Medication error
- 1. MEDICATION ERROR PRESENTED BY GROUP # 3
- 2. Medication errors, broadly defined as any error in the prescribing, dispensing, or administration of a drug, irrespective of whether such errors lead to adverse consequences or not, are the single most preventable cause of patient Harm. DEFINIITON
- 3. Inaccurate recording and transcribing orders. Unclear or erroneous labeling of drugs Misidentification of client Incomplete delivery of drugs Verification errors Use of inadequate knowledge or inaccurate knowledge base. Time and performance pressure SOURCES OF MEDICATION ERROR
- 5. It is the failure to administer by nurse the physician's ordered dose. These errors includes patients intake of less than prescribed dose or discontinuing of drug before prescribed time and omitting dose prescribed as needed, when it is needed. The medication omission is not regarded as an error if patient refuse to take medication or if dose is not administered because of any recognized contraindications. 1. OMISSION ERROR
- 6. It is the giving of drug dose not authorized for a particular patient. It includes error as the administration of drug to a wrong patient, duplication of doses or intake of an unordered drug. A dose given outside a stated set of clinical parameter e.g. medication ordered to administer only if the patient blood pressure falls below a pre determined level. These errors may lead to unpredictable blood level of the drug in patient. 2. UNAUTHORIZED DRUG ERROR
- 7. 3. WRONG DOSE ERROR A wrong dose error is administration of wrong number of performed drug units e.g. two tablets instead of one or one tablet instead of two.
- 8. The giving of a drug by a route other than the prescribed one. For example, administration of drug through IM route instead of employing an IV or oral intake of transdermal patch. 4. WRONG ROUTE ERROR
- 9. It is the medication error in which a dose is given at a wrong site. For example, instilling of a drug into left ear instead of right. This error leads to no therapeutic response. 5. WRONG SITE ERROR
- 10. The administration of a drug at a rate not specified in patient's order. For example, the administration of a short term infusion when a bolus IV infusion was ordered. 6. WRONG RATE ERROR
- 11. Intake of drug in a different dosage form than that of the specified in physician order. For example, use of an ophthalmic ointment when the solution was ordered. 7. WRONG DOSAGE FORM ERROR
- 12. The wrong dose error is an administration of a dose of a drug greater or lesser than its scheduled medication time. This error also includes intake of a dose prescribed as needed, at a time other than when needed in prescription. A hospital sets a policy for maximum permissible deviation of an administration time. In most of the hospitals it is, ±1 hour. 8. WRONG TIME ERROR
- 13. The type of error is an incorrect preparation of a dose not complied with physician in instruction. For example, use of incorrect reconstitution volume, wrong dilution, not shaking a suspension, not keeping a light sensitive drug protected from a light etc. The use of a expired drug is included in this category. 9. WRONG PREPARATION OF A DOSE
- 15. Lack of knowledge of the prescribed drug, its recommended dose, and of the patient details contribute to prescribing errors. Illegible handwriting. Inaccurate medication history taking. Confusion with the drug name. Inappropriate use of decimal points. A zero should Always precede a decimal point (e.g. 0·1). Use of a trailing zero (e.g. 1·0). Use of abbreviations (e.g. AZT has led to confusion between zidovudine and azathioprine). Use of verbal orders. CONTRIBUTING FACTORS INCLUDE
- 16. STEPS TO BE TAKEN IN PREVENTING MEDICATION ERROR
- 17. Follow the rights of medication administration Right patient Right drug Right dose Right time Right route Right recording Right assessment Right education Right evaluation Right to refuse medication STEPS TO BE TAKEN IN PREVENTING MEDICATION ERROR
- 18. Double check all calculation, even simple calculation Do not allow any other activity to interrupt your administration of medication to a client. Routinely refer to drug interaction charts or drug reference source and commit common interactive drugs to memory. Do not use any unstandard abbreviation and symbols, question if any one use Read the leaflet of the drug carefully when giving new drug first time. Do not make assumptions of illegible orders. Do not accept incomplete orders and telephonic or verbal orders.