Question

1. Research computer controlled medication systems on the internet. Describe aspects of at least two such systems that could actually foster medication errors along with what procedures or protocols could help prevent such errors.

2.Discuss the rights of medication administration.
B. Discuss the three checks of medication administration.
C. Discuss all of the various routes of medication administration.

Answer 1

1. Automated dispensing cabinets (ADCs) are decentralized medication distribution systems that provide computer-controlled storage, dispensing, and tracking of medications at the point-of-care in patient care units.

In general, after ADCs were implemented, these studies identified:-

•lower rates of dispensing errors in filling ADCs compared with manual filling of traditional unit-dose cassettes.

•fewer errors in drug administration (mostly drugs given at the wrong time) and fewer missing doses.

•fewer drug-administration errors in a cardiovascular surgery unit but more errors in an intensive-care unit (ICU).

•an increase in errors (by more than 30%) in six of seven nursing units evaluated.

2.
A. Rights of medication administration:-

a. Right Drug.

The first right of drug administration is to check and verify if it’s the right name and form. Beware of look-alike and sound-alike medication names.

b. Right Patient.

Ask the name of the client and check his/her ID band before giving the medication. Even if you know that patient’s name, you still need to ask just to verify.

c. Right Dose.

Check the medication sheet and the doctor’s order before medicating. Be aware of the difference between an adult and a pediatric dose.

d. Right Route.

Check the order if it’s oral, IV, SQ, IM, etc..

e. Right Time and Frequency.

Check the order for when it would be given and when was the last time it was given.

f. Right documentation.

Make sure to write the time and any remarks on the chart correctly.

g. Right History and Assessment.

Secure a copy of the client’s history to drug interactions and allergies.

h. Drug approach and Right to Refuse.

Give the client enough autonomy to refuse the medication after thoroughly explaining the effects.

i. Right Drug-Drug Interaction and Evaluation.

Review any medications previously given or the diet of the patient that can yield a bad interaction to the drug to be given. Check also the expiry date of the medication being given.

j. Right Education and Information.

Provide enough knowledge to the patient of what drug he/she would be taking and what are the expected therapeutic and side effects.


B.
a. First Check

* Read medication administration record and remove the medication(s) from the clients drawer.
Verify that the client's name and room number match MAR.

* Compare the label of the Medication against the MAR

* If the dosage does not match the MAR, determine if you need to do a math calculation

* Check the expiration date

b. Second Check

* While preparing the medication (e.g. Pouring, Drawing up, or Placing unopened package in a medication cup), look at the medication label and check against MAR

c. Third Check

* Recheck the label on the container (e.g., vial, bottle, or unused unit-dose medications) before returning to its storage place.
or
* Check the Label on the medication against the MAR before opening the package at the bedside.

C. Routes of drug administration:-

1. Taken by mouth (orally)

2. Given by injection into a vein (intravenously, IV), into a muscle (intramuscularly, IM), into the space around the spinal cord (intrathecally), or beneath the skin (subcutaneously, sc)

3. Placed under the tongue (sublingually) or between the gums and cheek (buccally)

4. Inserted in the rectum (rectally) or genital (vaginally)

5. Placed in the eye (by the ocular route) or the ear (by the otic route)

6. Sprayed into the nose and absorbed through the nasal membranes (nasally)

7. Breathed into the lungs, usually through the mouth (by inhalation) or mouth and nose (by nebulization)

8. Applied to the skin (cutaneously) for a local (topical) or bodywide (systemic) effect

9. Delivered through the skin by a patch (transdermally) for a systemic effect.