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Pharmacy, Nursing Distractions Contribute to Medication Errors

March 10, 2008
Written by: , Filed in: Practice Management
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Numerous distractions occur in pharmacies and on nursing floors that
contribute to medication errors, which may result in death, or severe patient
disability.

Medication errors that result in patient death or serious disability are
included in one group of ‘never events’ (serious preventable medical errors)
defined by the National Quality Forum.

The entire process of medication administration begins with a handwritten or
computerized medication order from the physician. Next, the order is delivered
to the pharmacy, which is responsible for filling the order as it is written.
The pharmacist may need to get clarification from the physician.

When ready, the pharmacist starts mixing various compounds. Because many of
the materials in a pharmacy are clear liquids, the pharmacist must ensure that
the correct concentration is used and that the correct clear liquids are mixed
together to make the product needed by the patient. The number of distractions
that can occur during this process is innumerable.

Most pharmacies have a double-check system, but even these systems are not
foolproof. Inpatient pharmacies in which only one pharmacist works have many
challenges associated with this work environment. Their work is double-
checked, but staff members often get distracted or are very busy and they go
through only the motions of doing the double-check system. Therefore,
medication errors may get missed in the pharmacy.

When the medication arrives on the hospital floor, the nursing staff must
ensure that the medication gets to the right patient and is administered via
the right route and at the right time. Medication errors can occur because an
inpatient nursing unit can be very busy with many distractions and frequent
reprioritizations. Getting medication into patients without error is an
increasingly challenging situation in these environments.

Reference:
Kathleen Hale, RN, BSN, MHSA, and Richard P. Kidwell, JD Pharmacy and
Nursing Factors Contributing to Medication Errors

Numerous distractions occur in pharmacies and on nursing floors that contribute to medication errors, which may result in death, or severe patient disability. Medication errors that result in patient death or serious disability are included in one group of 'never events' (serious preventable medical errors) defined by the National Quality Forum. The entire process of medication administration begins with a handwritten or computerized medication order from the physician. Next, the order is delivered to the pharmacy, which is responsible for filling the order as it is written. The pharmacist may need to get clarification from the physician. When ready, the pharmacist starts mixing various compounds. Because many of the materials in a pharmacy are clear liquids, the pharmacist must ensure that the correct concentration is used and that the correct clear liquids are mixed together to make the product needed by the patient. The number of distractions that can occur during this process is innumerable. Most pharmacies have a double-check system, but even these systems are not foolproof. Inpatient pharmacies in which only one pharmacist works have many challenges associated with this work environment. Their work is double- checked, but staff members often get distracted or are very busy and they go through only the motions of doing the double-check system. Therefore, medication errors may get missed in the pharmacy. When the medication arrives on the hospital floor, the nursing staff must ensure that the medication gets to the right patient and is administered via the right route and at the right time. Medication errors can occur because an inpatient nursing unit can be very busy with many distractions and frequent reprioritizations. Getting medication into patients without error is an increasingly challenging situation in these environments. Reference: Kathleen Hale, RN, BSN, MHSA, and Richard P. Kidwell, JD Pharmacy and Nursing Factors Contributing to Medication Errors [text_ad]
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