medication administration & preventing errors · principles of medication administration talk...

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MEAGAN RAY, RN AMG SPECIALTY HOSPITAL Medication Administration & Preventing Errors

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Page 1: Medication Administration & Preventing Errors · Principles of Medication Administration Talk with the patient and explain what you are doing before giving medications (answer questions)

M E A G A N R A Y R N

A M G S P E C I A L T Y H O S P I T A L

Medication Administration amp Preventing Errors

Principles of Medication Administration

Talk with the patient and explain what you are doing before giving medications (answer questions)

Help the patient to be as involved as possible in the process Provide patient privacy Give medication administration your

complete attention - give medications in a quiet area free of distractions - never leave medications unattended Wash your hands before and after giving medications Read the medication label at least 3 times (when picking up the medication

just prior to administering the medication amp just after administering the medication)

Medications must be administered by the individual who prepared the dose except for unit doses or sterile preparations from the pharmacy

Medication Reconciliation amp Administration

When ordering or administering drugs and biologicals health care providers must includereview the following

information Name of the patient Allergy information Age weight or other dose calculation requirements Date and time of the order Dose frequency and route Exact strength andor concentration Quantity andor duration Specific instructions for use if applicable Name of the prescriber

Six Rights of Medication Administration

Prior to administering medications nurses must utilize the 6 Rights of Medication Administration

Right Patient

Right Medication

Right Dose

Right Time

Right Route

Right Documentation

Right Patient

Employees must compare the patientrsquos name on the prescription label the medication order and medication administration

record (MAR) Acceptable patient identifiers include - patients full name - identification number assigned by the hospital - date of birth Identifiers must be confirmed by patient wrist band patient

identification card patient statement (when possible) or other means outlined without the hospitalrsquos policy

Prepare medications for one patient at a time Give the medication as soon as you prepare it Avoid distractions

Right Medication

In order to be sure that you are giving the right medication you must

Read the medication label carefully (brand namegeneric look alikesound alike)

Ensure that the medication name on the label order and MAR match before giving the medication

Label medicines that are not labeled (syringes cups and basins)

Right Dose

The right dose is how much of the medication is to be administered to

the patient To determine the dose you must first know the strength of each

medication - In the case of liquid medications you need to know the strength

of medication in liquid measure The dose equals the strength of the medication multiplied by the

amount Compare the dose on the prescription label medication order and

medication log

Right Time

Some medications must be administered only at very specific times of the day

- Before meals

- One hour after meals

- Bedtime

Compare the time on the prescription label medication order and the medication log

Medications must be given within a frac12 hour of time that is listed on the medication log (does not apply to PRN medications)

Right Route

The route means how and where the medication gets into the body

Most medication is taken into the mouth and swallowed but others enter the body through the skin rectum vagina eyes ears nose and lungs through a g-tube or by injectioninfusion

Compare the route on the prescription label medication order and the medication log

Right Documentation

Each time a medication is administered it must be documented

Documentation must be done in black ink

No pencil or white out may be used

Never cross out or write over documentation

If you make a mistake when you are documenting on the medication log circle your mistake and write a note explaining what happened

Medication Errors

Medication errors are among the most common health threatening mistakes that affect patient care (increased mortality rate length of hospital stay increased

medical expenses etc)

According to the Institute of Medicine of the National Academies medication errors are among the most common medical errors harming at least 15 million people each year

Studies indicate that 400000 preventable drug-related injuries take place in hospitals each year as a result of errors that occur at various points in the medication administration process

Types of Medication Errors

Medication errors include prescribing errors dispensing errors medication administration errors and patient compliance

errors Drug product nomenclature (look-alike or sound-alike) Illegible handwriting Improper transcription Inaccurate dosage calculation Inadequately trained personnel Inappropriate abbreviations used in prescribing Labeling errors Excessive workload Lapses in individual performance Medication unavailable

Under Staffing

Fatigued Nurses

Medication Errors

Vague Communications

Common Causes of Medication Errors During Medication Administration

Medication Administration

Process

Medication is Prescribed

Medication Order is

Transcribed amp Verified

Medication is Dispensed

Medication is Administered

Opportunities to Prevent Medication Errors

The Nursesrsquo Role in Preventing amp Reporting Medication Errors

Reporting medication errors is an ethical duty to maximize the benefits of patient care thereby promoting patient safety and

health

Report medication errors to the patientrsquos physician and your nursing supervisor immediately or when the error is first identified (monitor amp treat patient as needed)

The medication administered in error or omitted in error and the action taken must be properly recorded in the patients medical record

- the entry in the patients medical record need not indicate that an error occurred

Complete the event reporting process (ActionCue)

If a medication error causes an adverse drug reaction a medication error report and an adverse drug reaction report must be completed

References

ASHP Guidelines of Preventing Medication Errors in Hospitals

Iranian Journal of Nursing and Midwifery Research Types and Causes of Medication Errors from the Nurses Viewpoint

Hospital National Patient Safety Goals 2014

Centers for Medicaid and Medicare Services Medication Administration httpwwwcmsgov

Page 2: Medication Administration & Preventing Errors · Principles of Medication Administration Talk with the patient and explain what you are doing before giving medications (answer questions)

Principles of Medication Administration

Talk with the patient and explain what you are doing before giving medications (answer questions)

Help the patient to be as involved as possible in the process Provide patient privacy Give medication administration your

complete attention - give medications in a quiet area free of distractions - never leave medications unattended Wash your hands before and after giving medications Read the medication label at least 3 times (when picking up the medication

just prior to administering the medication amp just after administering the medication)

Medications must be administered by the individual who prepared the dose except for unit doses or sterile preparations from the pharmacy

Medication Reconciliation amp Administration

When ordering or administering drugs and biologicals health care providers must includereview the following

information Name of the patient Allergy information Age weight or other dose calculation requirements Date and time of the order Dose frequency and route Exact strength andor concentration Quantity andor duration Specific instructions for use if applicable Name of the prescriber

Six Rights of Medication Administration

Prior to administering medications nurses must utilize the 6 Rights of Medication Administration

Right Patient

Right Medication

Right Dose

Right Time

Right Route

Right Documentation

Right Patient

Employees must compare the patientrsquos name on the prescription label the medication order and medication administration

record (MAR) Acceptable patient identifiers include - patients full name - identification number assigned by the hospital - date of birth Identifiers must be confirmed by patient wrist band patient

identification card patient statement (when possible) or other means outlined without the hospitalrsquos policy

Prepare medications for one patient at a time Give the medication as soon as you prepare it Avoid distractions

Right Medication

In order to be sure that you are giving the right medication you must

Read the medication label carefully (brand namegeneric look alikesound alike)

Ensure that the medication name on the label order and MAR match before giving the medication

Label medicines that are not labeled (syringes cups and basins)

Right Dose

The right dose is how much of the medication is to be administered to

the patient To determine the dose you must first know the strength of each

medication - In the case of liquid medications you need to know the strength

of medication in liquid measure The dose equals the strength of the medication multiplied by the

amount Compare the dose on the prescription label medication order and

medication log

Right Time

Some medications must be administered only at very specific times of the day

- Before meals

- One hour after meals

- Bedtime

Compare the time on the prescription label medication order and the medication log

Medications must be given within a frac12 hour of time that is listed on the medication log (does not apply to PRN medications)

Right Route

The route means how and where the medication gets into the body

Most medication is taken into the mouth and swallowed but others enter the body through the skin rectum vagina eyes ears nose and lungs through a g-tube or by injectioninfusion

Compare the route on the prescription label medication order and the medication log

Right Documentation

Each time a medication is administered it must be documented

Documentation must be done in black ink

No pencil or white out may be used

Never cross out or write over documentation

If you make a mistake when you are documenting on the medication log circle your mistake and write a note explaining what happened

Medication Errors

Medication errors are among the most common health threatening mistakes that affect patient care (increased mortality rate length of hospital stay increased

medical expenses etc)

According to the Institute of Medicine of the National Academies medication errors are among the most common medical errors harming at least 15 million people each year

Studies indicate that 400000 preventable drug-related injuries take place in hospitals each year as a result of errors that occur at various points in the medication administration process

Types of Medication Errors

Medication errors include prescribing errors dispensing errors medication administration errors and patient compliance

errors Drug product nomenclature (look-alike or sound-alike) Illegible handwriting Improper transcription Inaccurate dosage calculation Inadequately trained personnel Inappropriate abbreviations used in prescribing Labeling errors Excessive workload Lapses in individual performance Medication unavailable

Under Staffing

Fatigued Nurses

Medication Errors

Vague Communications

Common Causes of Medication Errors During Medication Administration

Medication Administration

Process

Medication is Prescribed

Medication Order is

Transcribed amp Verified

Medication is Dispensed

Medication is Administered

Opportunities to Prevent Medication Errors

The Nursesrsquo Role in Preventing amp Reporting Medication Errors

Reporting medication errors is an ethical duty to maximize the benefits of patient care thereby promoting patient safety and

health

Report medication errors to the patientrsquos physician and your nursing supervisor immediately or when the error is first identified (monitor amp treat patient as needed)

The medication administered in error or omitted in error and the action taken must be properly recorded in the patients medical record

- the entry in the patients medical record need not indicate that an error occurred

Complete the event reporting process (ActionCue)

If a medication error causes an adverse drug reaction a medication error report and an adverse drug reaction report must be completed

References

ASHP Guidelines of Preventing Medication Errors in Hospitals

Iranian Journal of Nursing and Midwifery Research Types and Causes of Medication Errors from the Nurses Viewpoint

Hospital National Patient Safety Goals 2014

Centers for Medicaid and Medicare Services Medication Administration httpwwwcmsgov

Page 3: Medication Administration & Preventing Errors · Principles of Medication Administration Talk with the patient and explain what you are doing before giving medications (answer questions)

Medication Reconciliation amp Administration

When ordering or administering drugs and biologicals health care providers must includereview the following

information Name of the patient Allergy information Age weight or other dose calculation requirements Date and time of the order Dose frequency and route Exact strength andor concentration Quantity andor duration Specific instructions for use if applicable Name of the prescriber

Six Rights of Medication Administration

Prior to administering medications nurses must utilize the 6 Rights of Medication Administration

Right Patient

Right Medication

Right Dose

Right Time

Right Route

Right Documentation

Right Patient

Employees must compare the patientrsquos name on the prescription label the medication order and medication administration

record (MAR) Acceptable patient identifiers include - patients full name - identification number assigned by the hospital - date of birth Identifiers must be confirmed by patient wrist band patient

identification card patient statement (when possible) or other means outlined without the hospitalrsquos policy

Prepare medications for one patient at a time Give the medication as soon as you prepare it Avoid distractions

Right Medication

In order to be sure that you are giving the right medication you must

Read the medication label carefully (brand namegeneric look alikesound alike)

Ensure that the medication name on the label order and MAR match before giving the medication

Label medicines that are not labeled (syringes cups and basins)

Right Dose

The right dose is how much of the medication is to be administered to

the patient To determine the dose you must first know the strength of each

medication - In the case of liquid medications you need to know the strength

of medication in liquid measure The dose equals the strength of the medication multiplied by the

amount Compare the dose on the prescription label medication order and

medication log

Right Time

Some medications must be administered only at very specific times of the day

- Before meals

- One hour after meals

- Bedtime

Compare the time on the prescription label medication order and the medication log

Medications must be given within a frac12 hour of time that is listed on the medication log (does not apply to PRN medications)

Right Route

The route means how and where the medication gets into the body

Most medication is taken into the mouth and swallowed but others enter the body through the skin rectum vagina eyes ears nose and lungs through a g-tube or by injectioninfusion

Compare the route on the prescription label medication order and the medication log

Right Documentation

Each time a medication is administered it must be documented

Documentation must be done in black ink

No pencil or white out may be used

Never cross out or write over documentation

If you make a mistake when you are documenting on the medication log circle your mistake and write a note explaining what happened

Medication Errors

Medication errors are among the most common health threatening mistakes that affect patient care (increased mortality rate length of hospital stay increased

medical expenses etc)

According to the Institute of Medicine of the National Academies medication errors are among the most common medical errors harming at least 15 million people each year

Studies indicate that 400000 preventable drug-related injuries take place in hospitals each year as a result of errors that occur at various points in the medication administration process

Types of Medication Errors

Medication errors include prescribing errors dispensing errors medication administration errors and patient compliance

errors Drug product nomenclature (look-alike or sound-alike) Illegible handwriting Improper transcription Inaccurate dosage calculation Inadequately trained personnel Inappropriate abbreviations used in prescribing Labeling errors Excessive workload Lapses in individual performance Medication unavailable

Under Staffing

Fatigued Nurses

Medication Errors

Vague Communications

Common Causes of Medication Errors During Medication Administration

Medication Administration

Process

Medication is Prescribed

Medication Order is

Transcribed amp Verified

Medication is Dispensed

Medication is Administered

Opportunities to Prevent Medication Errors

The Nursesrsquo Role in Preventing amp Reporting Medication Errors

Reporting medication errors is an ethical duty to maximize the benefits of patient care thereby promoting patient safety and

health

Report medication errors to the patientrsquos physician and your nursing supervisor immediately or when the error is first identified (monitor amp treat patient as needed)

The medication administered in error or omitted in error and the action taken must be properly recorded in the patients medical record

- the entry in the patients medical record need not indicate that an error occurred

Complete the event reporting process (ActionCue)

If a medication error causes an adverse drug reaction a medication error report and an adverse drug reaction report must be completed

References

ASHP Guidelines of Preventing Medication Errors in Hospitals

Iranian Journal of Nursing and Midwifery Research Types and Causes of Medication Errors from the Nurses Viewpoint

Hospital National Patient Safety Goals 2014

Centers for Medicaid and Medicare Services Medication Administration httpwwwcmsgov

Page 4: Medication Administration & Preventing Errors · Principles of Medication Administration Talk with the patient and explain what you are doing before giving medications (answer questions)

Six Rights of Medication Administration

Prior to administering medications nurses must utilize the 6 Rights of Medication Administration

Right Patient

Right Medication

Right Dose

Right Time

Right Route

Right Documentation

Right Patient

Employees must compare the patientrsquos name on the prescription label the medication order and medication administration

record (MAR) Acceptable patient identifiers include - patients full name - identification number assigned by the hospital - date of birth Identifiers must be confirmed by patient wrist band patient

identification card patient statement (when possible) or other means outlined without the hospitalrsquos policy

Prepare medications for one patient at a time Give the medication as soon as you prepare it Avoid distractions

Right Medication

In order to be sure that you are giving the right medication you must

Read the medication label carefully (brand namegeneric look alikesound alike)

Ensure that the medication name on the label order and MAR match before giving the medication

Label medicines that are not labeled (syringes cups and basins)

Right Dose

The right dose is how much of the medication is to be administered to

the patient To determine the dose you must first know the strength of each

medication - In the case of liquid medications you need to know the strength

of medication in liquid measure The dose equals the strength of the medication multiplied by the

amount Compare the dose on the prescription label medication order and

medication log

Right Time

Some medications must be administered only at very specific times of the day

- Before meals

- One hour after meals

- Bedtime

Compare the time on the prescription label medication order and the medication log

Medications must be given within a frac12 hour of time that is listed on the medication log (does not apply to PRN medications)

Right Route

The route means how and where the medication gets into the body

Most medication is taken into the mouth and swallowed but others enter the body through the skin rectum vagina eyes ears nose and lungs through a g-tube or by injectioninfusion

Compare the route on the prescription label medication order and the medication log

Right Documentation

Each time a medication is administered it must be documented

Documentation must be done in black ink

No pencil or white out may be used

Never cross out or write over documentation

If you make a mistake when you are documenting on the medication log circle your mistake and write a note explaining what happened

Medication Errors

Medication errors are among the most common health threatening mistakes that affect patient care (increased mortality rate length of hospital stay increased

medical expenses etc)

According to the Institute of Medicine of the National Academies medication errors are among the most common medical errors harming at least 15 million people each year

Studies indicate that 400000 preventable drug-related injuries take place in hospitals each year as a result of errors that occur at various points in the medication administration process

Types of Medication Errors

Medication errors include prescribing errors dispensing errors medication administration errors and patient compliance

errors Drug product nomenclature (look-alike or sound-alike) Illegible handwriting Improper transcription Inaccurate dosage calculation Inadequately trained personnel Inappropriate abbreviations used in prescribing Labeling errors Excessive workload Lapses in individual performance Medication unavailable

Under Staffing

Fatigued Nurses

Medication Errors

Vague Communications

Common Causes of Medication Errors During Medication Administration

Medication Administration

Process

Medication is Prescribed

Medication Order is

Transcribed amp Verified

Medication is Dispensed

Medication is Administered

Opportunities to Prevent Medication Errors

The Nursesrsquo Role in Preventing amp Reporting Medication Errors

Reporting medication errors is an ethical duty to maximize the benefits of patient care thereby promoting patient safety and

health

Report medication errors to the patientrsquos physician and your nursing supervisor immediately or when the error is first identified (monitor amp treat patient as needed)

The medication administered in error or omitted in error and the action taken must be properly recorded in the patients medical record

- the entry in the patients medical record need not indicate that an error occurred

Complete the event reporting process (ActionCue)

If a medication error causes an adverse drug reaction a medication error report and an adverse drug reaction report must be completed

References

ASHP Guidelines of Preventing Medication Errors in Hospitals

Iranian Journal of Nursing and Midwifery Research Types and Causes of Medication Errors from the Nurses Viewpoint

Hospital National Patient Safety Goals 2014

Centers for Medicaid and Medicare Services Medication Administration httpwwwcmsgov

Page 5: Medication Administration & Preventing Errors · Principles of Medication Administration Talk with the patient and explain what you are doing before giving medications (answer questions)

Right Patient

Employees must compare the patientrsquos name on the prescription label the medication order and medication administration

record (MAR) Acceptable patient identifiers include - patients full name - identification number assigned by the hospital - date of birth Identifiers must be confirmed by patient wrist band patient

identification card patient statement (when possible) or other means outlined without the hospitalrsquos policy

Prepare medications for one patient at a time Give the medication as soon as you prepare it Avoid distractions

Right Medication

In order to be sure that you are giving the right medication you must

Read the medication label carefully (brand namegeneric look alikesound alike)

Ensure that the medication name on the label order and MAR match before giving the medication

Label medicines that are not labeled (syringes cups and basins)

Right Dose

The right dose is how much of the medication is to be administered to

the patient To determine the dose you must first know the strength of each

medication - In the case of liquid medications you need to know the strength

of medication in liquid measure The dose equals the strength of the medication multiplied by the

amount Compare the dose on the prescription label medication order and

medication log

Right Time

Some medications must be administered only at very specific times of the day

- Before meals

- One hour after meals

- Bedtime

Compare the time on the prescription label medication order and the medication log

Medications must be given within a frac12 hour of time that is listed on the medication log (does not apply to PRN medications)

Right Route

The route means how and where the medication gets into the body

Most medication is taken into the mouth and swallowed but others enter the body through the skin rectum vagina eyes ears nose and lungs through a g-tube or by injectioninfusion

Compare the route on the prescription label medication order and the medication log

Right Documentation

Each time a medication is administered it must be documented

Documentation must be done in black ink

No pencil or white out may be used

Never cross out or write over documentation

If you make a mistake when you are documenting on the medication log circle your mistake and write a note explaining what happened

Medication Errors

Medication errors are among the most common health threatening mistakes that affect patient care (increased mortality rate length of hospital stay increased

medical expenses etc)

According to the Institute of Medicine of the National Academies medication errors are among the most common medical errors harming at least 15 million people each year

Studies indicate that 400000 preventable drug-related injuries take place in hospitals each year as a result of errors that occur at various points in the medication administration process

Types of Medication Errors

Medication errors include prescribing errors dispensing errors medication administration errors and patient compliance

errors Drug product nomenclature (look-alike or sound-alike) Illegible handwriting Improper transcription Inaccurate dosage calculation Inadequately trained personnel Inappropriate abbreviations used in prescribing Labeling errors Excessive workload Lapses in individual performance Medication unavailable

Under Staffing

Fatigued Nurses

Medication Errors

Vague Communications

Common Causes of Medication Errors During Medication Administration

Medication Administration

Process

Medication is Prescribed

Medication Order is

Transcribed amp Verified

Medication is Dispensed

Medication is Administered

Opportunities to Prevent Medication Errors

The Nursesrsquo Role in Preventing amp Reporting Medication Errors

Reporting medication errors is an ethical duty to maximize the benefits of patient care thereby promoting patient safety and

health

Report medication errors to the patientrsquos physician and your nursing supervisor immediately or when the error is first identified (monitor amp treat patient as needed)

The medication administered in error or omitted in error and the action taken must be properly recorded in the patients medical record

- the entry in the patients medical record need not indicate that an error occurred

Complete the event reporting process (ActionCue)

If a medication error causes an adverse drug reaction a medication error report and an adverse drug reaction report must be completed

References

ASHP Guidelines of Preventing Medication Errors in Hospitals

Iranian Journal of Nursing and Midwifery Research Types and Causes of Medication Errors from the Nurses Viewpoint

Hospital National Patient Safety Goals 2014

Centers for Medicaid and Medicare Services Medication Administration httpwwwcmsgov

Page 6: Medication Administration & Preventing Errors · Principles of Medication Administration Talk with the patient and explain what you are doing before giving medications (answer questions)

Right Medication

In order to be sure that you are giving the right medication you must

Read the medication label carefully (brand namegeneric look alikesound alike)

Ensure that the medication name on the label order and MAR match before giving the medication

Label medicines that are not labeled (syringes cups and basins)

Right Dose

The right dose is how much of the medication is to be administered to

the patient To determine the dose you must first know the strength of each

medication - In the case of liquid medications you need to know the strength

of medication in liquid measure The dose equals the strength of the medication multiplied by the

amount Compare the dose on the prescription label medication order and

medication log

Right Time

Some medications must be administered only at very specific times of the day

- Before meals

- One hour after meals

- Bedtime

Compare the time on the prescription label medication order and the medication log

Medications must be given within a frac12 hour of time that is listed on the medication log (does not apply to PRN medications)

Right Route

The route means how and where the medication gets into the body

Most medication is taken into the mouth and swallowed but others enter the body through the skin rectum vagina eyes ears nose and lungs through a g-tube or by injectioninfusion

Compare the route on the prescription label medication order and the medication log

Right Documentation

Each time a medication is administered it must be documented

Documentation must be done in black ink

No pencil or white out may be used

Never cross out or write over documentation

If you make a mistake when you are documenting on the medication log circle your mistake and write a note explaining what happened

Medication Errors

Medication errors are among the most common health threatening mistakes that affect patient care (increased mortality rate length of hospital stay increased

medical expenses etc)

According to the Institute of Medicine of the National Academies medication errors are among the most common medical errors harming at least 15 million people each year

Studies indicate that 400000 preventable drug-related injuries take place in hospitals each year as a result of errors that occur at various points in the medication administration process

Types of Medication Errors

Medication errors include prescribing errors dispensing errors medication administration errors and patient compliance

errors Drug product nomenclature (look-alike or sound-alike) Illegible handwriting Improper transcription Inaccurate dosage calculation Inadequately trained personnel Inappropriate abbreviations used in prescribing Labeling errors Excessive workload Lapses in individual performance Medication unavailable

Under Staffing

Fatigued Nurses

Medication Errors

Vague Communications

Common Causes of Medication Errors During Medication Administration

Medication Administration

Process

Medication is Prescribed

Medication Order is

Transcribed amp Verified

Medication is Dispensed

Medication is Administered

Opportunities to Prevent Medication Errors

The Nursesrsquo Role in Preventing amp Reporting Medication Errors

Reporting medication errors is an ethical duty to maximize the benefits of patient care thereby promoting patient safety and

health

Report medication errors to the patientrsquos physician and your nursing supervisor immediately or when the error is first identified (monitor amp treat patient as needed)

The medication administered in error or omitted in error and the action taken must be properly recorded in the patients medical record

- the entry in the patients medical record need not indicate that an error occurred

Complete the event reporting process (ActionCue)

If a medication error causes an adverse drug reaction a medication error report and an adverse drug reaction report must be completed

References

ASHP Guidelines of Preventing Medication Errors in Hospitals

Iranian Journal of Nursing and Midwifery Research Types and Causes of Medication Errors from the Nurses Viewpoint

Hospital National Patient Safety Goals 2014

Centers for Medicaid and Medicare Services Medication Administration httpwwwcmsgov

Page 7: Medication Administration & Preventing Errors · Principles of Medication Administration Talk with the patient and explain what you are doing before giving medications (answer questions)

Right Dose

The right dose is how much of the medication is to be administered to

the patient To determine the dose you must first know the strength of each

medication - In the case of liquid medications you need to know the strength

of medication in liquid measure The dose equals the strength of the medication multiplied by the

amount Compare the dose on the prescription label medication order and

medication log

Right Time

Some medications must be administered only at very specific times of the day

- Before meals

- One hour after meals

- Bedtime

Compare the time on the prescription label medication order and the medication log

Medications must be given within a frac12 hour of time that is listed on the medication log (does not apply to PRN medications)

Right Route

The route means how and where the medication gets into the body

Most medication is taken into the mouth and swallowed but others enter the body through the skin rectum vagina eyes ears nose and lungs through a g-tube or by injectioninfusion

Compare the route on the prescription label medication order and the medication log

Right Documentation

Each time a medication is administered it must be documented

Documentation must be done in black ink

No pencil or white out may be used

Never cross out or write over documentation

If you make a mistake when you are documenting on the medication log circle your mistake and write a note explaining what happened

Medication Errors

Medication errors are among the most common health threatening mistakes that affect patient care (increased mortality rate length of hospital stay increased

medical expenses etc)

According to the Institute of Medicine of the National Academies medication errors are among the most common medical errors harming at least 15 million people each year

Studies indicate that 400000 preventable drug-related injuries take place in hospitals each year as a result of errors that occur at various points in the medication administration process

Types of Medication Errors

Medication errors include prescribing errors dispensing errors medication administration errors and patient compliance

errors Drug product nomenclature (look-alike or sound-alike) Illegible handwriting Improper transcription Inaccurate dosage calculation Inadequately trained personnel Inappropriate abbreviations used in prescribing Labeling errors Excessive workload Lapses in individual performance Medication unavailable

Under Staffing

Fatigued Nurses

Medication Errors

Vague Communications

Common Causes of Medication Errors During Medication Administration

Medication Administration

Process

Medication is Prescribed

Medication Order is

Transcribed amp Verified

Medication is Dispensed

Medication is Administered

Opportunities to Prevent Medication Errors

The Nursesrsquo Role in Preventing amp Reporting Medication Errors

Reporting medication errors is an ethical duty to maximize the benefits of patient care thereby promoting patient safety and

health

Report medication errors to the patientrsquos physician and your nursing supervisor immediately or when the error is first identified (monitor amp treat patient as needed)

The medication administered in error or omitted in error and the action taken must be properly recorded in the patients medical record

- the entry in the patients medical record need not indicate that an error occurred

Complete the event reporting process (ActionCue)

If a medication error causes an adverse drug reaction a medication error report and an adverse drug reaction report must be completed

References

ASHP Guidelines of Preventing Medication Errors in Hospitals

Iranian Journal of Nursing and Midwifery Research Types and Causes of Medication Errors from the Nurses Viewpoint

Hospital National Patient Safety Goals 2014

Centers for Medicaid and Medicare Services Medication Administration httpwwwcmsgov

Page 8: Medication Administration & Preventing Errors · Principles of Medication Administration Talk with the patient and explain what you are doing before giving medications (answer questions)

Right Time

Some medications must be administered only at very specific times of the day

- Before meals

- One hour after meals

- Bedtime

Compare the time on the prescription label medication order and the medication log

Medications must be given within a frac12 hour of time that is listed on the medication log (does not apply to PRN medications)

Right Route

The route means how and where the medication gets into the body

Most medication is taken into the mouth and swallowed but others enter the body through the skin rectum vagina eyes ears nose and lungs through a g-tube or by injectioninfusion

Compare the route on the prescription label medication order and the medication log

Right Documentation

Each time a medication is administered it must be documented

Documentation must be done in black ink

No pencil or white out may be used

Never cross out or write over documentation

If you make a mistake when you are documenting on the medication log circle your mistake and write a note explaining what happened

Medication Errors

Medication errors are among the most common health threatening mistakes that affect patient care (increased mortality rate length of hospital stay increased

medical expenses etc)

According to the Institute of Medicine of the National Academies medication errors are among the most common medical errors harming at least 15 million people each year

Studies indicate that 400000 preventable drug-related injuries take place in hospitals each year as a result of errors that occur at various points in the medication administration process

Types of Medication Errors

Medication errors include prescribing errors dispensing errors medication administration errors and patient compliance

errors Drug product nomenclature (look-alike or sound-alike) Illegible handwriting Improper transcription Inaccurate dosage calculation Inadequately trained personnel Inappropriate abbreviations used in prescribing Labeling errors Excessive workload Lapses in individual performance Medication unavailable

Under Staffing

Fatigued Nurses

Medication Errors

Vague Communications

Common Causes of Medication Errors During Medication Administration

Medication Administration

Process

Medication is Prescribed

Medication Order is

Transcribed amp Verified

Medication is Dispensed

Medication is Administered

Opportunities to Prevent Medication Errors

The Nursesrsquo Role in Preventing amp Reporting Medication Errors

Reporting medication errors is an ethical duty to maximize the benefits of patient care thereby promoting patient safety and

health

Report medication errors to the patientrsquos physician and your nursing supervisor immediately or when the error is first identified (monitor amp treat patient as needed)

The medication administered in error or omitted in error and the action taken must be properly recorded in the patients medical record

- the entry in the patients medical record need not indicate that an error occurred

Complete the event reporting process (ActionCue)

If a medication error causes an adverse drug reaction a medication error report and an adverse drug reaction report must be completed

References

ASHP Guidelines of Preventing Medication Errors in Hospitals

Iranian Journal of Nursing and Midwifery Research Types and Causes of Medication Errors from the Nurses Viewpoint

Hospital National Patient Safety Goals 2014

Centers for Medicaid and Medicare Services Medication Administration httpwwwcmsgov

Page 9: Medication Administration & Preventing Errors · Principles of Medication Administration Talk with the patient and explain what you are doing before giving medications (answer questions)

Right Route

The route means how and where the medication gets into the body

Most medication is taken into the mouth and swallowed but others enter the body through the skin rectum vagina eyes ears nose and lungs through a g-tube or by injectioninfusion

Compare the route on the prescription label medication order and the medication log

Right Documentation

Each time a medication is administered it must be documented

Documentation must be done in black ink

No pencil or white out may be used

Never cross out or write over documentation

If you make a mistake when you are documenting on the medication log circle your mistake and write a note explaining what happened

Medication Errors

Medication errors are among the most common health threatening mistakes that affect patient care (increased mortality rate length of hospital stay increased

medical expenses etc)

According to the Institute of Medicine of the National Academies medication errors are among the most common medical errors harming at least 15 million people each year

Studies indicate that 400000 preventable drug-related injuries take place in hospitals each year as a result of errors that occur at various points in the medication administration process

Types of Medication Errors

Medication errors include prescribing errors dispensing errors medication administration errors and patient compliance

errors Drug product nomenclature (look-alike or sound-alike) Illegible handwriting Improper transcription Inaccurate dosage calculation Inadequately trained personnel Inappropriate abbreviations used in prescribing Labeling errors Excessive workload Lapses in individual performance Medication unavailable

Under Staffing

Fatigued Nurses

Medication Errors

Vague Communications

Common Causes of Medication Errors During Medication Administration

Medication Administration

Process

Medication is Prescribed

Medication Order is

Transcribed amp Verified

Medication is Dispensed

Medication is Administered

Opportunities to Prevent Medication Errors

The Nursesrsquo Role in Preventing amp Reporting Medication Errors

Reporting medication errors is an ethical duty to maximize the benefits of patient care thereby promoting patient safety and

health

Report medication errors to the patientrsquos physician and your nursing supervisor immediately or when the error is first identified (monitor amp treat patient as needed)

The medication administered in error or omitted in error and the action taken must be properly recorded in the patients medical record

- the entry in the patients medical record need not indicate that an error occurred

Complete the event reporting process (ActionCue)

If a medication error causes an adverse drug reaction a medication error report and an adverse drug reaction report must be completed

References

ASHP Guidelines of Preventing Medication Errors in Hospitals

Iranian Journal of Nursing and Midwifery Research Types and Causes of Medication Errors from the Nurses Viewpoint

Hospital National Patient Safety Goals 2014

Centers for Medicaid and Medicare Services Medication Administration httpwwwcmsgov

Page 10: Medication Administration & Preventing Errors · Principles of Medication Administration Talk with the patient and explain what you are doing before giving medications (answer questions)

Right Documentation

Each time a medication is administered it must be documented

Documentation must be done in black ink

No pencil or white out may be used

Never cross out or write over documentation

If you make a mistake when you are documenting on the medication log circle your mistake and write a note explaining what happened

Medication Errors

Medication errors are among the most common health threatening mistakes that affect patient care (increased mortality rate length of hospital stay increased

medical expenses etc)

According to the Institute of Medicine of the National Academies medication errors are among the most common medical errors harming at least 15 million people each year

Studies indicate that 400000 preventable drug-related injuries take place in hospitals each year as a result of errors that occur at various points in the medication administration process

Types of Medication Errors

Medication errors include prescribing errors dispensing errors medication administration errors and patient compliance

errors Drug product nomenclature (look-alike or sound-alike) Illegible handwriting Improper transcription Inaccurate dosage calculation Inadequately trained personnel Inappropriate abbreviations used in prescribing Labeling errors Excessive workload Lapses in individual performance Medication unavailable

Under Staffing

Fatigued Nurses

Medication Errors

Vague Communications

Common Causes of Medication Errors During Medication Administration

Medication Administration

Process

Medication is Prescribed

Medication Order is

Transcribed amp Verified

Medication is Dispensed

Medication is Administered

Opportunities to Prevent Medication Errors

The Nursesrsquo Role in Preventing amp Reporting Medication Errors

Reporting medication errors is an ethical duty to maximize the benefits of patient care thereby promoting patient safety and

health

Report medication errors to the patientrsquos physician and your nursing supervisor immediately or when the error is first identified (monitor amp treat patient as needed)

The medication administered in error or omitted in error and the action taken must be properly recorded in the patients medical record

- the entry in the patients medical record need not indicate that an error occurred

Complete the event reporting process (ActionCue)

If a medication error causes an adverse drug reaction a medication error report and an adverse drug reaction report must be completed

References

ASHP Guidelines of Preventing Medication Errors in Hospitals

Iranian Journal of Nursing and Midwifery Research Types and Causes of Medication Errors from the Nurses Viewpoint

Hospital National Patient Safety Goals 2014

Centers for Medicaid and Medicare Services Medication Administration httpwwwcmsgov

Page 11: Medication Administration & Preventing Errors · Principles of Medication Administration Talk with the patient and explain what you are doing before giving medications (answer questions)

Medication Errors

Medication errors are among the most common health threatening mistakes that affect patient care (increased mortality rate length of hospital stay increased

medical expenses etc)

According to the Institute of Medicine of the National Academies medication errors are among the most common medical errors harming at least 15 million people each year

Studies indicate that 400000 preventable drug-related injuries take place in hospitals each year as a result of errors that occur at various points in the medication administration process

Types of Medication Errors

Medication errors include prescribing errors dispensing errors medication administration errors and patient compliance

errors Drug product nomenclature (look-alike or sound-alike) Illegible handwriting Improper transcription Inaccurate dosage calculation Inadequately trained personnel Inappropriate abbreviations used in prescribing Labeling errors Excessive workload Lapses in individual performance Medication unavailable

Under Staffing

Fatigued Nurses

Medication Errors

Vague Communications

Common Causes of Medication Errors During Medication Administration

Medication Administration

Process

Medication is Prescribed

Medication Order is

Transcribed amp Verified

Medication is Dispensed

Medication is Administered

Opportunities to Prevent Medication Errors

The Nursesrsquo Role in Preventing amp Reporting Medication Errors

Reporting medication errors is an ethical duty to maximize the benefits of patient care thereby promoting patient safety and

health

Report medication errors to the patientrsquos physician and your nursing supervisor immediately or when the error is first identified (monitor amp treat patient as needed)

The medication administered in error or omitted in error and the action taken must be properly recorded in the patients medical record

- the entry in the patients medical record need not indicate that an error occurred

Complete the event reporting process (ActionCue)

If a medication error causes an adverse drug reaction a medication error report and an adverse drug reaction report must be completed

References

ASHP Guidelines of Preventing Medication Errors in Hospitals

Iranian Journal of Nursing and Midwifery Research Types and Causes of Medication Errors from the Nurses Viewpoint

Hospital National Patient Safety Goals 2014

Centers for Medicaid and Medicare Services Medication Administration httpwwwcmsgov

Page 12: Medication Administration & Preventing Errors · Principles of Medication Administration Talk with the patient and explain what you are doing before giving medications (answer questions)

Types of Medication Errors

Medication errors include prescribing errors dispensing errors medication administration errors and patient compliance

errors Drug product nomenclature (look-alike or sound-alike) Illegible handwriting Improper transcription Inaccurate dosage calculation Inadequately trained personnel Inappropriate abbreviations used in prescribing Labeling errors Excessive workload Lapses in individual performance Medication unavailable

Under Staffing

Fatigued Nurses

Medication Errors

Vague Communications

Common Causes of Medication Errors During Medication Administration

Medication Administration

Process

Medication is Prescribed

Medication Order is

Transcribed amp Verified

Medication is Dispensed

Medication is Administered

Opportunities to Prevent Medication Errors

The Nursesrsquo Role in Preventing amp Reporting Medication Errors

Reporting medication errors is an ethical duty to maximize the benefits of patient care thereby promoting patient safety and

health

Report medication errors to the patientrsquos physician and your nursing supervisor immediately or when the error is first identified (monitor amp treat patient as needed)

The medication administered in error or omitted in error and the action taken must be properly recorded in the patients medical record

- the entry in the patients medical record need not indicate that an error occurred

Complete the event reporting process (ActionCue)

If a medication error causes an adverse drug reaction a medication error report and an adverse drug reaction report must be completed

References

ASHP Guidelines of Preventing Medication Errors in Hospitals

Iranian Journal of Nursing and Midwifery Research Types and Causes of Medication Errors from the Nurses Viewpoint

Hospital National Patient Safety Goals 2014

Centers for Medicaid and Medicare Services Medication Administration httpwwwcmsgov

Page 13: Medication Administration & Preventing Errors · Principles of Medication Administration Talk with the patient and explain what you are doing before giving medications (answer questions)

Under Staffing

Fatigued Nurses

Medication Errors

Vague Communications

Common Causes of Medication Errors During Medication Administration

Medication Administration

Process

Medication is Prescribed

Medication Order is

Transcribed amp Verified

Medication is Dispensed

Medication is Administered

Opportunities to Prevent Medication Errors

The Nursesrsquo Role in Preventing amp Reporting Medication Errors

Reporting medication errors is an ethical duty to maximize the benefits of patient care thereby promoting patient safety and

health

Report medication errors to the patientrsquos physician and your nursing supervisor immediately or when the error is first identified (monitor amp treat patient as needed)

The medication administered in error or omitted in error and the action taken must be properly recorded in the patients medical record

- the entry in the patients medical record need not indicate that an error occurred

Complete the event reporting process (ActionCue)

If a medication error causes an adverse drug reaction a medication error report and an adverse drug reaction report must be completed

References

ASHP Guidelines of Preventing Medication Errors in Hospitals

Iranian Journal of Nursing and Midwifery Research Types and Causes of Medication Errors from the Nurses Viewpoint

Hospital National Patient Safety Goals 2014

Centers for Medicaid and Medicare Services Medication Administration httpwwwcmsgov

Page 14: Medication Administration & Preventing Errors · Principles of Medication Administration Talk with the patient and explain what you are doing before giving medications (answer questions)

Medication Administration

Process

Medication is Prescribed

Medication Order is

Transcribed amp Verified

Medication is Dispensed

Medication is Administered

Opportunities to Prevent Medication Errors

The Nursesrsquo Role in Preventing amp Reporting Medication Errors

Reporting medication errors is an ethical duty to maximize the benefits of patient care thereby promoting patient safety and

health

Report medication errors to the patientrsquos physician and your nursing supervisor immediately or when the error is first identified (monitor amp treat patient as needed)

The medication administered in error or omitted in error and the action taken must be properly recorded in the patients medical record

- the entry in the patients medical record need not indicate that an error occurred

Complete the event reporting process (ActionCue)

If a medication error causes an adverse drug reaction a medication error report and an adverse drug reaction report must be completed

References

ASHP Guidelines of Preventing Medication Errors in Hospitals

Iranian Journal of Nursing and Midwifery Research Types and Causes of Medication Errors from the Nurses Viewpoint

Hospital National Patient Safety Goals 2014

Centers for Medicaid and Medicare Services Medication Administration httpwwwcmsgov

Page 15: Medication Administration & Preventing Errors · Principles of Medication Administration Talk with the patient and explain what you are doing before giving medications (answer questions)

The Nursesrsquo Role in Preventing amp Reporting Medication Errors

Reporting medication errors is an ethical duty to maximize the benefits of patient care thereby promoting patient safety and

health

Report medication errors to the patientrsquos physician and your nursing supervisor immediately or when the error is first identified (monitor amp treat patient as needed)

The medication administered in error or omitted in error and the action taken must be properly recorded in the patients medical record

- the entry in the patients medical record need not indicate that an error occurred

Complete the event reporting process (ActionCue)

If a medication error causes an adverse drug reaction a medication error report and an adverse drug reaction report must be completed

References

ASHP Guidelines of Preventing Medication Errors in Hospitals

Iranian Journal of Nursing and Midwifery Research Types and Causes of Medication Errors from the Nurses Viewpoint

Hospital National Patient Safety Goals 2014

Centers for Medicaid and Medicare Services Medication Administration httpwwwcmsgov

Page 16: Medication Administration & Preventing Errors · Principles of Medication Administration Talk with the patient and explain what you are doing before giving medications (answer questions)

References

ASHP Guidelines of Preventing Medication Errors in Hospitals

Iranian Journal of Nursing and Midwifery Research Types and Causes of Medication Errors from the Nurses Viewpoint

Hospital National Patient Safety Goals 2014

Centers for Medicaid and Medicare Services Medication Administration httpwwwcmsgov