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ASSESSMENT:
+complete planning for pt care + assessment/interventions/evaluations of results
+complete history/ all medical conditions allergies, all other meds
+vitals, posture, skin temp/color, facial expression before and after drug admin
INTERVENTIONS:
+judgment in timing, d/c med if required
+take steps to counteract adverse reactions
+knowing what/when to report to phys
EVALUATION/DOCUMENTATION of results:
+plays vital role for all hcp in planning effective drug therapy
***GOAL***
maximize effectiveness of drug with least discomfort to pt
be sensitive to unique needs of each pt
+for pt to benefit from drug therapy..must understand importance of proper dosage, time, route
+in language they understand both verbal and written and demonstrations of technique
+if med admin requires extra equipment or has multiple steps, return demonstration required
MEDICATION ERRORS:
-most errors reported from acute care setting where risk is greatest
-in outpt: often older adults/likely to have several chronic conditions requiring multiple meds
**more meds= increase risk of interactions/adverse side effects/error
1.wrong pt
2.wrong drug/form
3.wrong route
4.wrong time
5.wrong dosage
6.wrong documentationimproperly documenting drug admin info on pt’s medical record
+must report error immediately to person in charge so corrective action can be taken for pt’s welfare
+pt’s record should reflect corrective action taken for justification in case of legal proceedings
+incident report legal requirement
+failure to report errors may jeopardize pt’s welfare/ increase possibility of lawsuit again hcp/loss of
license or certificate
HCP responsible for quality care/pt safety-prevention of errors, and reporting med errors
USP established Medication Errors Reporting (MER) program
Agency for Healthcare Research and Quality has federally certified Institute for Safe Medication
Practices (ISMP) as Patient Safety Organization (PSO) to operate national error reporting program for
both vaccine and medication errors
-Medication reconciliation: method used to compare meds pt taking to meds ordered by pt’s physician
+comparision done everytime change in pt’s care when pt is admitted, transferred, or discharged
+done to prevent errors caused by omissions, duplications, errors in doses, medication interactions
PRINCIPLE OF ADMIN:
Advantage of NG tube:
+ability to bypass mouth/pharynx
+elimination of numerous injections
Disadvantage of NG tube:
+with conscious ptdiscomfort of tube in nose/throat for prolonged periods of time
+when pt unable to take nourishment by mouth for long period, surgeon will insert gastric tube through
skin of abdomen, directly into stomach (G-tube or PEG tube) secured in place and can remain there for
feeding purposes indefinitely
disadvantage: unavailability
+difficulty retaining suppositories (older adults/children)
+prolonged use can cause rectal irritation (bisacodyl)
+absorption irreg or incomplete if feces are present