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Researchers at the University of Sydney studied 98 nurses while they prepared and administered medications to more than 4,000 patients between September 2006 and March 2008. The study authors point out that the risk for major errors increased significantly the more that nurses were interrupted.
Whatever the potential solution, the authors say that this is indeed a problem, and one that requires additional research to solve.
5 Things You Should Know About Chicken Pox and Shingles6 Breathing Exercises to Relax in 10 Minutes or Less13 Reasons Tea Is Good for You10 Ways to Build Healthy Bones (and Keep Them Strong)It’s True. A young woman given heart medication instead of the anti-depressant pills she needed suffered worse depression as a result. She was given the heart medication Duride, which is used to treat angina, rather than the anti-depressant fluoxetine. Over almost three months, her mood worsened, she struggled to find work and lost a key relationship.
A woman was given the wrong drug, the wrong dosage and incorrectly labelled medication because of a series of mistakes by two pharmacists. A GP and a District Health Board have been heavily criticised for the delay in specialist treatment for a man with rectal bleeding who died of advanced bowel cancer. The Waikato District Health Board has been criticised over the way it administered paracetamol to a frail, elderly woman who subsequently died. An elderly woman with dementia died after being given four times the prescribed dose of an anti-psychotic drug. A woman was not told for a month of a medical mishap that left her eye permanently damaged. There are five stages of drug addiction: Experimental, Occasional, Regular, Abuse and Addiction.
Stimulants produce feelings of euphoria along with an adrenalin rush which is then followed by a crash. Heroin is an extract of the Opium Poppy, a white or off-white powder which can be snorted, swallowed, injected and smoked. Worldwide, between eighty-thousand and a hundred-thousand kids start smoking each day according to a study conducted by TNT. Your body builds up a resistance to nicotine over a long period of time and it will no longer have the same effect as what it had in the beginning. It is a vicious cycle, the body gets used to the drug and then you progress to the next drug, the stronger drug, and it spirals out of control. Incidence and preventability of adverse drug events among older adults in the ambulatory setting.
The costs associated with adverse drug events among older adults in the ambulatory setting.
But when you’re interrupted while measuring medication for patients, the consequences can be more dire—as patient safety advocates point out, some 200,000 people die each year from medical mistakes and preventable infections. For a total of 505 hours during this period, investigators noted any interruptions that nurses encountered while dealing with medication, and also tracked two types of mistakes: procedural, which included things like not reading medication labels or failing to fully read a patient chart, and clinical, which included actually giving patients the wrong dose or wrong medication. They also suggest that reconsidering how the physical space of a hospital ward is organized could play a role in reducing errors. It is an ever growing industry which does not only destroy lives, but also has a negative impact on a country’s economy. It comes as small squares of paper, saturated with this liquid, are sold and it is usually placed under the tongue or swallowed.
It can cause neurological disorders such as depression, bipolar, psychosis and schizophrenia. More than half of these events occurred because of a lack of drug information at the time of prescribing.4Maintain drug references. Do not store drugs with look-alike names or similar packaging in close proximity to each other in the medication storage area, exam medication storage area, exam rooms or sample closet. All liquid oral medications prescribed or dispensed in the office should be administered using a proper measuring device. The key concepts in all of these strategies are to simplify and to standardize your systems related to medications.



A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. Perhaps it’s not surprising then that, in addition to issues like miscommunication during hospital hand-offs or lack of sleep increasing preventable errors, distractions can have a negative impact as well. For all administrations of medication studied, researchers noted that fewer than one fifth of cases were mistake-free.
To help ensure that the right patient receives the right medication, instruct your staff to use at least two patient-specific identifiers, such as the patient's name and date of birth, when administering medications. It is unrealistic to expect any physician can be conversant on the tens of thousands of prescription and over-the-counter medications on the market. This encourages all physicians and staff to be vigilant and to detect and act on potential error signals, rather than dismissing them.
The use of parenteral syringes to administer oral medications, a common but dangerous practice, has resulted in aspiration of the syringe tips when they are not removed.
In some cases, you may be able to determine that a patient has low health literacy simply by the way he or she fills out the new patient questionnaire or other forms in your practice. Using this article as your guide, assess how well your office is currently doing at following known safe practices. While it does take effort, it doesn't necessarily involve a large financial investment, and it will improve the way your practice functions and the level of safety you can offer your patients. Vaida is executive vice president for the Institute for Safe Medication Practices, based in Huntingdon Valley, Pa. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. A new study published this week in the Archives of Internal Medicine finds that, perhaps unsurprisingly, when interrupted while dosing out medication, nurses are more likely to make mistakes. Nurses were interrupted more than half the time (53%), and researchers noted procedural errors in nearly three quarters (74.4%) of administrations, and clinical errors in a quarter of all cases. While on a hallucinogen trip, a user may experience a combination of emotions, rapidly changing from one to another. Smoking of cigarettes is a common method used by teenagers to reduce stress levels and relax the smoker. To help decrease risk to patients, make sure that all staff members who prescribe, dispense, administer or provide patient education on medications have easy access to current drug information and other decision support resources.
Physicians can model this behavior simply by asking their nurses, medical assistants and others for input and by sharing information with other team members on a regular basis.Improve your handwriting. This assessment process should allow all team members to share information openly and honestly.
Inhalants such as hairspray, deodorant and glue are considered as depressants because they produce the same effect. Hallucination occurs and users may experience mixed senses such as seeing sounds and hearing colours.
Nicotine, the substance that makes smoking addictive, is a stimulant with similar effects to cocaine. This article will focus on simple, low-cost strategies for safe medication use that can be incorporated into office-based practice.
A 1979 study estimated that one-third of physicians' handwriting was illegible.6 Presumably little has changed over the years. ISMP has reported on several mix-ups with PPD being given in place of vaccines and vice versa.Separate external solutions, non-drug items, testing solutions, reagents and chemicals from internal products. All office personnel who dispense or prescribe any device (multiple daily injection devices, glucose monitoring devices, etc.) should be educated on its use. It is possible to accomplish this assessment in approximately three minutes during the initial intake evaluation of a patient.
The tool was developed by ISMP, the Medical Group Management Association and the Health Research and Educational Trust.Make it easy to learn from errors. Written medication guidelines that outline the correct dosages, contraindications, precautions and other critical information for frequently prescribed medications can be invaluable.
The FDA and ISMP in July 2006 embarked on a joint campaign to eliminate the use of potentially confusing abbreviations, symbols and dose designations in various forms of medical communication.


Designate a staff member to routinely check (at least quarterly) all medications (including samples), reagents and other products that carry an expiration date and discard any that have expired. Your staff should feel comfortable disclosing information on errors that have occurred, discussing unsafe practices and sharing external reports on medication errors.
These abbreviations, symbols and dose designations have proven to be a barrier to effective communication and have resulted in significant harm to patients.
The storage area should be maintained at temperatures between 57 and 84 degrees, it should not be cramped, shelves should be at eye level with labels facing forward, and the area should be well lit making it less likely the staff will misread labels.Control access to medications. Patients should be given both oral and written instructions on the use of their medications, and they or their caregivers should be asked to repeat back the information to demonstrate complete understanding.
Make sure you have a system in place for reporting errors, and make it clear to your staff that errors will be considered opportunities for education, not punishment.
While it may seem unnecessary, prescribers need to stress to patients the importance of getting the prescription filled and taking the medication as ordered.
When errors or near misses take place, include all clinicians and non-clinical personnel in educational efforts, rather than including only those involved in the event.Look for system changes that will help prevent future errors. Four important diagnoses have a significant impact on medication selection, dosing and frequency. High-alert medications are those that have a propensity to cause serious patient harm when used in error.
In addition, your practice should have strict procedures for logging, storing and monitoring drug samples.
Office personnel should share past experiences and follow the literature for errors that have been reported in articles or case presentations.
They include warfarin, low-molecular-weight heparins, insulin and oral agents for diabetes, opiates and methotrexate. Many, if not all, of these drugs with similar names carry different indications for use; therefore, including the indication with the medication can reduce confusion. All medications dispensed to patients should be properly labeled with the name of the medication, strength, dose, frequency, purpose, lot number, expiration date and quantity of medication, along with the patient's name, date of dispensing and prescribing, and prescribing information. Many patients may not have insurance or their co-pays may be excessive, which may affect whether they fill their medications. The prescription pad shown in this article contains check boxes for common indication categories that can help communicate the purpose of the medication being prescribed. A current medication profile listed in a standard prominent location on each patient's chart can be an important safety measure.
This should be updated at each visit and should include a reminder to ask not only about prescription drugs but also over-the-counter medications, herbal medicines, supplements and vitamins.
For example, in the following prescription the drug name Avandia was incorrectly interpreted as Coumadin.INCLUDING THE INDICATIONIncluding a drug's indication on the prescription is a simple safety measure. Structure the medication list to require that the drug, dose, route, frequency and purpose be recorded for each medication, herbal or vitamin.Standardize height and weight measurements. The indication, whether hand-written or communicated via check boxes, helps pharmacists and others avoid confusion between look-alike drug names.
ISMP recommends that health care professionals record information in metric units, which are commonly used in medication labeling and package inserts, as a way to standardize measurement. Orders given verbally, rather than in written form, are inherently problematic because of different dialects and accents, misinterpretations of names and strengths, etc.
Electronic prescribing systems can produce computer-generated prescriptions or can electronically transmit the prescription directly to the pharmacy. The technical aspects of implementing and using an e-prescribing system are beyond the scope of this article, but they are worth investigation.



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