Page 40 - FPGEE Management Q&A Book

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event (ADE). An ADE can be defined as any harm or
injury resulting from medication use. ADEs can be
classified according to their preventability. ADEs are
considered to be non-preventable if the causative
agent is used for an appropriate indication at the
appropriate dose and under adequate monitoring –
these non-preventable ADEs are known as adverse
drug reactions (ADRs).
The American Society of Health-System Pharmacists
(ASHP) defines a significant ADR as any unexpected,
unintended, undesired, or excessive response to a
drug that meets any of the following criteria:
1. Requires discontinuation of the drug;
2. Requires changing the drug therapy;
3. Requires modifying the dose;
4. Necessitates admission to a hospital;
5. Prolongs stay in a health care facility;
6. Necessitates supportive treatment;
7. Significantly complicates diagnosis;
8. Negatively affects prognosis; or
9. Results in temporary or permanent harm,
disability, or death.
62. (a) Errors can take many forms in the pharmacy,
but can be simplified into the following main
categories from a causation viewpoint: mechanical
errors and judgmental errors.
A mechanical error is an error in the preparation
and/or processing of a prescription, including
dispensing an incorrect medication, dosage form, or
dose.
A judgmental error, on the other hand, is an error
or omission involving patient counseling, drug
therapy management, patient screening, or
monitoring.
The study revealed a number of factors that
pharmacists perceive as contributory to the
occurrence of medication errors. The most
commonly cited factors are:
Most Common Factors Cited by Pharmacists as
Contributing to Medication Errors
85
Krisman
1. Too many telephone calls (62%)
2. Overload/unusually busy day (59%)
3. Too many customers (53%)
4. Lack of concentration (41%)
5. No one available to double-check (41%)
6. Staff shortage (32%)
7. Similar drug names (29%)
8. Lack of time to counsel (29%)
9. Illegible prescription (26%)
10. Misinterpreted prescription (24%)
63. (a,b,c and d) Below is a summary of potential
advantages of e-Prescribing, many of which relate
directly to improving medication safety and
potentially reducing medication errors because of
prescription clarity and improved pharmacy work-
flow.
1. Helping in the identification and resolution of
potential problems before the patient arrives at the
pharmacy.
2. Eliminating the need to clarify prescription
information because of illegible handwritten
prescriptions.
3. Validating payment coverage of a drug based on
the patient's formulary coverage.
4. Making the patient's complete drug history
available to the prescriber and pharmacist.
5. Providing prescribers and pharmacists with a
comprehensive patient profile to assist with
monitoring adherence.
6. Linking the prescription information to laboratory
data and other medical information.
7. Minimizing dosing errors.
8. Screening for drug interactions and patient
allergies at the point of care.
64.(c) II and III only. You can’t improve quality if you
don’t measure it.
HEDIS (Health Plan Employer Data and Information