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PHM 102-Chapter 14
Study guide
Question | Answer |
---|---|
What are the 5 rights? | The right patient, The right medication, The right dose, The right route, The right time |
What are examples of high-alert medications according to ISMP? | Epinephrine, Insulin, Warfarin, Opium tincture, Methotrexate, Metformin, Heparin, Potassium chloride, Promethazine |
What is an error? | Any type of preventable event |
What is a Monitoring Error? | Failure to review prescribed medications for proper regimen |
What is Wrong Drug Preparation Error? | Drug is incorrectly formulated or manipulated |
What is a Prescribing Error? | Prescriber orders wrong medication, or incorrectly selects medications when ordering |
According to MERP, what is a Category A error? | Circumstances that have the potential to cause errors |
What is a Category B error? | Error occurred before reaching the patient |
What is a Category I error? | Error occurred that may have contributed to or resulted in patient death |
What is an Administrative Error? | Failure to document medication administration records accurately, or application of the wrong method or technique when administering medication |
What are some common causes of errors according to ASHP? | illegible handwriting, improper transcription, labeling errors, inappropriate abbreviations, inadequately trained personnel |
What does ASHP stand for? | American Society of Health-system Pharmacists |
What does REMS stand for? | Risk Evaluation & Mitigation Strategies |
What is REMS used for? | Used to look at the pros and cons of a drug & managing the benefits that far outweigh the risks that are continually evaluated |
What does ADR mean? | Adverse Drug Reaction |
What is provided to patient's that take medications on the REMS list that can be found on the FDA website? | Package insert; Medguide |
What can a pharmacy technician look for on a stock bottle that shows medications must be accompanied with a Medguide when dispensed? | Red or Yellow symbol |
What are some changes manufacturing companies made to labels to help reduce errors? | Bold lettering, Tall man lettering, color coding |
Why are changes to labels (made by manufacturing companies) important? | Reduces errors & confusing look-alike/sound-alike medications |
Coumadin(Warfarin) can interact with which drugs? | Aspirin & NSAIDS |
Drug errors can be reported to the FDA through where? | Medwatch, TJC, ISMP, & MERP |
What do most Health care-associated infections (HAIS) involve? | Pneumonia, Urinary Tract Infections, Blood Stream Infections |
What is polypharmacy? | Multiple Medications |
What is a pictograph? | Standardized graphics that represent how/when to take & store medications |
Why are IV Heparin errors extremely dangerous? | Take effect quickly, cannot be easily reversed, IV lines flushed with Heparin-lock solutions can be confused with more concentrated Heparin solutions |
What is an Extended-Release (E-R) medication? | Designed to deliver dose over a longer period of time versus Immediate-Release |
What are the benefits of Extended Release (E-R) medication? | Can improve patient compliance & result in better health (If crushed or administered as Immediate-Release dose, can cause medication errors) |
What medication information is contained in a bar code? | NDC (National Drug Code), Lot Number, Expiration Date |
What is the most important aspect of dealing with errors? | The reporting process |
What are some examples of organizations that track records? | ISMP, FDA Medwatch, TJC, CDC |
What is the primary purpose of ISMP VERP? | Capture unique causes & consequences of vaccine-related errors (only for vaccines) |
What are 5 safety standards outlined by the TJC | Leadership Process & Accountability, Safe Environment for Staff & Patients, Improving Quality & Safety, Competent & Capable Workforce, Clinical Care of Patient |
What are some examples of Automated Dispensing Machines? | Baker Cell System, SP (ScriptPro), Kirby Lester |
Why does TJC require hospitals and institutions to prepack all liquid doses in oral syringes or containers? | Opening bulk containers led to increased risk of contamination, Not Patient-Specific(inappropriate dose increases), Pharmacy must ensure accuracy of each dose |
What does CSP stand for? | Compounded Sterile Preparation |
What USP Chapter covers Sterile Compounding? | USP 797 |
How many times is it recommended for technicians to check a medication during the filling process? | No less than 3 |
What strategies can be implemented by a pharmacy to reduce errors? | Use automated filling systems, scan original prescription, use electronic prescribing, keep high alert medications in a separate location of the pharmacy, maintain up-to-date patient profiles (include OTC & Herbs), Designate medication safety leader |
What is medication reconciliation? | Identifying the most up-to-date list of medications the patient is currently taking. -Verification -Clarification -Reconciliation |
Which one of the reasons below is not related to errors? A. Look-alike, sound-alike drugs B. Stress and noise levels C. Orders arriving from different sources D. Multitasking | Orders arriving from different sources |
All of the following are common causes of medication errors according to the ASHP except: A. drug product nomenclature B. improper transcription C. inappropriate abbreviations D. use of bar codes | Use of bar codes |
Warfarin (Coumadin) administered to prevent blood clotting can interact with which medication? | Aspirin & NSAIDs |
Drug errors can be reported to the U.S. Food and Drug Administration (FDA) through | MedWatch |
Medication errors frequently involve which of the following? A. Allergies B. Multiple medications C. OTC medications D. All options are correct | Allergies, Multiple medications, & OTC medications |
Which one of the following is not a high-alert IV medication according to the Institute for Safe Medication Practices? A. Insulin B. Heparin C. Potassium chloride (KCl) D. Penicillin | Penicillin |
How often is it recommended for a technician to check a medication during the filling process? | Three times |
What is an ADR? | Adverse Drug Reaction |
A physician ordering an IV to run at 100 mL/hr instead of 125 mL/hr is an example of what type of error? | Prescribing error |
What type of error occurs when an IV medication, reconstituted with the incorrect diluent, is given to a patient? | Wrong drug preparation |
What type of error occurs when a pharmacist fails to adjust the amount of KCl to be added to a TPN mixture? | Omission error |
Which one of the following distractions cannot be avoided in the workplace? A. Excessive talking and laughing B. Text messaging C. Telephones ringing D. Loud music | Telephones ringing |
Changes in labeling that drug companies are incorporating to reduce errors include: | Tall-man lettering, color coding, & boldface lettering |
The majority of health care–associated infections (HAIs) are; | Urinary tract infections (UTIs), bloodstream and surgical site infections, & pneumonia |
The most important aspect of dealing with errors is: | Reporting process |
What drug identification information is contained on a bar code? | National Drug Code (NDC) number, Lot number, & Expiration date |
The ISMP focuses on all of the following except: A. type of error B. how the error occurred C. recommendations on preventing a similar error D. placing blame on the appropriate individual | Placing blame on the appropriate individual |
In 2012, the ISMP launched the National Vaccine Error Reporting Program (ISMP VERP) to: | Collect information on vaccine errors |
Which of the following is not one of the five safety standards outlined by TJC? A. Leadership Process and Accountability B. Competent and Capable Workforce C. Safe Environment for Staff and Patients D. Clinical Care of Staff | Clinical Care of Staff |
What strategies may be implemented by a pharmacy to reduce medication errors? | Use an automatic dispensing system (ADS), Keep high-alert medications in a separate location in the pharmacy, & Designate a medication safety leader |
Which organization tracks medication errors? | Institute of Medicine (IOM), Centers for Disease Control and Prevention ((CDC), & National Coordinating Council for Medication Error Reporting and Prevention |
Which one of the MERP error categories includes errors that contribute to the death of a patient? | I error |
Which of the following systems contribute to decreased errors? | Computerized physician order entry (CPOE), ADS machines, coupled with bar coding, & Medication error-reporting programs |
A medication error occurred but did not reach patient is classified as a which Category error? | Category B error |
What process identifies the most up-to-date list of all of the medications a patient is currently taking? | Medication reconciliation |
Which USP Chapter addresses the problem of contamination of any type of sterile product? | USP < 797> |
All of the following are examples of automated dispensing systems used in community pharmacy except: A. Baker cell systems B. Kirby Lester KL20 C. Med Carousel D. ScriptPro SP 200 | Med Carousel |
Medications requiring a medication guide to be provided to the patient can be identified by: | Red or yellow symbol found on the manufacturer’s container |