Ma Rs And Drug Distrubution Systems

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Ma Rs And Drug Distrubution Systems

  1. 1. Calculate with Confidence 5 th edition Gray Morris Mosby items and derived items © 2010 by Mosby, Inc., an affiliate of Elsevier Inc.
  2. 2. Medication Administration Records and Drug Distribution Systems Unit Three: Chapter 12 Mosby items and derived items © 2010 by Mosby, Inc., an affiliate of Elsevier Inc.
  3. 3. MARs and Distribution Systems: Objectives <ul><li>After reviewing this chapter, you should be </li></ul><ul><li>able to: </li></ul><ul><li>Identify the necessary information that must be transcribed to a Medication Administration Record (MAR) </li></ul><ul><li>Read an MAR and identify medications that are given on a routine basis, including the name of the medication, the dosage, the route, and the time </li></ul>
  4. 4. MARs and Distribution Systems: Objectives (cont’d) <ul><li>Transcribe medication orders to a MAR </li></ul><ul><li>Identify various drug distribution systems </li></ul>
  5. 5. Documentation: 6 th “Right” <ul><li>SPECIAL CONSIDERATIONS to avoid errors: </li></ul><ul><li>TRANSCRIBE CAREFULLY </li></ul><ul><li>Document AFTER med administration </li></ul><ul><li>Document accurately </li></ul><ul><li>Document legibly </li></ul><ul><li>Document timely </li></ul><ul><li>MAR is a legal record </li></ul><ul><li>MAR is verified against orders daily </li></ul>
  6. 6. Essential Information on a MAR <ul><li>Client information </li></ul><ul><ul><li>Name, DOB, medical record #, ALLERGIES </li></ul></ul><ul><li>Dates (when written, start and stop) </li></ul><ul><li>Medication information </li></ul><ul><li>Time of administration </li></ul><ul><li>Initials (transcriber, person giving med) </li></ul><ul><li>Special instructions </li></ul><ul><ul><li>Data such as BP, “Hold if…,” etc. </li></ul></ul><ul><li>Legends—describe abbreviations </li></ul>
  7. 7. Documentation of Meds Administered <ul><li>Complete schedule written </li></ul><ul><li>Initialed in appropriate area by giver </li></ul><ul><li>One-time doses </li></ul><ul><li>PRN doses (may be a different record) </li></ul><ul><li>Refused or held meds (special symbols) </li></ul>
  8. 8. Figure 12-2 Transcription of medication orders to a medication administration record. (Used with permission of St. Barnabas Hospital, Bronx, New York.)
  9. 9. Figure 12-2 Transcription of medication orders to a medication administration record. (Used with permission of St. Barnabas Hospital, Bronx, New York.)
  10. 10. Figure 12-2 Transcription of medication orders to a medication administration record. (Used with permission of St. Barnabas Hospital, Bronx, New York.)
  11. 11. Use of Computers <ul><li>Handwritten transcription and documentation are among most common causes of med errors </li></ul><ul><li>Goal </li></ul><ul><ul><li>Elimination of errors </li></ul></ul><ul><ul><li>Electronic record keeping </li></ul></ul><ul><li>Systems utilize </li></ul><ul><ul><li>CPOE (computer prescriber order entry) </li></ul></ul><ul><ul><li>Electronic MAR </li></ul></ul>
  12. 12. Medication Distribution Systems <ul><li>Unit Dose </li></ul><ul><ul><li>Prepared daily and sent to unit </li></ul></ul><ul><ul><li>Not available for all products </li></ul></ul><ul><li>Computer-Controlled Dispensing </li></ul><ul><ul><li>Automated dispensing system (ADS)—60% of hospitals </li></ul></ul><ul><ul><li>Detailed transaction records </li></ul></ul><ul><ul><li>Linked to pharmacy dispensing system </li></ul></ul><ul><li>Bar-Code Medication Delivery </li></ul><ul><ul><li>Studies show errors reduced by 65%-86% </li></ul></ul>
  13. 13. Figure 12-3 Unit-dose cabinet. (From Clayton BD, Stock YN, Harroun RD: Basic pharmacology for nurses, ed. 14, St. Louis, 2007, Mosby.) Figure 12-4 Pyxis Med Station. (From Clayton BD, Stock YN, Harroun RD: Basic pharmacology for nurses, ed. 14, St. Louis, 2007, Mosby.)
  14. 14. Figure 12-5 Bar code for unit drug dose. (From Kee JL, Marshall SM: Clinical calculations: with applications to general and specialty areas, ed. 6, St. Louis, 2009, Saunders.) Figure 12-6 Bar-code reader. (From Kee JL, Marshall SM: Clinical calculations: with applications to general and specialty areas, ed. 6, St. Louis, 2009, Saunders.)
  15. 15. Advantages and Disadvantages of Technology <ul><li>Advantages </li></ul><ul><ul><li>Improves accuracy and efficiency </li></ul></ul><ul><ul><li>Safeguards the 6 rights (especially Bar-Code) </li></ul></ul><ul><ul><li>Records can be readily accessed </li></ul></ul><ul><li>Disadvantages </li></ul><ul><ul><li>Human component in use of system </li></ul></ul><ul><ul><li>Human component in relying solely on system </li></ul></ul><ul><ul><li>Requires extensive up-front design and use planning </li></ul></ul>
  16. 16. Scheduling Times (Table 12-1)

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