M3: MEDICATION ERROR

Question 1

• mishaps that occur during prescribing, trasncribing, dispensing, administering, adherence, or monitoring a drug

Answer 1

MEDICATION ERROR

Question 2

• an error of commission or omission at any step along the pathway that begins when a clincian prescribes a medication and ends when a patient receives the medication

Answer 2

MEDICATION ERROR

Question 3

CHEMICAL INCOMPAT

• the harm experienced by a patient as a result of exposure to a medication
• the occurrence DOES NOT necessarily indicate an error or poor quality care

Answer 3

ADVERSE DRUG EVENT

Question 4

• these are preventable
• medication errors that DO NOT CAUSE ANY HARM – either because they are intercepted before reaching the patient or because of luck

Answer 4

potential ADEs

Question 5

STAGES/CRITERIA of Medication Error

• error of PHYSICIANS
• UNAMBIGUOUS prescription
• OMISSION of: drug name, formulation, route, dose, dosing regime, date, signature, treatment time
• CHOOSING A MEDICINE: irrational, inappropriate, ineffective prescribing, underprescribing, overprescribing
• WRITING THE PRESCRIPTION: prescription errors, illegibility

Answer 5

ORDERING or PRESCRIBING

Question 6

how to prevent medication error

Answer 6

CONSERVATIVE PRESCRIBING

Question 7

STAGES/CRITERIA of Medication Error

ORDERING or PRESCRIBING:
* the prescription should have the same INTERPRETATION for every pharmacist
* should be STRAIGHTFORWARD

Answer 7

UNAMBIGUOUS

Question 8

STAGES/CRITERIA of Medication Error

• error by NURSES
• an identical copy of prescription in medical record
• DISCREPANCY: drug name, formulation, route, dose, dosing regime, omission of drug, unordered drug

Answer 8

TRANSCRIPTION

Question 9

STAGES/CRITERIA of Medication Error

TRANSCRIPTION:
* how to avoid discrepancy

Answer 9

COMPUTERIZED PROVIDER ORDER ENTRY (CPOE)

Question 10

STAGES/CRITERIA of Medication Error

TRANSCRIPTION:
* it is the ordering of drugs ONLINE

Answer 10

COMPUTERIZE PROVIDER ORDER ENTRY (CPOE)

Question 11

STAGES/CRITERIA of Medication Error

TRANSCRIPTION:
* CPOE is better in partner with

Answer 11

CLINICAL DECISION SUPPORT (CDS)

Question 12

STAGES/CRITERIA of Medication Error

TRANSCRITPION:
* if Clinical Decision Support (CDS) is NOT AVAILABLE, what is the alternative

Answer 12

CLINICAL PHARMACISTS can give CDS

Question 13

STAGES/CRITERIA of Medication Error

• error of the PHARMACIST
• dispensed medication is concordant with prescribed drug in nurse medication chart
• dispensing the formulation: wrong drug, formulation, label

Answer 13

DISPENSING

Question 14

STAGES/CRITERIA of Medication Error

DISPENSING:
* common causes

Answer 14

SALADs
HAM

Question 15

STAGES/CRITERIA of Medication Error

DISPENSING:
* how to avoid SALADs

Answer 15

TALL MAN LETTERING

Question 16

STAGES/CRITERIA of Medication Error

DISPENSING:
* how to avoid HAM

Answer 16

Automated Dispensing Cabinet

Question 17

STAGES/CRITERIA of Medication Error

• error of NURSES
• the right medication to the right patient in the right way at the right time
• WRONG: admnistration technique, route, time, deliver, unordered drug, unordered dose, omission of dose, lack of identity control

Answer 17

ADMINISTRATION

Question 18

what are the 5 RIGHTS

Answer 18

drug
dose
time
administration
patient

Question 19

• any abnormal signs or symptoms WITHOUT TAKING THE DRUG
• events that are NOT reactions to a medicine

Answer 19

ADVERSE EVENTS

Question 20

• any harmful/obnoxious reaction to the DRUG
• NOT from errors

Answer 20

ADVERSE DRUG REACTIONS

Question 21

TYPES of Medication Error

• deals with the specific time, place, medicines, and people involved

Answer 21

CONTEXTUAL CLASSIFICATION

Question 22

TYPES of Medication Error

• examines the ways in which errors occur (by omission, repetition, or susbtitution)

Answer 22

MODAL CLASSIFICATION

Question 23

TYPES of Medication Error

• preferred as it explains events rather than merely describing them

Answer 23

PSYCHOLOGICAL CLASSIFICATION

Question 24

TYPES of Medication Error

PSYCHOLOGICAL:
* due to LACK of KNOWLEDGE

Answer 24

KNOWLEDGE-BASED errors

Question 25

# **TYPES of Medication Error** PSYCHOLOGICAL: * error in **applying BAD RULE** or **misapplying GOOD RULE**

Answer 25

RULE-BASED erorrs

Question 26

# **TYPES of Medication Error** PSYCHOLOGICAL: * error in **ACTION** * **slips**

Answer 26

ACTION-BASED errors

Question 27

# **TYPES of Medication Error** PSYCHOLOGICAL: * **forgotten information** * **lapses**

Answer 27

MEMORY-BASED errors

Question 28

maximum dose of paracteamol

Answer 28

4g

Question 29

# **PRESCRIBING FAULTS and PRESCRIPTION ERRORS** * being **UNAWARE of the interaction** between WARFARIN and ERYHTROMYCIN * willl cause **Warfarin toxicity** due to enzyme inhibition

Answer 29

KNOWLDEGE BASED

Question 30

# **PRESCRIBING FAULTS and PRESCRIPTION ERRORS** * prescribing **ORAL treatment** in a patient with **DYSPHAGIA** (difficulty in swallowing) * will result in **lung aspiration** or **failure of treatment**

Answer 30

RULE BASED

Question 31

what do we use for administration in patients with **dysphagia**

Answer 31

NGT

Question 32

# **PRESCRIBING FAULTS and PRESCRIPTION ERRORS** * being **DISTRACTED**, writing DIAZEPAM for DILTIAZEM

Answer 32

ACTION BASED

Question 33

# **PRESCRIBING FAULTS and PRESCRIPTION ERRORS** * writing **ILLEGIBLY**, PANADOL instead of PRIADEL

Answer 33

TECHNICAL

Question 34

# **PRESCRIBING FAULTS and PRESCRIPTION ERRORS** * **FORGOTTING** to specify a maximum daily dose for an 'as required' drug

Answer 34

MEMORY BASED

Question 35

# **CATEGORIES of Medication Error** * **NO ERROR** or **capacity** to cause error

Answer 35

A | ala nangyare

Question 36

# **CATEGORIES of Medication Error** * error that **DID NOT REACH** the patient

Answer 36

B | Bitin, hindi inaBot

Question 37

# **CATEGORIES of Medication Error** * error that **REACHED PATIENT** but **UNLIKELY to cause harm**

Answer 37

C | Char wala pala

Question 38

# **CATEGORIES of Medication Error** * MULTIVITAMIN was NOT ordered on admission

Answer 38

C | not need in admission

Question 39

# **CATEGORIES of Medication Error** * error that **reached the patient** and could habe mecessitated **MONITORING** and/or **INTERVENTION** to preclude harm

Answer 39

D | Dapat imonitor

Question 40

# **CATEGORIES of Medication Error** * **Regular release** metoprolol was ordered for patient **instead of extended-release**

Answer 40

D

Question 41

# **CATEGORIES of Medication Error** * error that could have cause **TEMPORARY HARM**

Answer 41

E | tEmporaraE harm

Question 42

# **CATEGORIES of Medication Error** * blood pressure emdication was **inadvertently omitted** from orders

Answer 42

E

Question 43

# **CATEGORIES of Medication Error** * errors that could have cause **temporary harm** requiring **INITIAL** or **PROLONGED HOSPITALIZATION**

Answer 43

F | Frolonged hosFitalization

Question 44

# **CATEGORIES of Medication Error** * Anitcoagulant, such as warfarin, was **ordered daily** when the patient takes it **every other day**

Answer 44

F

Question 45

# **CATEGORIES of Medication Error** * errors that could have resulted in **PERMANENT HARM**

Answer 45

G | Grabe permanent

Question 46

# **CATEGORIES of Medication Error** * immunosuppressant medication was unintentionally ordered at **one-fouth** the dose

Answer 46

G

Question 47

# **CATEGORIES of Medication Error** * error that could have necessitated **INTERVENTION** to sustain life

Answer 47

H | Hingalo na

Question 48

# **CATEGORIES of Medication Error** * anticonvulsant therapy was **inadvertently omitted**

Answer 48

H

Question 49

# **CATEGORIES of Medication Error** * error that could have resulted in **DEATH**

Answer 49

I | pat-I na

Question 50

# **CATEGORIES of Medication Error** * beta blocker was **not reordered post-operatively**

Answer 50

I

Question 50

WHO STRATEGIC FRAMEWORK **key action areas**

Answer 50

Health care professionals Medicines Systems & Practices of medication Patient and the Public

Question 51

KEY STEPS FOR ENSURING **MEDICATION SAFETY**

Answer 51

1. appropriate prescribing and risk assessment 2. medication review 3. dispensing, preparation and administration 4. communication and patient engagement 5. medication reconciliation at care transitions