Unit 2: Pharmacology and the Nurse-Client Relationship

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Unit 2Pharmacology and the Nurse-Client
Relationship

• Chapter 9
• Medication Errors and Risk Reduction

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Medication Errors

• any preventable event that may cause or lead to
  inappropriate medication use or client harm while
  the medication is in the control of the
  healthcare professional, client, or consumer.
• Definition from the National Coordinating Council
  for Medication Error Reporting and Prevention
  (NCC MERP)

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Medication Errors

• Why are medication errors such a concern?
• What are key factors contributing to medication
  errors by the health care provider?
• What are key factors contributing to medication
  errors by the client?

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Common Medication Errors

• Identify examples of common medication errors in
  relation to
• Medication administration
• Lack of follow-up or clinical correlation
• Misinterpretation of orders
• Who are the collaborative partners in medication
  administration

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Categorizing Medication Errors

• NCC MERP
• Index for Categorizing Medication Errors
  Algorhythm (Figure 9.1, p. 91)
• Index for Categorizing Medication Errors (Figure
  9.2, p. 95)

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Nurse Practice Act and Standards of Care

• Explain the relationship of the Nurse Practice
  Act to medication error.
• Explain the relationship of standards of care to
  medication error.
• What is the rule of reasonable and prudent
  action?

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Impact of Medication Errors

• Most common cause of morbidity and preventable
  death within hospitals
• No acceptable level
• All errors should be investigated

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Reporting and Documenting Medication Errors

• Document according to agency policy.
• Report with an incident report.
• In relation to the associated legality, why is
  documentation of the error important?

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Reduction of Medication Errors-Assessment

• Assess
• Food or medication allergies
• Current health concerns
• Use of OTCs and herbal supplements
• Review
• Recent laboratory tests
• Recent physical assessment findings
• Identify
• Need for education about medication regimen

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Reduction of Medication Errors- Planning

• Use only approved abbreviations
• Question unclear orders
• Do not accept verbal orders
• Follow policies and procedures
• Ask for client participation

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Reduction of Medication Errors-Implementation

• Be aware of potential distractions
• Remove distractions if possible
• Focus on medication administration task
• Practice six rights

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Reduction of Medication Errors- Evaluation

• Assess client for expected outcomes
• Determine if any adverse effects have occurred
• How will you ensure that you pass medications
  safely?

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Client Education Associated with Medication
Administration

• Client education will decrease the number of
  medication errors.
• What needs to be provided to the client?
• What should the nurse teach the client?

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Agencies that Collect and Report on Medication
Errors

• FDAs MedWatch
• Institute of Safe Medication Practices (ISMP)
• MedMarx

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Reducing Medication Errors in Health Care
Facilities

• Methods
• Automated, computerized, locked cabinets for
  medication storage on client-care units
• Risk management departments
• Collaboration with nursing to modify policies and
  procedures