Question

5 21 1 AaBbCcDc AaBbCcDc AaBbcc 1 Normal 1 No Spac... Heading 1 Editi ph τιτανε στα γονιμοποιο οτανοπποτιοτοιι οσιισισαν ντανε να ναιιααταιγουιτεσια γυναικες please reference in APA my corecteur you can Case Study #4: Giving Medications at the Wrong Time The Medication Erron An overnight nurse administered a dose of an antiarrhythmic medication earlier than instructed. which resulted in the patient receiving two doses too close together. How It Happened The patient was supposed to take dofstilids every 12 hours. Defetilids is an anti-arrhythmic drug. before his surgery, a nurse saw that the patient was expected to receive meds at 6 a.m., but he was also slated to leave for the operating room before 6 a.m. To keep him from skipping a dose, she administered the medication two hours early, at 4 a.m. It was later discovered that the patient had received his evening dose later than usual, at 10p.m. ---so he ended up taking two doses six have not intent of 12 hore anart hours apart instead of 12 hours apart. The Result According to the Agency for Healthcare Research and Quality (AHRQ), which published the case study, the patient was found to have severe QTc prolongation on his electrocardiogram putting him at high risk for a fatal cardiac arrhythmia." As a result, they had to postpone his surgery until his QTc returned to its regular level. Your Solution Case Study #5: Forgetting a Dosage Due to Fatione

Answer 1

A Although Although all on used 1. Those medications Carry risk of potential harm in error, some medications are aisker than are also known as high -alert medications. Others. is an high alert medication, is to and helps in an oral Dofeti lide class - Ill auto arrhythmic used maintenance of normal sinus ohythm in patients with the atrial fibrillation cool atrial flutter. It can cause QTC prolongation in a dose dependent manner. Plasma concentr- cation increase due to overdore, too frequent dosing, ding-drug interactions or d aeual function and elevates the risk of induced asshythmias. National recommendations exist regarding designation of high - alert medications but there is no national std that national hospitals should follow: Joint commission requires hospitals to develope their own high-alart medication but and to implement a Process for managing these medications

e is unknown whether the hospital in corrent case had included dosetilide on its list. Even if they had, this case Pillustrates that simply identifying a medication as high- alert may not be enough to prevent errors but identification of high alert druge is first step. Some hospitale may rely colely on low- leverage, on relatively ineffective risk reduction strategies such as high alert labels on pharmacy bius con) dispensed medications cor double checke by nurser during administration. However, these approaches may not adequately warn prescribers about a medications high risk designation. One strategy to ensure that error prevention plans are comprehensive is to create safeguards in node of medication use every process Most hospitals have Pharnearly and therapeutice (P & 7) Committee that manages drug formulary, it

for must also be responsible identifying mediunes that reed safeguards. Dofetilide should have been identified as high-alext nedication by PET committee. o several strategies could be employed during the preseribing process. Thorough medication de werk- cation at all care transitions. Prior to surgery the prescriter must weigh risks and benefits of adaun- a -stering pts home medications E a focus on the hich alert medications. We believe prescribing such a should be inhands of clinicans with expertise. Prospective pharmaciet onder verification and diepensing is important step. for egin verification of do fetilde order should include checking patients dose, renal function, are internal, time of last dose admin nistration & concomitant medications. Centers for medicare and medicaid services eme) acquire hospitals speufy medications those "

early con late which cause might early cor) administration > 30 min cause harm" or " negative impact on intended erapeutic cor) pharmacological effect ". Many EHR celectronic the record) syetems can alert a nurse attempting to wister a medication outside acceptable window. All patients should be monitored for effectiveness and administration of a toniuty after medication is also major step. tion strategy FDA requeres risk evaluation and mitigar strategies CRMs) from manufacturens as a safety to manage disk assorated with medications.