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How to Prevent Medication Errors

Medication Errors: What to do?

Medication errors may cause grave patient harm. Effects may range from a simple allergic reaction to death. However, these errors are preventable.

Further, administering medications involve a lot of factors. The form of medication preparation, frequency orders, dosage and site are just a handful. Not to mention the hard-to-recognize, almost-unreadable physician’s handwriting. (No stereotyping intended)

Moreover, good communication is the most basic requisite in order to prevent medication negligence.

To enumerate, here are some of the information nurses have to familiarize in order avoid committing such.


MEDICATION ORDERS – Common Abbreviations Used

ABBREVIATION

MEANING

A.C.

Before Breakfast

Liq.

Liquid

Ad Lib

As Desired

mcg

Microgram

Alt. H.

Alternate Hours

mEq

Milliequivalent

mg

Milligram

A.D.

Right Ear

A.S.

Left Ear

No

Number

For the full list of commonly used medical abbreviations click here.

MEDICINE PREPARATIONS

ORAL MEDICATIONS

Tablets – compressed or molded substances.


Capsules – substances encased in either hard or a soft soluble container or a gelatin shell that dissolves in the stomach.


Powder and granules – finely ground substances that are usually mixed with water or juices.


Troches, lozenges and pastilles – designed to dissolve in the mouth.


Enteric-coated – coated tablets that dissolve in the intestines, rather than the stomach, to decrease gastric irritability. These type of drugs should never be crushed.


Time-release capsules – encased substances that are further enclosed in smaller casings in order to deliver drug dose over an extended period of time.


Sustained-release – these are compounded substances designed to release a drug dosage slowly in order to maintain a steady blood medication level.

INHALANTS

Inhalations – drug administered via nasal or respiratory route for a local or systemic effect.

TOPICAL MEDICATIONS

Powder – it should be dusted lightly on skin.


Ointments – semi-solid substances applied topically.


Liniments – substances that are either mixed with alcohol, oil or a soapy emollient.


Creams – semi-solid substances that are thicker than ointments. It is slowly absorbed through the skin.


Transdermal Patches – contains medication that is absorbed through the skin over an extended period of time.


Suppossitories – gelatinous substances intended to be inserted and dissolved in the rectum or vagina.

SOLUTIONS

Emulsions – a 2-phase system in which one liquid is dispersed in the form of small droplets throughout another liquid.


Nasal Drops – aqueous solutions in the form of drops or sprays.


Gargles


Douches – liquid solutions that functions as a cleansing or antiseptic agent. It may be dispensed in powder form that should be dissolved in warm water.


Opthalmic/Otic Solutions – liquid solutions that are instilled as drops.


Enemas – liquid solutions for rectal instillation.


Moutwash – liquid solutions that may contain alcohol, glycerin, and synthetic sweeteners and surface-active flavoring and coloring agents.


Suspensions – particle or powder substances to be dissolved in water before administration.


Syrups – drug substances dissolved in a sugar liquid.


Elixirs –  solutions that contain water, varying alcohol content and glycerin or other sweeteners.


MEDICATION ORDERS

STAT Order PRN Order Single-dose Order Standing Order
Medications that are given one-time and IMMEDIATELY.

Most commonly used on emergency situations.

Medications to be given on a one-time basis..

Also, this may be given more than once.

Medications to be given one-time only.

Most commonly ordered as a medication prior to a diagnostic procedure or a treatment.

 

Also known as scheduled order.

The order is in effect until the prescriber discontinues, modifies dosage or frequency;

Otherwise, when there is a certain days of medication indicated in the order.

 

PARTS OF MEDICATION ORDER:

  1. Name of patient.
  2. Date and time when the medication was ordered.
  3. Name of drug to be administered, generic name and brand name should be written.
  4. Dosage of drug.
  5. Route of administration and other special directives.
  6. Time and frequency of administration.
  7. Signature of the ordering physician.

ROUTE OF INJECTABLE-MEDICATION ADMINISTRATION

INTRAVENOUS INTRAMUSCULAR SUBCUTANEOUS INTRADERMAL
Use to deliver a more faster systemic drug effect.

Site: Peripheral veins.

Route of choice for irritating substances, suspensions or oil.

Site: Ventrogulteal, dorsogluteal, deltoid, or vastus lateralis for pediatric patients.

Used for small doses of substances that are non-irritating and are water-soluble.

Site: Areas with adequate fat pads such as on abdomen and lateral thighs.

Used for observation of an inflammatory reaction.

Site: On lightly pigmented, lightly keratinized and hairless areas such as on the ventral middle forearm.


10 RIGHTS OF MEDICATION

  1. Patient
  2. Assessment
  3. Medication
  4. Documentation
  5. Drug Dosage
  6. Right of the Patient to Refuse
  7. Time
  8. Route
  9. Evaluation
  10. Right of the Patient to Proper Medication Education

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References:

  • Dr. Carl Balita’s Ultimate Guide to Nursing Review

 

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