1/17/2016 Winter Nursing Process and Drug Therapy Chapter One Preventing Medication Errors Chapter Six

1/17/2016 Winter

1/17/2016 Winter The Nursing Process in Drug Therapy  Assessment – Drug history  Prescription medications  Non prescription medications Tums, cough drops, laxatives  Social drugs Coffee, tea, alcohol, cola, tobacco  Herbal or dietary supplements Ginkgo, glucosamine  Problems with current medications Explore

1/17/2016 Winter The Nursing Process in Drug Therapy Example: Pt taking Antihypertensive medication every other day rather than daily. Now admitted for hypertensive episode. Example: Pt taking Antihypertensive medication every other day rather than daily. Now admitted for hypertensive episode. Nursing Diagnosis Nursing Diagnosis  Knowledge deficit R/T drug therapy regimen as evidenced by underuse of medication severe hypertension

1/17/2016 Winter The Nursing Process in Drug Therapy  Plan  Establish patient goals Patient will take medication as prescribed  Determine outcome criteria Patient will maintain a blood pressure between 130/80 and 145/92 following two weeks of prescribed therapy  Identify appropriate nursing action Teach patient about medication Instruct patient on how to monitor his own blood pressure

1/17/2016 Winter The Nursing Process in Drug Therapy  Intervention  Patient education Why is patient not taking the medication every day? CostCost Side effectsSide effects ForgettingForgetting Risks of uncontrolled hypertension Better understanding of how medication works Instruction on how to monitor his own Bp

1/17/2016 Winter The Nursing Process in Drug Therapy Evaluation Evaluation  If possible, ALWAYS FOLLOW-UP WITH PATIENT TO REASSESS EFFECTS OF INTERVENTION  COMMUNICATE! Plan further interventions if necessary Plan further interventions if necessary

Patient Safety Medication Errors: Preventing and Responding

1/17/2016 Winter SAFE MEDICATION ADMINISTRATION “SIX” RIGHTS RIGHT MEDICATION RIGHT DOSE RIGHT PATIENT RIGHT TIME RIGHT ROUTE THE RIGHT OF THE PATIENT TO REFUSE THE RIGHT TO INFORMATION ABOUT THE DRUG RIGHT DOCUMENTATION

The RIGHT Medication As the physician prescribed Trade name or generic? Does the drug match the MAR? (medication administration record) Is the drug appropriate for the patient?

The RIGHT Dose Does the dose of medication in your hand agree with the dose on the MAR? Are the mg, mcg, ml the same?

The RIGHT Patient Have you checked using two patient identifiers?  Patient states…verifies BD  Patient armband  Compare Pt. ID number to MAR What if there is no arm band? BCMA

The RIGHT Time AM or PM 24 Hour Clock Q4 Tid Bid Qid qd

The RIGHT Route PO IV SC (SQ) TRANSDERMAL RECTAL IM IN SL DOES IT MAKE SENSE??