hard copy ( meet Medicaid tamper system requirement )

category 1 : copy resistant : void/illegal/copy background pantograph with or without Reverse RX ---- Microprint signature line by electronic medical record

category 2 : Erasure or modification resistant -

category 3 : counterfeit resistant - quantity check off box and refill indicator

Verbal order (chemotherapy , look like drugs , complex drugs aren't permitted)

Fax

it is required whenever patients are admitted , transfer from one care to another, when they are discharged

five rights : right patient , right medication , right route , right dose , right time

Key elements : Collection and verification of medication history , profile development , transfer reconciliation , discharge reconciliation,

it is required whenever patients are admitted , transfer from one care to another, when they are discharged

five rights : right patient , right medication , right route , right dose , right time

Key elements : Collection and verification of medication history , profile development , transfer reconciliation , discharge reconciliation,

Ordering and Prescribing :)

Transcribing and documenting

Dispensing

administering

Monitoring

it is an  organization that looks for the root cause of an error .

it defines three behaviors : Human error, at risk behavior, reckless behavior

incorporating edication error reducation into a strategic plan

( define its strengths , barriers , within barriers define their risks , potential solutions, cost , and timeline)

Promoting medication error reporting systems

near miss event : a potential error identified before reacing a patient

establishing medication error committee

using technology

computerized prescriber order entry ( CPOE)

Bar code administeration

Electronic medication administeration records

automated dispensing cabinets

robotics

decenteralized practice model( a pharmacist can intervene at the point of ordering and prescribing)

eliminating abbreviations

creating a high alert risk drug list

addressing illegible handwriting

Medication trigger tools

diphenhydramine , naloxone , vit K

clinical alerts , notify health care provider of sudden changes in lab values , medications, potential drug interaction to monitor and reduce the likelihood of any adverse outcome.

inpatient centralized

floor stock distribution

unit dose distribution

cart delivery

inpatient decentralized

blended or hybrid

PDSA cycle  ( plan-do-study-act)

Failure mode effect analysis(FMEA)

establish severity ( 1 no danger ,10 (critical danger ) , occurence  score (1 low frequency , 10 hig frequency ).detection scores (1 high like to detect)

root cause analysis