Medication Guidelines to Be Used in Healthcare Sector

Welcome to today's lecture on drug calculation. Accurate drug calculation is an essential skill for all healthcare professionals, ensuring that patients receive the correct dosage of medication. This skill is critical in preventing medication errors, which can have serious consequences for patient safety.

In this lecture, we will cover the fundamental principles of drug calculation, including understanding different measurement units, converting between units, and calculating dosages for various forms of medication administration. We will also discuss common pitfalls and strategies to avoid errors in drug calculation.

By the end of this session, you will be equipped with the knowledge and confidence to perform drug calculations accurately and efficiently, thereby enhancing the safety and effectiveness of the care you provide to your patients.

1. Medication guidelines Nemer Tawbeh, EL Housseiny Fatmé Staff development coordinators

2. Objectives : By the end of this lecture you will be able to : Identify general guidelines to handle and administer medications safely . Define medication error Implement correct procedure of reporting in case of medication error according to SGH policies 13/12/2012

3. Outlines: Five rights Ten rights Before administration Preparation / Administration Post administration General rules. Medication error: Definition Reporting Management 13/12/2012

4. Five rights Right Patient Right Medication Right Dosage Right Route Right Time 13/12/2012

5. Ten rights Right Documentation. Right Education. Right to Refuse. Right Assessment. Right Evaluation RIGHT EXPIRY DATE 13/12/2012

6. Before administration Review medication order and medication sheet at least once at the beginning of duty for: complete clear order, correct carrying all doses are signed clear and complete notes. Never administer a medication without full information concerning: Medication family, Indication, Nursing considerations: dilution, rate, stability, side effects, patient’s observations… 13/12/2012

7. Before administration (cont.) Patient assessment : patent IV, patient available in adequate position , patient condition, V/S if needed, … Check 5 rights + expiry date. Always prepare medication labels including 5 rights. ( min. pt name, med name and dose) . Prepare your work area: wipe the preparation space, prepare all needed supplies: syringes, swabs, cotton, 13/12/2012

8. Preparation/ Administration : Respect aseptic technique measures :wash your hands, keep syringes sterile, use clean disposable cups for po meds,… Discard used supplies in appropriate receptacles: sharps in needle box ,…. Correctly identify patient directly before administration. Re-check 5 rights. Provide patient with adequate education . 13/12/2012

9. Post administration Wash your hands. Directly document the administration: clear initials and key, recheck 5 rights, …. Dangerous drugs requiring double checking and double signature are mentioned on the medication sheet. All calculations required for administration shall be done and separately double checked and co signed before the administration. 13/12/2012

10. Post administration (cont.) In case of any comments (medication not given for any reason,..) a clear and dated note should be clearly written and signed. Always flush microdrips after IV medication administration (un flushed lines implies medication dose error). Evaluate the patient for side effects 13/12/2012

11. General rules Never administer a medication prepared by another staff. Never use a medication with unclear labeling. Respect drugs stability (diluents, temperature, time,…)- refer to the pharmacist if any doubt. In multi dose vials, keep the remaining dose in medications’ fridge, labeled with the following: Date and time Diluent: volume and nature Initials 13/12/2012

12. General rules (cont.) No need to cover the vials with antiseptic swab. Never leave medications at bed side. For patient’s personal medications (not available, financial issues) : Ensure a medical order. Get pharmacy approval. Keep the medication at the medication carriage. Administer by nurse. Do not forget to give it back to the patient before discharge. 13/12/2012

13. General rules (cont.) Note that all kind of: creams, gels, suppositories, .. Are “medications”, requiring medical orders and should be administered exclusively by RNs. 13/12/2012

14. Medication error 13/12/2012

15. Definition “ 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 health professional , patient or consumer “ US National Council for Medication Error 13/12/2012

16. Reporting : Anyone who discover a medication error is allowed to report it in appropriate channel. The reporting is done on “medication form (NUR-83) and is anonymous and blame free . The report is filled and submitted to the nursing supervisor on duty. 13/12/2012

17. Report management: The supervisor investigate the error and recommend the appropriate management and send it to the pharmacist in charge. The pharmacist review the accident, sign the form, and participate to the management, and send it back to nursing supervisor. The supervisor send the report to Quality Department . 13/12/2012

18. Questions??? 13/12/2012