Dr. Mahira Maideen discusses medication errors and the 10 rights of medication safety. Medication errors are preventable events that may harm patients and are defined as any error in prescribing, dispensing, or administering drugs. Common errors include wrong drug, dose, time, and patient. The 10 rights of medication safety are: right patient, right drug, right dose, right time, right route, right education, right to refuse, right assessment, right evaluation, and right documentation. Following these 10 rights can help prevent medication errors.
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4. DEFINITION
“ A medication error is a 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.”
4Dr. Mahira Maideen, Pharm D
5. NCCMERP CATEGORY OF ERRORS
A B C D E F G H I
No error
A Circumstances or events that have the capacity to
cause error
Error, no harm
B An error occurred, but the medication did not
reach the patient
C An error occurred that reached the patient but did
not cause patient harm
D An error occurred that resulted in the need for
increased patient monitoring but no patient harm
5Dr. Mahira Maideen, Pharm D
6. Error, harm
E An error occurred that resulted in the need for
treatment or intervention and caused temporary
patient harm
F An error occurred that resulted in initial or
prolonged hospitalization and caused temporary
patient harm
G An error occurred that resulted in permanent
patient harm
H An error occurred that resulted in a near-death event
(e.g., anaphylaxis, cardiac arrest)
Error, death
I An error occurred that resulted in patient death
6Dr. Mahira Maideen, Pharm D
7. DEFINITION
• Medication errors, defined as any error in the
prescribing, dispensing or administration of a
drug whether there are adverse consequences
or not .
7Dr. Mahira Maideen, Pharm D
9. PRESCRIBING ERRORS
• Wrong drug
• Wrong dose
• Wrong time
• Wrong indication
• Illegible handwriting
• Drug name confusion
• Inappropriate use of decimal points
9Dr. Mahira Maideen, Pharm D
18. • Perform a triple check of the medication’s
label
1. When retrieving the medication.
2. When preparing the medication.
3. Before administering medication to patient.
• Always check the medication label with the
physician’s orders.
• Never administer medication prepared by
another person
• Never administer medication that is not
labeled.
18Dr. Mahira Maideen, Pharm D
20. • Check label for medication concentration.
• Compare prepared dose with medication
order.
• Triple all medication calculations.
• Check all medication calculations with another
nurse.
• Verify that dosage is within appropriate dose
range for patient and medication.
20Dr. Mahira Maideen, Pharm D
23. • Verify schedule of medication with order.
1. Date
2. Time
3. Specified period of time
• Check last dose of medication given to
patient.
• Administer medication within 30 minutes of
schedule.
23Dr. Mahira Maideen, Pharm D
25. • Verify medication route with medication order
before administering.
• Medication may only be administered via
route specified in order.
25Dr. Mahira Maideen, Pharm D
27. • Inform patient of medication being
administered.
• Inform patient of desired effects of medication.
• Ask patient if they have any known allergies to
medication.
27Dr. Mahira Maideen, Pharm D
29. • The legally responsible party (patient, parent,
family member, guardian, etc.) for patient’s
care has the right to refuse any medication.
• Inform responsible party of consequences of
refusing medication.
• Verify that responsible party understands all
of these consequences.
• Notify physician that ordered medication and
document notification.
• Document refusal of medication and that
responsible party understands consequences.
29Dr. Mahira Maideen, Pharm D
31. • Properly assess patient and tests to determine
if medication is safe and appropriate.
• If deemed unsafe or inappropriate, notify
ordering physician and document notification.
• Document that medication was not
administered and the reason that dose was
skipped.
31Dr. Mahira Maideen, Pharm D
33. • Assess patient for any adverse side effects.
• Assess patient for effectiveness of medication.
• Compare patient’s prior status with post
medication status.
• Document patient’s response to medication
33Dr. Mahira Maideen, Pharm D
35. • Never document before medication is
administered.
• Document
1. Medication
2. Dosage
3. Route
4. Date and Time
5. Signature and credentials
35Dr. Mahira Maideen, Pharm D
36. Keep these tips in mind:
• Have the patient’s chart available when calling the
prescriber, and write down the order while you’re
still on the phone.
• Verify the patient’s name.
• Read back and confirm the medication. If you’re
unfamiliar with the drug, ask the prescriber to
spell the drug name.
36Dr. Mahira Maideen, Pharm D
37. • Confirm the medication dosage by stating each
number individually.
• To help prevent sound-alike errors, verify with
the prescriber the condition that the medication
is being used to treat.
37Dr. Mahira Maideen, Pharm D
38. • Having the prescription, the drug and the
patient in the same place so they can be
checked against one another.
• To prevent Transcribing errors: Double checks
and documentation.
38Dr. Mahira Maideen, Pharm D
39. • Focus on one patient at a time.
• Engage patient or family member in
medication administration process.
• Minimizing interruptions during drug rounds.
39Dr. Mahira Maideen, Pharm D
40. Nutshell……
10 RIGHTZZZZ….
RIGHT PATIENT
RIGHT DRUG
RIGHT DOSE
RIGHT TIME
RIGHT ROUTE
RIGHT EDUCATION
RIGHT TO REFUSE
RIGHT ASSESSMENT
RIGHT EVALUATION
RIGHT DOCUMENTATION
40Dr. Mahira Maideen, Pharm D
41. As a responsible Healthcare professional,
“I will follow the 10 RIGHTS of medication
safety”
41Dr. Mahira Maideen, Pharm D
