Question

The prescription and administration of medications is a high risk area in hospital and ambulatory medical operations. Please focus in performing risk assessments.Write a 2-3 page double-spaced paper. Identify risks associated with medication administration, estimate the likelihood of each risk, and to develop risk mitigation strategies applicable to the case study "Children's Hospital and Clinics." How are the risks of medication administration different in children's hospitals than adult hospitals?

Answer 1

The prescription and administration of medicines is a high risk area in hospital and ambulatory medical operations There are many rationals behind this high grade error.

Medication error is one of the core problems in the health care system and it may lead to drastic changes and complications for the patient .

Medication error are broadly defined as any error made at the prescribing, dispensing, storing and administration level . It is an unintentionally made error.

The risks of medication administration in children hospital are not different from adult hospitals . The medication error does not depend on the size ,age etc of the patient . It depends on the process of administration at the different levels.

# The risk factor leading to medication error are:-

- Lack of adequate staffing

- Patient poor aquity level

- Inadequate access to policy and medication information

- Physical environment like improper lightening etc

- Organizational culture,routines, and communication channel

- Pharmacy related issues

- Improper Incident reporting culture

- Inadequate knowledge and skills of staffs

- Improperly written drug name,route,dose and time

- Misidentification of patients

- Improper documentation.

# Classification of medication error are:-

1. Near miss- an act could have harmed the patient but did not because the professional have identified the error just before the time of administration.

2. Chance - patient received the wrong medicine but did not have any adverse effects.

3. Prevention- potential harmful dose or drug was prescribed but the nurse identified it before administration and asked for the corrections

# 4.Mitigation - a lethal dose of drug was administered but discovered early and antidote was given .

Medication errors are of different types:-

Prescribing error

Omission error

Wrong time error

Improper dose error

Improper route error

Unauthorized drug error

# Measures to prevent medication errors:-

1. Never assume anything about drug order clarify your doubts regarding drug order before administration.

2. Minimize verbal and telephonically made drug orders.

3. Spell the name of drug if there is any confusion while making the indent to pharmacy.

4. Ensuring a safe dispensing method.

5. Separating the drugs which have similar name and appearance.

6. Maintain a good staff patient ratio like 2:1to reduce workload related error.

7. Adequate knowledge regarding drugs especially the high risk drugs like potassium chloride etc.

8. Electronic prescribing will reduce the manual prescription error.

9. Computerized physician order entry system to avoid in-between involvement of nursing staff in making indent.

10. Checking the 6R's before administration of a drug . 6R's are:-

Right patient

Right drug

Right route

Right dose

Right time

Right documentation

11. Following the policies of organization related to drug administration.

12. Training and review the knowledge of staffs

13. Double checking before administration of drugs.

14. Documenting all medicines as soon as they are given.

15. Proper filling up of incident report by the staff if they made a error ,which will help in avoiding the same in future.

16. Providing in service training on medication administration of common drugs and high risk drugs.

17. Proper storage of lock and key medicines.

18. Administration of medications under supervision for the staffs who are newly recruited and those under training.

# If a professional has ade an error ,first of all assess the patient for adverse effects ,inform the physician and then inform the uncharged and fill the incident form with in 24 hrs.