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Prescribing errors
Compounding errors
Dispensing errors
Admininstration errors
Monitoring errors
Communication and management errors, including failures in
error reporting
• Although medication errors can occur through any route of administration, this online course will
focus on the prevention of medication errors in the dispensing and administration of intravenous
(IV) medications.
• The administration of IV medications carries a relatively greater risk for error than other routes of
medication administration, in part because of the complexity associated with their preparation and
administration. For example:
• Infusion devices account for up to 35% of all medication errors that result in significant harm. The
most common error is incorrect manual programming of infusion parameters (eg, rate, drug, dose)
into infusion devices. (Other errors include administering the wrong drug, administering the right
drug to the wrong patient, and tampering with the recommended infusion parameters.)
Research
• In 1979, Falk et al reported an increased mutagenic
activity in the urine of nurses exposed to cytotoxics.
• In 1983
1983,, Sotaniemi et al reported that destruction in 3
nurse liver that work at oncology ward
ward..
• In two Hospital, In Italy, has carried cyclophosphamide
and iphosphamide in nurse urine and pharmacy staff that
not follow procedure of handling cytotoxic
cytotoxic..
• Taxis,K..,Barber,W
Taxis,K ,Barber,W..,2003
2003,, reported that occured 249
mistakes by nurses from 430 times preparation intra
vena drugs (dispencing and administration)
administration)..
• Lim..S., 1998
Lim 1998,, Princess Margareth Hospital, reported that
cost saving for drugs about $ 250 250..000
000/year
/year and
efficiency time of nurse is 330 hour/month
hour/month..
Microbiology Data In Oncology ward ’Dharmais’ Hospital
2000
Clean room
Storage Area
Administrasi Area
Clean Area
Toilet Area
Ante Room
Pass Box
Biological Safety cabinet (BSC)
Biological Safety Cabinet (BSC) :
• BSC Class II for Cytotoxic drugs (Cytogard)
• Fungsi : Memberikan proteksi kepada
petugas, materi yang dikerjakan, dan
lingkungan.
• Prinsip kerja : Tekanan udara didalam
cytogard lebih negatif dari tekanan udara
luar, sehingga aliran udara bergerak dari luar
ke dalam BSC, Didalam BSC udara bergerak
vertical membentuk barrier, sehingga jika ada
percikan obat kanker didalam BSC tidak
kembali kearah petugas.
• Validasi alat : kalibrasi 6 bulan sekali
Personal Protective Equipment
1. Protective Gown
2. Head Cap
2
3. Chemotherapy Mask
3
4. Glove
5. Shoe and Boot 1
6. Emergency Kit :
4
- H2O2 3 % 500 ml
Drug &
Chemotherapy DEPARTMENT OF PHARMACY
order form
Checklist Preparation :
- Data of Patient (MR, Name, Age, Weight, Doctor/
Height, Diagnose) Not Complete nurse
- Dosis & Exp.Date of Drugs
completed
Delivery
- Inpatient Ward Labeling Desinfection
outside
- One day care Ward
Pass box
Clean Room
rekonstitution
Syringe/infuse
Rp.. 22,923,251,496.00
Rp Rp.. 943,315,266.67
Rp
Total