E: Error caused temporary harm and some intervention F: Temporary harm with initial or prolonged hospitalization G: Error resulted in permanent patient harm H: Error required intervention to sustain the patient’s life I: Error c nt ib t d t t ti nt’ d t  7 Medication Errors may result in: 1. Morbidity: the rate of DISEASE in a population. 2. Mortality: the rate of DEATH in a population. 3. Increases in monitoring and cost of care 4. Delays in discharge from hospital (leaving the hospital) 5. Side Effects: Unplanned symptoms or feelings you have when taking a medicine. Most side effects are not serious and go away on their own; others can be more bothering and even serious.  8 How to reduce or manage medication errors? 1. Forcing functions to independent double-check systems while entering patient information to the software programs during registration. 2. Prescription orders should include a brief notation of purpose (e.g. for cough). 3. Prescribers should include age, and when appropriate, weight of the patient on the prescription or medication order. 4. Prescribers should avoid use of abbreviations including those for drug names and Latin directions for use.  9 The 10 Rights (10 R’s) for Drug Administration: When a patient is given medicines, it is important to remember the TEN (10) Rights (also known as 10 R’s): Right patient Right drug Right dose Right route of administration Right dosing time Right documentation Right history and assessment. Right to refuse. Right drug-drug interaction and evaluation Right education and information  10 AT-RISK Patients: In normal patients, drugs usually produce their therapeutic effects after which they will be eliminated out of the body through certain elimination processes. However, a group of patients are considered to be AT-RISK patients when taking medicines due to their different responses: These category of patients include: 1. Geriatric patients 2. Pediatric patients 3. Pregnant women 4. Lactating women 5. Liver-diseased patients 6. Kidney-diseases patients Therefore, special attention should be given when these groups are taking medicines specially those with serious side effects.  11 Drug Interactions: There are FOUR (4) kinds of drug interactions. In these interactions, drug interact to cause adverse effects or no effects at all. 1. Drug-Drug Interaction: Happens when two or more medications interact and cause one medicine to not work as well or even make one medicine stronger than it should be. EXAMPLE: you should not take aspirin if you are taking a prescription blood thinner, such as Warfarin, unless your health care professional tells you to. Aspirin also thins the blood. 2. Drug-Disease Interaction: happens when a disease makes certain drugs potentially harmful. EXAMPLE: if you have high blood pressure or asthma, you could have an unwanted reaction if you take a nasal decongestant (like Otrivin). Nasal decongestants make the blood vessels smaller, which could cause your blood pressure to go up to unacceptable levels.  12 Drug Interactions (Cont’d…): There are FOUR (4) kinds of drug interactions. In these interactions, drug interact to cause adverse effects or no effects at all. 3. Drug-Food Interaction: Results from drugs reacting with foods or drinks. In some cases, food in the digestive track can affect how a drug is absorbed. Some medicines also may affect the way nutrients are absorbed or used in the body. EXAMPLE: It is possible that eating a diet rich in Vitamin K (such as different kinds of berries and kiwi) could reduce the effect of Warfarin on clotting factors. 4. Drug-Herb Interaction: Can happen when the medicine reacts with a herbal plant. EXAMPLE: Mixing herbs with some medicines may cause serious reactions. Cranberry when taken with the blood thinner Warfarin may lead to bleeding.  13 General Guidelines for Taking Medications: 1. Patient should follow doctor’s instructions. 2. Patient should take the medicines for the whole time they are prescribed, even if they feel better (especially antibiotics). 3. Patient should take only their own medicines. 4. Patient should know about medicines they are taking. 5. Patient should plan for medicines they need to take during the night. 6. Patient should organize their medicines at home. 7. Patient should keep medicines in a cool, dry place, away from bright light. 8. If there are children in the home, patient should remember to put medicines out of their sight and reach. 9. Patient should always keep medicines in their original containers. 10. Whenever learning and practicing skills that involve medication use, consider the potential hazards to the patient and what you can do to enhance patient safety.  Thank You 800 MyHCT (800 69428) www.hct.ac.ae