Which patient identifiers should be used together to prevent medication administration errors? Show The patient's bed number The patient's telephone number The patient's room number The patient's Medicaid number The patient's medication record number The patient's telephone number If the right drug is not administered to the right patient, it is considered a medication error. To avoid this, at least two separate written patient identifiers must be used. The patient's telephone number and medication record number, generally found on the patient's wristband as a written patient identifier, are appropriate identifiers. The patient's bed number, room number, and Medicaid number are not acceptable identifiers. A prescriber is in a hurry to leave the unit to get back to the office and states to the nurse, "Please administer the usual dose of paracetamol when my patient comes back from the procedure." What is the nurse's most appropriate response? Sure, no problem." "Just call me with the order when you get back to your office." "Can you please repeat the order?" "Please write the medication order "Please write the medication order before you leave." Rationale A prescriber may not give a verbal order in a non-emergent situation, so the most appropriate action would be to request that the prescriber write the medication order before leaving the unit. Accepting the order can lead to medication errors. A telephone order from the office is a form of a verbal order, which is unacceptable except in cases of emergency. Asking the prescriber to repeat the order is not helpful, because the nurse should not accept the verbal order. Which item should be excluded from the list of computer-controlled dispensing systems used in various health care facilities? Pyxis Silent Knight Rationale Which organization established a National Patient Safety Goals to prevent medication errors and created the official Do Not Use list? The Institute for Safe Medication Practices (ISMP) The Joint Commission (TJC) Rationale TJC established National Patient Safety Goals to address areas of concern regarding patient safety and created the official Do Not Use list of abbreviations to prevent medication errors. ISMP also came up with an extensive list of abbreviations, symbols, and dose designations that have led to medication errors but not the National Patient Safety Goals. QSEN addresses quality and safety competency of prelicensed nurses. USP develops and publishes standards for drug substances, drug products, excipients, and dietary supplements in the United States. Which organization has developed guidelines that include 12 interdisciplinary core processes for safe use of computer-controlled dispensing systems? The Joint Commission (TJC) The American Health Care Association (AHCA) Centers for Disease Control and Prevention (CDC) The Institute for Safe Medication Practices (ISMP) The Institute for Safe Medication Practices (ISMP) To guide health care organizations to use computer-controlled dispensing systems safely, the ISMP has developed and posted guidelines that include 12 interdisciplinary core processes. TJC is an independent, not-for-profit organization which accredits and certifies health care organizations and programs in the United States. The AHCA is a non-profit federation of affiliate state health organizations that care for approximately one million elderly and disabled individuals each day. The CDC is a federal agency under the Department of Health and Human Services; the CDC's main goal is to protect public health and safety through the control and prevention of disease, injury, and disability. Which component of a medication administration record (MAR) listed by the student nurse needs correction? Date of patient's birth Date of patient's discharge from the facility The date of a patient's discharge from the facility is not a component of the MAR. The patient's date of birth, date of admission to the facility, and date of first administration of a particular medication must be listed in the MAR. The nurse is receiving a medication order via telephone from the primary care provider. The provider indicates that the medication should be given "by mouth," what does the nurse write to identify this route? PO PO "PO" or "per os" is the correct abbreviation for "by mouth." "NPO," or "non per os" means "nothing by mouth." "SQ" stands for "subcutaneous" for injections, and "IV" means "intravenous." What is the dosage of a medication? Interval between medication administrations Amount and strength of medication Time the medication will be administered Frequency the medication will be administered Amount and strength of medication The dosage is the amount and strength of medication. The interval between medication administrations is the time in between administering the medication. The time the medication is to be administered is the chronological time. The frequency indicates the number of times per day that the medication is administered. How should "QD" be written? q.d. daily Rationale "Daily" is the correct written communication. "QD," "q.d.," or "q.i.d." may be misinterpreted. "Every other day" is incorrect. What does the nurse know the abbreviation "SR" means? Slow
release Sustained release The abbreviation "SR" stands for "sustained release." It may be used for "slow release," but sustained release is a more accurate term. "SROM" stands for "spontaneous rupture of membranes." "SRS" stands for "stereotactic radiotherapy." Who enters the details of a medication order for the patient in a computer-controlled dispensing system? Nurse Pharmacist The pharmacist receives the medication order and enters it in the computer-controlled dispensing system. The physician provides the medication order, which is served by the pharmacist. The nurse administers the medication to the patient. The unit secretary is not involved in any of these activities. Which information may be (i.e., is not required) transcribed into a medication administration record (MAR) as per individual hospital policy? Date of admission of the patient Name of any medication withheld Withholding of any medication may be recorded on the MAR as per hospital policy, but this is not included on all MAR forms. Date of admission of the patient, time of the administration of a particular medication, and the full signature of the nurse administering the medication all must be recorded on the MAR. SSI is on a list of error-prone abbreviations. How should the abbreviation be spelled out? Sliding scale of insulin Sliding scale of insulin "Sliding scale" specifically refers to insulin dosing and should be spelled out. "SSI" can be mistaken for the number 551. "SSSI" is an abbreviation that can be used to mean skin and skin structure infection. "SSRI" is a selective serotonin reuptake inhibitor. Which credentials will allow the nurse access to the computerized medication dispensing system to obtain medications? User
identification User identification Rationale To obtain medication for a patient, the nurse can access the computerized medication dispensing system with a user ID, personal password, and/or biometric fingerprint scan. Social security numbers and patient identification numbers are not appropriate for accessing the computerized medication dispensing system. What does the nurse understand about the abbreviation "D/C?" It should not be used. "D/C" is on the list of error-prone abbreviations and may be interpreted as "discontinue" or "discharge." Because it is considered error-prone, the Institute for Safe Medication Practices states that it should not be used when discharging a patient, in an electronic order, or in a verbal order. Which statement about the distribution of controlled substances by a computer-controlled dispensing system is correct? It distributes controlled substances only when the pharmacy gives the system access. It provides a detailed record regarding the usage and the user of the controlled substances. It cannot monitor the distribution of controlled substances after 48 hours of a physician's order. It provides a detailed record regarding the usage and the user of the controlled substances. Rationale Controlled substances are distributed through the computer-controlled dispensing system, and it provides a detailed record indicating which controlled substances were used and by whom. Computer-controlled dispensing systems distribute any controlled substances irrespective of their abuse potential and physical and psychological dependence. The pharmacy does not need to give the system access. Any narcotic has an automatic 48-hour limit and then must have a written renewal order. What does a nurse use to begin acceptable interpretation of a verbal order for medication? Review of the active ingredients A formal read back A formal read back with the prescriber is an acceptable interpretation of a verbal order. Reviewing the active ingredients in the medication is not relevant to interpreting a verbal order. The pharmacist or a charge nurse cannot verify or clarify the order, because neither one is the person who prescribed it. What type of medication order must have a frequency, which designates the minimum time allowed between doses? A single-dose telephone order A prn medication order For safety, a prn (or "as needed") order must have a frequency, which designates the minimum time allowed between doses. Single-dose and one-time dose orders of any kind does not require the frequency. How does a computerized medication dispensing system reduce the time required for end-of-shift narcotic counts? This system automatically sends the usage information to the pharmacy. This system requires the confirmation of the count of narcotics after each withdrawal. This system prepares an automatic report regarding the usage of narcotics during the shift. This system requires confirmation from the physician before the withdrawal of any narcotics. This system requires the confirmation of the count of narcotics after each withdrawal. Computerized medication dispensing systems require the confirmation of the count of controlled substance medications after each withdrawal. This process helps keep the track of narcotics use and reduces the time required for end-of-shift narcotic counts. If a computerized medication dispensing system is linked to the pharmacy system, information regarding the usage of any drug, normal or controlled, is sent to the pharmacy. This helps reduce medication error. At the end of the shift, the system may prepare the usage report. The report regarding narcotics is dependent on the count confirmation after each narcotic withdrawal. Narcotic orders from the physician are valid for 48 hours; no further confirmation is required regarding this. To what does the frequency component of an ordered medication refer? The generic name of the drug How often the drug is to be administered The frequency indicates how often the drug is administered. The generic name of the drug is the proper name, chemical name, or nonproprietary name of the drug. The start and stop dates of a medication are determined by the date and time the order was written. Dosage refers to the amount of medication given at a single time. After reading back a telephone order, what should the nurse do? Sign the order. Sign the order. After the nurse notes whether it was an oral or telephone order, he or she must sign the order. Implementation of the order occurs after it is sent to the pharmacy, which cannot take place until after it is signed. The order cannot be transcribed until it has been written Which must be included among the components of a medication order in order for it to be legal? Special instructions Signature of the prescriber For a medication order to be legal, it must be signed by the prescriber. Special instructions, the purpose of administration, and the medication's side effects are not legally required components of a medication order. When transcribing a telephone order, the nurse hangs up the phone without a formal "read back." Which is the nurse's priority action? Submit the order to the pharmacy Telephone the prescriber to read back the order Telephoning the prescriber to read back the order is a priority action to ensure safe medication administration. Submitting the order to the pharmacy, administering the medication to the patient, and entering the order in the computer without a formal read back are actions that do not ensure safe communication and clarification of the medication order. What is an advantage of the unit-dose method of drug dispensing? More drugs are available for selection. Nurses save time preparing drugs for administration. In the unit-dose method, a drug is packaged in single doses by the pharmacy. Because the correct dose is provided, no calculation is needed. This saves the nurse time otherwise spent on preparing the drug dose. In the stock-drug method, a drug is stored in a large container on the floor. Hence, more drugs are available for selection, and the drug is always available for administration. In the stock-drug method, cost efficiency is enhanced by having large quantities of the drug. Which point would the nurse include while making a presentation regarding the usage of the Omnicell Savvy Mobile Medication System? Nurses can retrieve scheduled medications from this system. Nurses can retrieve scheduled medications from this system. Rationale The Omnicell Savvy Mobile Medication System allows nurses to retrieve medications that are scheduled and those given on an as-needed basis. This system saves nurses from making trips to an automated dispensing cabinet such as Omnicell. Access to the system requires a security code and password or a biometric fingerprint scan. Medications administered as well as those wasted are remotely recorded using this system. Which is the correct example of the use of the tall man letters that can reduce errors for look-alike and sound-alike medications? dopAMINE and dobutAMINE DOPamine and DOBUTamine Use of tall man letters can reduce errors for look-alike and sound-alike medications. The tall man lettering system differentiates the drugs by capitalizing the letters that are different. Correct representation of tall man letters, as outlined by the FDA, is illustrated in "DOPamine and DOBUTamine." The uses in "dopAMINE and dobutAMINE," "DOpamine and DObutamine," and "DOpAMINE and DObutAMINE" do not show the different letters, so these are not appropriate examples. Which statement regarding unit-dose packaging is correct? Unit-dose packages are reusable. Unit-dose packages
contain generic and/or trade names of the medication as per the facility policy. Unit-dose packages are labeled with generic and trade names. They sometimes contain manufacturer, lot number, and expiration date as well, depending on facility policy. Unit-dose packages are for single use only and are not reusable. Unit-dose packages are placed in a patient-identified drawer in a large unit-dose cabinet at the nurse's station. Unit-dose packages are prepared in the pharmacy. Which order can be safely interpreted as Lasix 40 milligrams orally daily? Lasix 40 μg prn per os q.d Lasix 40 mg PO daily "Lasix 40 mg PO daily" means Lasix 40 milligrams orally daily. The abbreviation μg is for micrograms and is identified as an error-prone abbreviation; it is the incorrect unit of measurement in the order. "Per os," "q.d.," and "qd" can be misinterpreted and are designated error-prone abbreviations. Which nursing action is correct when non-nursing personnel transcribe the physician's orders onto the patient's medication administration record (MAR)? The nurse signs the MAR to validate the document. The nurse verifies the transcription against the physician's order and initials the document. The nurse uses the transcribed MAR as-is for implementation. The nurse sends the transcribed MAR to the physician for validation. The nurse verifies the transcription against the physician's order and initials the document. After non-nursing personnel transcribe the physician's order to the patient's MAR, the nurse is required to verify the transcription against the physician's order and initial the form. This indicates the transcription was correctly completed. The nurse cannot validate the MAR just by signing the document; verification is also required. The nurse cannot use the MAR unless it is verified and signed. The physician is not required to sign the MAR. Which medication errors are prevented by inserting a zero in front of a decimal when a whole number is not part of a medication order? The decimal is mistaken for a zero. The position of the decimal is missed. The zero indicates the correct strength. The dose is mistaken for a whole number. The frequency of medication administration becomes unclear. The decimal is mistaken for a zero. , The nurse should always insert a zero in front of a decimal fraction when a whole number is absent; this draws attention to the decimal and avoids mistaking the decimal for a whole number, missing the decimal, and mistaking the correct dose for a whole number. The zero does not indicate the correct strength, and frequency would never be expressed as a decimal. What must be included in a medication order quizlet?Terms in this set (8). Name of the patient.. Name of the drug to be administered.. Dosage of the drug.. Route by which the drug is to be administered.. Frequency, time and special instructions related to administration.. Date and Time when the order was written.. Signature of the person writing the order. •. What data should be included on all medication orders?According to the Centers for Medicare & Medicaid Services, all orders for the administration of drugs and biologicals must contain the following information:. Name of the patient.. Age or date of birth.. Date and time of the order.. Drug name.. Dose, frequency, and route.. Name/Signature of the prescriber.. What are the 7 essential parts of a drug order?When a medication order is written, it must contain the following seven important parts or it is considered invalid or incomplete: (1) client's full name, (2) date and time the order was written, (3) name of the medication, (4) dosage of the medication, (5) route of administration, (6) frequency of administration, and ...
Which of the following types of medication orders allows for a medication to be given as needed?STAT Orders
These medications need to be given immediately or NOW.
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Which must be included among the components of a medication order in order for it to be legal quizlet?
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