Nursing Syllabus

2. INTRODUCTION
A medication error is any preventable event that may cause or
lead to inappropriate medication use or patient harm while the
medication is in the control of the health care professional,
patient, or consumer.

3. Such events may be related
• Professional practice
• Health care products
• Procedures and systems
• Product labeling, packaging.
• Administration
• Education
• Monitoring etc.

4. TYPES OF MEDICATION ERRORS
Medication errors can occur anywhere along the route, from
the clinician who prescribes the medication to the healthcare
professional who administers the medication.

5. TYPES OF MEDICATION ERROR
1. Prescribing error
2. Omission error
3. Wrong time error
4. Improper dosing error
5. Wrong dose error
6. Wrong route error
7. Wrong drug preparation
8. Lack or communication error

6. 1. Prescribing error
• Prescribing errors, wherein the selection of a
drug is incorrect based on the patient's
allergies or other indications.
• Additionally, the wrong dose, form, quantity,
route (oral vs intravenous), concentration, or
rate of admission could be used.

7. 2. Omission error
• Omission errors, in which there is
a failure to give a medication dose
before the next one is scheduled.

8. 3. Wrong time errors
• Wrong time errors, wherein a medication
is given outside the predetermined
interval from its scheduled time.

9. 4. Improper dosing error
• Improper dosing errors, wherein a
greater or lesser amount of a
medication is delivered than is
required to manage the patient's
condition.

10. 5. Wrong dose error
• Wrong dose errors, wherein the correct dosage
was prescribed, but the wrong dose was
administered.

11. 6. Wrong route error
Improper administration technique errors ,
such as administering a medication
intravenously instead of orally.

12. 7. Wrong drug preparation
• Wrong drug preparation errors,
wherein a medication is incorrectly
formulated (i.e. too much or too little
diluting solution added when a
medication is reconstituted).

13. 8. Lack or communication error
• Fragmented care errors, wherein a
lack of communication exists between
the prescribing physician and other
healthcare professionals.

15. CUASE OF MEDICATION ERRORS
1. Distraction
2. Environment
3. Lack of knowledge/Understanding
4. Incomplete patient information
5. Memory Lapse
6. Systemic problem

16. Distraction
• A nurse who is distracted may read
"diazepam" as "diltiazem.“
• The outcome is not insignificant-if
diazepam is accidentally administered, it
could sedate the patient, or worse (e.g ., if
the patient has an allergy to the drug).

17. Environment
• A nurse who is chronically overworked
can make medication errors out of
exhaustion.
• Additionally, lack of proper lighting,
heat/cold, and other environmental factors
can cause distractions that lead to errors.

18. Lack of knowledge/Understanding
• Nurse who lack complete knowledge about
how a drug works,its various name
(generic,brand name), its side effects, its
contraindication, etc can make errors.

19. Incomplete patient information
• Lacking information about which medications
a patient is allergic to, other medication the
patient is taking, previous diagnosis, or current
lab results can all lead to errors.
• Nurses who aren't sure should always ask the
physician or crosscheck with another nurse.

20. Memory Lapse
• A nurse may know that a patient is allergic, but
forget.
• This is often caused by distractions. Forgetting to
specify a maximum daily dose for an "as
required" drug is another example of a memory-
based error.

21. Systemic problem
• Medications that aren't properly labelled,
medications with similar names placed in
close proximity to one another, lack of bar
code scanning system, and other issues can
lead to medical errors.

22. Preventing Medication
Errors

23. Know the patient
• This includes the patient's name, age, date
of birth, weight, vital signs, allergies,
diagnosis, and current lab results.
• Avoid shortcuts.

24. Know the drug
• Nurses need access to accurate, current, readily
available drug information, whether the information
comes from computerized drug information systems,
order sets, text references, or patient profiles.
• If you have any questions or concerns about a drug, don't ignore your
instincts-ask.
• Remember that you are still culpable, even if the physician prescribed the
wrong medication, the wrong dose, the wrong frequency, etc.

25. Keep line of communication open
• Breakdowns in communication among
physicians, nurses, pharmacists, and others in
the healthcare system can lead to medication
errors.

26. Document each drug administered
Accurate documentation is essential and should
include accurate recording of the drug
information, the name of the drug, the dose,
route, time, patient response, and any refusal of
the drug by the patient.

27. Take an active role in correcting issues you
identify
EXAMPLE-
• If you see that look-alike or sound-alike
(LASA) medications are stored next to each
other, ask your supervisor to correct the
problem, emphasizing the increased risk of
medication errors.

28. Consequences of errors
Medication errors can have serious and
costly consequences, such as increased
patient lengths of stay, additional medical
interventions, serious harm, or even death.

29. CARE OF
MEDICINE
AND
MEDICINE
CUPBOARD

30. CARE OF MEDICINE AND MEDICINE CUPBOARD
• All the medicines and drugs must be checked as they are
received from the dispensary.
• Dangerous drugs are given by special order and every dose
should be accurate.
• Medicine cupboard should be kept in room, near to the ward.

31. • All high alert drugs must be kept separately in a separate cupboard
and it must be kept locked and the keys should be with ward sister.
• Medicine for external use should be kept in a separate part of the
cupboard.
• The cupboard should be kept in well lighted
and high alert drugs should be clearly labelled.
CARE OF MEDICINE AND MEDICINE CUPBOARD

32. • There should be separate compartment
for mixture, tablets, powders, etc.
• The container should be arranged
alphabetically so that it is easy to find
them
• A register should be maintained to keep
the account of the dangerous drugs.
CARE OF MEDICINE AND MEDICINE CUPBOARD

33. • Check the expiry date of every drug
and make use of it before its expiry
date.
• Emergency drugs should be kept in a
place where they are easily obtained
for emergency use.
CARE OF MEDICINE AND MEDICINE CUPBOARD

35. NARCOTIC DRUGS
• The nurse must know the law about the use of narcotics drugs.
• These drugs should be kept in a separate cupboard and locked.
• The key should be with the ward senior or senior nurse incharge on duty.
• A special register should be maintained for narcotic drugs.
• Proper documentation should be done about the patient, nurse, doctor who
ordered narcotic drug and dosage.
• The narcotic drug should be stocked only person/institution who have licensed
to do so.