Module: Pharmacy Professional Skills Coordinator: Dr. Arwa M. Amin Mostafa Academic Level: Undergraduate, B.Pharmacy School: Dubai Pharmacy College Year of first presented in Class: 2018 This presentation is for Educational purpose. It has no commercial value associated with it.

1. PHARMACIST ROLE IN PATIENT
SAFETY
ARWA M. AMIN MOSTAFA
PHD, M.PHARM CLINICAL PHARMACY, DIP MANGT, B.PHARM.

2. WHAT WE WILL DISCUSS TODAY?
•Patient Safety
•Medication Errors
•How Pharmacist can reduce Medications Errors
•Medications Reconciliation
•Organizational Strategies to Reduce Medications Errors

3. PATIENT’S SAFETY
•Patient safety is a health-care principle which focus on
preventing habitual harm to the patient during the health-care
process
•Pharmacist as a Health care professional plays vital Role in
Ensuring patient’s safety and preventing and reducing
Medications Errors.
•What are Medications Errors ???

4. MEDICATION ERRORS
•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.*
•This can be related to professional practice, health care
Products, procedures, and Systems.*
*National Coordination Council of Medication Error Reporting and Preventing: http://www.nccmerp.org/about-medication-errors

5. Prescribing
Errors
Dispensing
Errors
Administration
Errors
TYPES OF MEDICATION ERRORS

6. TYPES OF MEDICATION ERRORS
•Prescribing Errors
•Inappropriate Drug selection
• Contraindicated for the patient (e.g. Pregnancy, Asthma, CKD)
•Inappropriate Drug Dose
• Miscalculation of the dose
•Prescribed Drug without an indication
•Missing to prescribe a drug for a present indication

7. TYPES OF MEDICATION ERRORS
•Prescribing Errors .. Cont.
• Duplication of Drug/Class
• Different brands with the same drug
• Different Drugs from the same class
• Prescription Writing Errors
• Handwriting errors: Un-clear prescription
• Use of Abbreviation
• 20U → Patient given 200 U instead
• Bt (Bed time) → BID twice daily

8. TYPES OF MEDICATION ERRORS
•Dispensing Errors
• Dispensing Wrong Drug
• Wrong drug dispensed to wrong patient
• Incorrect Drug Strength
• Dispensing of Higher or lower strength of the drug
• Incorrect Dose
• Incorrect Drug frequency
• Incorrect Labeling
• Improper Drug / Device counseling

9. TYPES OF MEDICATION ERRORS
•Administration Errors
• Mostly involves Nurses, Patients and caregivers
• Wrong drug given to wrong patient
• Incorrect Drug timing
• Incorrect drug dose
• Incorrect drug concentration (IV solution).
• Incorrect Infusion Rate
• Incorrect Drug administration technique
• Incorrect Use of Device

10. THE FIVE RIGHTS OF DRUG ADMINISTRATION
•Right Patient
•Right Drug
•Right Dose
•Right Time
•Right Route and Technique

11. HOW PHARMACIST CAN REDUCE MEDICATIONS ERRORS
AND IMPROVE PATIENT SAFETY?

12. HOW PHARMACIST CAN REDUCE MEDICATIONS ERRORS?
•Read Prescriptions/Medications Orders carefully
(check patient’s name, prescribed medicines,
drug names, dosages and frequencies).
•Pay more attention to special groups
prescriptions (Pregnancy, Children, CKD,
elderly).
• Ask Colleague or senior to countercheck your
prepared medications before dispensing

13. HOW PHARMACIST CAN REDUCE MEDICATIONS ERRORS?
•Proper patients counselling is a Key factor
in preventing Dispensing Errors
•Never to dispense Medications without
counselling the Patient or the caregiver
• Ask the Patient (Name, History …)
• Counsel the patient
• Ensure that the patient was educated perfectly

14. HOW PHARMACIST CAN REDUCE MEDICATIONS ERRORS?
•Call the prescribing doctor to get clarification
on uncertainties and ambiguous contents of
the prescription (Abbreviations, decimals ..).
•Don’t Guess!
•Calling to Confirm is better than guessing!

16. HOW PHARMACIST CAN REDUCE MEDICATIONS ERRORS?
•Use online drug information resources for quick
access of drug information
• Side effects, drug safety warning and drug-drug
interactions.
•Check thoroughly prescriptions containing high alert
Medication
• High Alert Medications are medications which if used in
error they can lead to significant harm to the patient.

17. HIGH ALERT MEDICATIONS
Examples of High Alert Medications:
• Concentrated Potassium Chloride for Injection
• Chemotherapeutic Medications
• Anaesthetic Medications (e.g. Propofol)
• Insulins (dispensing short acting insulin instead of basal insulin)
• Oral Hypoglycaemic drugs
• Inotropic IV Medications (e.g. Digoxin IV)
• Anticoagulants (e.g. Warfarin)

18. HOW PHARMACIST CAN REDUCE MEDICATIONS ERRORS?
•Organize Your Pharmacy
•Store Look-alike Medications in different shelves
•Place Concentrated intravenous (IV) solutions in
a different place from ready to use IV fluids.
•Make Shelves with different colours or put Red
colour tape on high alert medications shelf
•Place Narcotic and controlled drugs in separate
cabinet

19. HOW PHARMACIST CAN REDUCE MEDICATIONS ERRORS?
•Train Pharmacy staff on well Known scenarios of
Dispensing Errors
• Different concentrations of the medications
• Look alike and sound alike medications
• Decimals Errors
•Reduce Stress and High workload inside the Pharmacy
• High work load and stress were associated with higher
incidence of Medication Errors

21. MEDICATION RECONCILIATION
• Medication Errors may result from insufficient or missing information
about co-prescribed medications, laboratory values and allergic
sensitivities.
• Implementing Medication Reconciliation List can prevent such errors.
• Medication reconciliation is the process of creating the most accurate
list possible of all medications a patient is taking at all patient
transition points

22. MEDICATION RECONCILIATION
• Medication Reconciliation List aims:
• To prevent medication errors and adverse drug reaction
• To provide the correct medications to the patient
• The Medications Reconciliation list should include Drug name, dosage,
frequency, and route
• The Medications list should be compared against the physician’s
admission, transfer, and/or discharge orders
Video: Medication Reconciliation
https://www.youtube.com/watch?v=64rsSN5CZ7s

23. MEDICATION RECONCILIATION
Medication Reconciliation
1- Patient at home
On medications
for Chronic
conditions
2- Patient transferred
to ER
(medications order)
3- Patient admitted to ICU
(medications order)
4- Patient transferred
to the ward
(medications order)
5- Patient
Discharged
(medications order)

24. MEDICATION RECONCILIATION
•What should the pharmacist do In Medication Reconciliation?
•Ask the patient about what medications they have been taking
before admission to the hospital
• What is each medication for?
• What is the dose of the medication he/she is taking?
• How he/she use the medications?
• Is the patient adherent to his medications?
• What are other supplements / home-remedies the patient is using at
home?

25. MEDICATION RECONCILIATION
VIDEOS
Health Coaching (Medication Reconciliation): Techniques to
Deliver Patient Centered Care
https://www.youtube.com/watch?v=3UpzjkL_aYU

26. ORGANIZATIONAL STRATEGIES TO REDUCE ME
•Organizational strategies that help to
reduce Medication Errors
•Encouraging and Rewarding reporting of
Medication errors (Incentives)
•Reviewing events to identify ME causes
•Implementing changes to prevent future errors.
•Building Trust and proper coordination among
staff