Pharmacology for Nursing Care

a. Provide an analysis of the drug administration process used in your facility.

b. Identify any potential issues in the system in which a mistake could be made.

c. What strategies could a RN use to prevent such drug errors? (20 points)

When the patient is admitted to acute rehabilitation and physical therapy, the patient will arrives with a packet with transport service that contains a typed med reconciliation from their discharging location. The nurse may manually enter (typing each drug name, each dose, route, times and special instructions) all these drugs as “home meds” into MEDITECH system. This may cause confusion as the drugs may not necessarily be the home meds the patient was taking at home before their hospital admittance, just their newly prescribed hospital drugs. The nurse will ask the patient (if they are alert and oriented, or else a family member if available at bedside) if they recognize the drugs and know their indications. If the patient is from a HCA hospital (which is common,) the drugs will already be in their electronic record and the admitting nurse will review last time administered for each drug before calling the doctor to review, edit or continue the current drugs for the patient. The doctor here has the opportunity to change route, dose, timing, or give additional drugs here. Pharmacy then is to check for interactions and appropriate med times (like cholesterol meds in evening). Some drugs (usually the very expensive or rare) are not stocked by pharmacy and so it is a drug that is continued under an order labeled “okay for patient to take own drug”, which means the patient’s family can bring in the unavailable drug and nursing brings it to be reviewed and barcoded by pharmacy, or else the drug is discontinued. After all is said and done, pharmacy reviews the drug list and then uploads all drug entries linked electronically to computer EMAR and the OMNICELL machine. After 5 pm, the nursing supervisor may have to track down the drug due to pharmacy not being in house. If they are unsuccessful to find it within the building, the patient may miss a dose that night, unless it is considered to be an emergent need, in which the drug can be transported over from main campus hospital by transport service. All admits after 5 pm are managed by the pharmacy at main campus hospital, who are easily accessed by phone.