PPM barcode medication administration
UPDATED ACTUAL Exam Questions and
CORRECT Answers
prior to automation of pharmacy systems in healthcare - CORRECT ANSWER - Little
automation or computerization in healthcare
No CPOE
BCMA deployed in < 1% of hospitals
Orders are handwritten
Nursing activities are also handwritten
where do medication errors occur - CORRECT ANSWER - prescribing - 39%
transcribing - 12%
dispensing - 11%
administering - 38%
swiss cheese model of accident causation - CORRECT ANSWER - Each step of process has a
potential for failure
Each step is a slice of Swiss cheese
Each hole is a potential process failure point
Workflows have multiple steps
An error may allow a problem to pass through one layer, but each layer is a defense against
potential error impacting the outcome
each slice of cheese - CORRECT ANSWER - opportunity to stop an error
The more defenses you put up the better
Having fewer and smaller holes in the system raises the likelihood of catching and stopping
errors before they occur
, for a catastrophic error to occur - CORRECT ANSWER - the holes need to align for each step
in the process allowing all the defenses to be defeated
drug prescribing process - CORRECT ANSWER - Front-end loaded with safeguards prior to
the administration of drugs to the patient
Nurse reviews order prior to sending it to pharmacy
Pharmacist reviews order
Nurse administering order will review it prior to giving to the patient
closed loop medication management - CORRECT ANSWER - physician writes and signs an
order
order goes to pharmacy verification cue
pharmacist reviews order for appropriateness and verifies
nurse can see physician ordered med and that pharmacist verified it
nurse will acknowledge the order
get med and administer it
checks and balances close the loop on med admin process
enhancements possible with electronic medication ordering - provider - CORRECT
ANSWER - provider with electronic ordering system has clinical support tools that assist in
writing a order
enhancements - pharmacist - CORRECT ANSWER - pharmacist has clinical decision support
tools (identical to physician alerts)
- potential drug-drug interactions
- drug-allergy alert
These alerts are identical to those the physician sees
- physician may override or miss
UPDATED ACTUAL Exam Questions and
CORRECT Answers
prior to automation of pharmacy systems in healthcare - CORRECT ANSWER - Little
automation or computerization in healthcare
No CPOE
BCMA deployed in < 1% of hospitals
Orders are handwritten
Nursing activities are also handwritten
where do medication errors occur - CORRECT ANSWER - prescribing - 39%
transcribing - 12%
dispensing - 11%
administering - 38%
swiss cheese model of accident causation - CORRECT ANSWER - Each step of process has a
potential for failure
Each step is a slice of Swiss cheese
Each hole is a potential process failure point
Workflows have multiple steps
An error may allow a problem to pass through one layer, but each layer is a defense against
potential error impacting the outcome
each slice of cheese - CORRECT ANSWER - opportunity to stop an error
The more defenses you put up the better
Having fewer and smaller holes in the system raises the likelihood of catching and stopping
errors before they occur
, for a catastrophic error to occur - CORRECT ANSWER - the holes need to align for each step
in the process allowing all the defenses to be defeated
drug prescribing process - CORRECT ANSWER - Front-end loaded with safeguards prior to
the administration of drugs to the patient
Nurse reviews order prior to sending it to pharmacy
Pharmacist reviews order
Nurse administering order will review it prior to giving to the patient
closed loop medication management - CORRECT ANSWER - physician writes and signs an
order
order goes to pharmacy verification cue
pharmacist reviews order for appropriateness and verifies
nurse can see physician ordered med and that pharmacist verified it
nurse will acknowledge the order
get med and administer it
checks and balances close the loop on med admin process
enhancements possible with electronic medication ordering - provider - CORRECT
ANSWER - provider with electronic ordering system has clinical support tools that assist in
writing a order
enhancements - pharmacist - CORRECT ANSWER - pharmacist has clinical decision support
tools (identical to physician alerts)
- potential drug-drug interactions
- drug-allergy alert
These alerts are identical to those the physician sees
- physician may override or miss
