{"id":910,"date":"2015-05-22T21:45:55","date_gmt":"2015-05-23T01:45:55","guid":{"rendered":"https:\/\/pressbooks.bccampus.ca\/clinicalproceduresforsaferpatientcaretrubscn\/chapter\/6-9-summary\/"},"modified":"2019-09-19T12:14:55","modified_gmt":"2019-09-19T16:14:55","slug":"7-9-summary","status":"publish","type":"chapter","link":"https:\/\/pressbooks.bccampus.ca\/clinicalproceduresforsaferpatientcaretrubscn\/chapter\/7-9-summary\/","title":{"raw":"7.9 Summary","rendered":"7.9 Summary"},"content":{"raw":"Parenteral medication administration is an effective method of delivering medication to patients, and it can be safely accomplished by utilizing the appropriate guidelines and policies in place to keep patients safe from harm. IV medications have a higher risk of harm than non-parenteral medication. The ever-increasing complexity of the health care environment increases the risk of a medication error with parenteral medications. The key takeaways below provide advice for preventing errors with parenteral medications.\r\n<div class=\"bcc-box bcc-success\">\r\n<h3 style=\"text-align: center\">Key Takeaways<\/h3>\r\n<ul>\r\n \t<li>Parenteral medications have a relatively quick onset of therapeutic effects. Be aware of the onset, peak, and duration of all parenteral medications.<\/li>\r\n \t<li>Know which medications are considered high-alert medications, and perform independent double checks to minimize errors.<\/li>\r\n \t<li>Always consider the therapeutic effects and adverse effects when administering parenteral medications.<\/li>\r\n \t<li>Safeguards for medication administration exist in most hospitals. Make use of all safety strategies (such as smart IV pumps, no-interruption zones, two patient identifiers, and checklists) to administer medications safely.<\/li>\r\n \t<li>Quality and safety controls for safe medication administration must be considered along the entire process, not just at the point of administration.<\/li>\r\n \t<li>It is human nature\u00a0to look for quick and easy ways to perform a task, but doing so\u00a0may lead to errors. Avoid workarounds: Most hospitals have operational failures that lead to front line health care providers finding ways to manage deficiency in hospital operating systems. Rather than creating workarounds, engage in the additional steps to prevent re-occurrence of issues.<\/li>\r\n \t<li>Stay current with evidence-based research regarding potential system errors in health care. Commit to improving patient safety with medication administration.<\/li>\r\n \t<li>Report all errors, near misses, and adverse reactions to ensure knowledge is shared, and to prevent further errors from occurring.<\/li>\r\n<\/ul>\r\n<\/div>\r\n<h2><a id=\"suggested7\"><\/a>Suggested\u00a0Online Resources<\/h2>\r\n<ol>\r\n \t<li><a href=\"http:\/\/www.ahrq.gov\/\" target=\"_blank\" rel=\"noopener\">Agency for Healthcare Research and Quality (AHRQ)<\/a>.\u00a0This website provides evidence-based research, guidelines, recommendations, and resources on\u00a0improving patient safety.<\/li>\r\n \t<li><a href=\"http:\/\/www.patientsafetyinstitute.ca\/English\/Pages\/default.aspx\" target=\"_blank\" rel=\"noopener\">Canadian Patient Safety Institute (CPSI)<\/a>.\u00a0This organization's website provides guidelines, research, and recommendations for improving patient safety in Canada.<\/li>\r\n \t<li><a href=\"http:\/\/testandcalc.com\/quiz\/index.asp\" target=\"_blank\" rel=\"noopener\">Drug calculations<\/a>. This medication calculation website reviews how to calculate the dosages for parenteral and non-parenteral medications, and IV fluids. It also includes metric conversions and IV drop rate calculations.<\/li>\r\n \t<li><a href=\"http:\/\/www.ihi.org\/Pages\/default.aspx\" target=\"_blank\" rel=\"noopener\">Institute for Healthcare Improvement (IHI)<\/a>. This group's website\u00a0provides educational resources, webinars, publications, and improvement stories and tools to enhance patient safety.<\/li>\r\n \t<li><a href=\"http:\/\/www.ismp.org\/\" target=\"_blank\" rel=\"noopener\">Institute for Safe Medication Practices (ISMP)<\/a>.\u00a0This organization focuses on improving medication administration. The website lists high-alert medications, offers newsletters and webinars, and provides a system for reporting medication errors, guidelines, and policies on safe practices.<\/li>\r\n<\/ol>\r\n<h2>References<\/h2>\r\nA\u011fac, E., &amp; G\u00fcnes, U. Y. (2011). 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(2014).\u00a0Aspiration in injections: Should we continue or abandon the practice? <i>F1000Research,<\/i> <em>3<\/em>(157). <a href=\"http:\/\/dx.doi.org\/10.12688\/f1000research.1113.1\" target=\"_blank\" rel=\"noopener\">10.12688\/f1000research.1113.1<\/a>.\r\n\r\nSiegel, J. D., Rhinehart, E., Jackson, M., Chiarello, L., &amp; Healthcare Infection Control Practices Advisory Committee. (2007). <em>Guideline for isolation precautions: Preventing transmission of infectious agents in healthcare settings<\/em>. Retrieved from <a href=\"http:\/\/www.cdc.gov\/ncidod\/dhqp\/pdf\/isolation2007.pdf\">http:\/\/www.cdc.gov\/ncidod\/dhqp\/pdf\/isolation2007.pdf<\/a>.\r\n\r\nShah, K., Lo, C., Babich, M., Tsao, N., &amp; Bansback, N. (2016). Bar code medication administration technology: A systematic review of impact on patient safety when used with computerized prescriber order entry and automated dispensing devices [PMID: 27826157]. <em>Canadian Journal of Hospital Pharmacy, 69<\/em>(5), 394-402. Retrieved from <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5085324\/\" target=\"_blank\" rel=\"noopener\">https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5085324\/<\/a>.\r\n\r\nSisson, H. (2015). Aspirating during the intramuscular injection procedure: A systematic literature review. <em>Journal of Clinical Nursing<\/em>, <em>24<\/em>(17-18), 2368-2375. <a href=\"https:\/\/doi.org\/10.1111\/jocn.12824\" target=\"_blank\" rel=\"noopener\">https:\/\/doi.org\/10.1111\/jocn.12824<\/a>.\r\n\r\nWilburn, S. Q. (2004). Needlestick and sharps injury prevention. <em>The Online Journal of Issues in Nursing, 9<\/em>(3). Retrieved from <a href=\"http:\/\/www.nursingworld.org\/MainMenuCategories\/ANAMarketplace\/ANAPeriodicals\/OJIN\/TableofContents\/Volume92004\/No3Sept04\/InjuryPrevention.html\">http:\/\/www.nursingworld.org\/MainMenuCategories\/ANAMarketplace\/ANAPeriodicals\/OJIN\/TableofContents\/Volume92004\/No3Sept04\/InjuryPrevention.html<\/a>.\r\n\r\nWilburn, S. Q., &amp; Eijkemans, G. (2004). Preventing needlestick injuries among healthcare workers: A\u00a0 WHO-ICN collaboration. <em>International Journal of Occupational and Environmental Health<\/em>, <em>10<\/em>(4), 451-456.\u00a0<a href=\"https:\/\/doi.org\/10.1179\/oeh.2004.10.4.451\" target=\"_blank\" rel=\"noopener\">https:\/\/doi.org\/10.1179\/oeh.2004.10.4.451<\/a>.\r\n\r\nWorkers Compensation Act:\u00a0Occupational health and safety regulation. (2015). BC Reg. 296\/297. Retrieved from the BC Laws website:\u00a0<span style=\"text-indent: 1em;font-size: 14pt\">. <\/span><span style=\"text-indent: 1em;font-size: 14pt\">\u00a0<\/span><a href=\"http:\/\/www.nursingworld.org\/MainMenuCategories\/ANAMarketplace\/ANAPeriodicals\/OJIN\/TableofContents\/Volume92004\/No3Sept04\/InjuryPrevention.html\" style=\"text-indent: 1em;font-size: 14pt\">http:\/\/www.bclaws.ca\/Recon\/document\/ID\/freeside\/296_97_04<\/a><span style=\"text-indent: 1em;font-size: 14pt\">.<\/span>\r\n\r\nWorkman, B. (1999). Safe injection techniques. <em>Nursing Standard<\/em>, <em>13<\/em>(39), 47-53.\u00a0<a href=\"https:\/\/doi.org\/10.7748\/ns1999.06.13.39.47.c2623\" target=\"_blank\" rel=\"noopener\">https:\/\/doi.org\/10.7748\/ns1999.06.13.39.47.c2623<\/a>.\r\n\r\nWorld Health Organization (WHO). (2012). <em>Course: Knowledge is the enemy of unsafe care<\/em>. Retrieved from\u00a0<a href=\"http:\/\/who.int\/patientsafety\/education\/curriculum\/course7_handout.pdf\">http:\/\/who.int\/patientsafety\/education\/curriculum\/course7_handout.pdf<\/a>.","rendered":"<p>Parenteral medication administration is an effective method of delivering medication to patients, and it can be safely accomplished by utilizing the appropriate guidelines and policies in place to keep patients safe from harm. IV medications have a higher risk of harm than non-parenteral medication. The ever-increasing complexity of the health care environment increases the risk of a medication error with parenteral medications. The key takeaways below provide advice for preventing errors with parenteral medications.<\/p>\n<div class=\"bcc-box bcc-success\">\n<h3 style=\"text-align: center\">Key Takeaways<\/h3>\n<ul>\n<li>Parenteral medications have a relatively quick onset of therapeutic effects. Be aware of the onset, peak, and duration of all parenteral medications.<\/li>\n<li>Know which medications are considered high-alert medications, and perform independent double checks to minimize errors.<\/li>\n<li>Always consider the therapeutic effects and adverse effects when administering parenteral medications.<\/li>\n<li>Safeguards for medication administration exist in most hospitals. Make use of all safety strategies (such as smart IV pumps, no-interruption zones, two patient identifiers, and checklists) to administer medications safely.<\/li>\n<li>Quality and safety controls for safe medication administration must be considered along the entire process, not just at the point of administration.<\/li>\n<li>It is human nature\u00a0to look for quick and easy ways to perform a task, but doing so\u00a0may lead to errors. Avoid workarounds: Most hospitals have operational failures that lead to front line health care providers finding ways to manage deficiency in hospital operating systems. Rather than creating workarounds, engage in the additional steps to prevent re-occurrence of issues.<\/li>\n<li>Stay current with evidence-based research regarding potential system errors in health care. Commit to improving patient safety with medication administration.<\/li>\n<li>Report all errors, near misses, and adverse reactions to ensure knowledge is shared, and to prevent further errors from occurring.<\/li>\n<\/ul>\n<\/div>\n<h2><a id=\"suggested7\"><\/a>Suggested\u00a0Online Resources<\/h2>\n<ol>\n<li><a href=\"http:\/\/www.ahrq.gov\/\" target=\"_blank\" rel=\"noopener\">Agency for Healthcare Research and Quality (AHRQ)<\/a>.\u00a0This website provides evidence-based research, guidelines, recommendations, and resources on\u00a0improving patient safety.<\/li>\n<li><a href=\"http:\/\/www.patientsafetyinstitute.ca\/English\/Pages\/default.aspx\" target=\"_blank\" rel=\"noopener\">Canadian Patient Safety Institute (CPSI)<\/a>.\u00a0This organization&#8217;s website provides guidelines, research, and recommendations for improving patient safety in Canada.<\/li>\n<li><a href=\"http:\/\/testandcalc.com\/quiz\/index.asp\" target=\"_blank\" rel=\"noopener\">Drug calculations<\/a>. This medication calculation website reviews how to calculate the dosages for parenteral and non-parenteral medications, and IV fluids. It also includes metric conversions and IV drop rate calculations.<\/li>\n<li><a href=\"http:\/\/www.ihi.org\/Pages\/default.aspx\" target=\"_blank\" rel=\"noopener\">Institute for Healthcare Improvement (IHI)<\/a>. This group&#8217;s website\u00a0provides educational resources, webinars, publications, and improvement stories and tools to enhance patient safety.<\/li>\n<li><a href=\"http:\/\/www.ismp.org\/\" target=\"_blank\" rel=\"noopener\">Institute for Safe Medication Practices (ISMP)<\/a>.\u00a0This organization focuses on improving medication administration. The website lists high-alert medications, offers newsletters and webinars, and provides a system for reporting medication errors, guidelines, and policies on safe practices.<\/li>\n<\/ol>\n<h2>References<\/h2>\n<p>A\u011fac, E., &amp; G\u00fcnes, U. Y. (2011). Effect on pain of changing the needle prior to administering medication intramuscularly: A randomized controlled trial. <em>Journal of Advanced Nursing<\/em>, <em>67<\/em>(3), 563-568. doi: 10.1111\/j.1365-2648.2010.05513.x.<\/p>\n<p>Agency for Healthcare Research and Quality. (2014). <em>Checklists<\/em>. Retrieved from\u00a0<a href=\"http:\/\/psnet.ahrq.gov\/primer.aspx?primerID=14\">http:\/\/psnet.ahrq.gov\/primer.aspx?primerID=14<\/a>.<\/p>\n<p>Alberta Health Services. (2009). Direct IV medications. <em>Specialized clinical competency program<\/em>. Retrieved from\u00a0<a href=\"http:\/\/extcontent.covenanthealth.ca\/Policies\/iii-45_Learning_Module.pdf\">http:\/\/extcontent.covenanthealth.ca\/Policies\/iii-45_Learning_Module.pdf<\/a>.<\/p>\n<p>American Nurses Association. (2002). <em>Needlestick prevention guide<\/em>. Retrieved from <a href=\"http:\/\/www.who.int\/occupational_health\/activities\/2needguid.pdf\">http:\/\/www.who.int\/occupational_health\/activities\/2needguid.pdf<\/a>.<\/p>\n<p>Astle, B., &amp; Duggleby, W. (2019). <em>Canadian fundamentals of nursing<\/em>\u00a0(6<sup>th<\/sup> ed.). Milton, ON: Elsevier.<\/p>\n<p><span style=\"color: #333333\">Becton, Dickinson UK. (2013). <em>Hidden talents of\u00a0BD Saf-T-Intima<\/em>. <\/span>Retrieved from\u00a0<a href=\"https:\/\/www.bd.com\/europe\/safety\/en\/pdfs\/Saf-T-Intima%20use%20Guide.pdf\">https:\/\/www.bd.com\/europe\/safety\/en\/pdfs\/Saf-T-Intima%20use%20Guide.pdf<\/a>.<\/p>\n<p>Berman, A., &amp; Snyder S. J. (2016). <em>Skills in clinical nursing<\/em> (8th ed.). Hoboken, NJ: Pearson.<\/p>\n<p>Black, L. (2013). Ditch the pinch: Bilateral exposure injuries during subcutaneous injections. <i>American Journal of Infection Control<\/i>, <em>41<\/em>(9), 815-819. doi: 10.1016\/j.ajic.2012.10.017.<\/p>\n<p>British Columbia Institute of Technology (BCIT). (2015). Week 11 PowerPoint notes. In, <em>NURS 3020: Clinical Techniques<\/em>. Vancouver, BC: BCIT.<\/p>\n<p>Brookside Associates. (2015a). <em>Procedure for administering an intradermal injection<\/em>. Retrieved from <a href=\"http:\/\/brooksidepress.org\/intramuscular\/lessons\/lesson-2-administer-an-intramuscular-injection\/2-07-procedure-for-administering-an-intradermal-injection\/\">http:\/\/brooksidepress.org\/intramuscular\/lessons\/lesson-2-administer-an-intramuscular-injection\/2-07-procedure-for-administering-an-intradermal-injection\/<\/a>.<\/p>\n<p>Brookside Associates. (2015b). <em>Procedure for administering a subcutaneous injection<\/em>. 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Retrieved from<br \/>\n<a href=\"https:\/\/www.cadth.ca\/sites\/default\/files\/pdf\/htis\/nov-2014\/RB0669%20Aspiration%20Prior%20to%20Injection%20Final.pdf\">https:\/\/www.cadth.ca\/sites\/default\/files\/pdf\/htis\/nov-2014\/RB0669%20Aspiration%20Prior%20to%20Injection%20Final.pdf<\/a>.<\/p>\n<p>Canadian Diabetes Association. (2013). Canadian Diabetes Association Clinical Practice Guidelines Expert Committee. Clinical practice guidelines for the prevention and management of diabetes in Canada. <em>Canadian Journal of Diabetes<\/em>, <em>37<\/em>(1), s1-s212.<\/p>\n<p>Canadian Institute for Health Information. (2009). <em>National system for incident reporting: An innovative approach to information management<\/em> [CPSI Forum, April 29, 2009]. Retrieved from\u00a0<a href=\"http:\/\/www.patientsafetyinstitute.ca\/en\/toolsResources\/Presentations\/Documents\/2009%20Forum\/Canada%27s%20Forum%20-%20Presentation%20A4-b.pdf\">http:\/\/www.patientsafetyinstitute.ca\/English\/toolsResources\/Presentations\/Documents\/2009\/Canada%27s%20Forum%20-%20Presentation%20A4-b.pdf<\/a><\/p>\n<p>Canadian Patient Safety Institute. (2012). <em>Canadian analysis incident framework<\/em>. Retrieved\u00a0 from\u00a0<a href=\"http:\/\/www.patientsafetyinstitute.ca\/en\/toolsResources\/IncidentAnalysis\/Documents\/Canadian%20Incident%20Analysis%20Framework.PDF\">http:\/\/www.patientsafetyinstitute.ca\/english\/toolsresources\/incidentanalysis\/documents\/canadian%20incident%20analysis%20framework.pdf<\/a>.<\/p>\n<p>Centers for Disease Control (CDC). (2012). <em>NOISH fast facts (home healthcare workers). How to prevent needlestick and sharps injuries<\/em>. 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(2014). <em>Teaching best evidence: Deltoid intramuscular injection techniques<\/em>. Retrieved from <a href=\"http:\/\/www.sciedu.ca\/journal\/index.php\/jnep\/article\/view\/1888\/1291\">http:\/\/www.sciedu.ca\/journal\/index.php\/jnep\/article\/view\/1888\/1291<\/a>.<\/p>\n<p>Debono, D. S., Greenfield, D., Travaglia, J. F., Long, J. C., Black, D., Johnson, J., &amp; Braithwaite, J. (2013). Nurses&#8217; workarounds in acute healthcare settings: A scoping review.\u00a0<em>BMC Health Services Research,<\/em> <em>13<\/em>(175). doi: 10.1186\/1472-6963-13-175.<\/p>\n<p>Ellis, J., &amp; Parush, A. (2012). <em>Preventing errors with high alert drugs: Testing a computerized double check<\/em>. 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Retrieved from\u00a0<a href=\"http:\/\/who.int\/patientsafety\/education\/curriculum\/course7_handout.pdf\">http:\/\/who.int\/patientsafety\/education\/curriculum\/course7_handout.pdf<\/a>.<\/p>\n","protected":false},"author":397,"menu_order":9,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":[],"pb_section_license":"cc-by"},"chapter-type":[],"contributor":[],"license":[50],"class_list":["post-910","chapter","type-chapter","status-publish","hentry","license-cc-by"],"part":809,"_links":{"self":[{"href":"https:\/\/pressbooks.bccampus.ca\/clinicalproceduresforsaferpatientcaretrubscn\/wp-json\/pressbooks\/v2\/chapters\/910","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.bccampus.ca\/clinicalproceduresforsaferpatientcaretrubscn\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.bccampus.ca\/clinicalproceduresforsaferpatientcaretrubscn\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/clinicalproceduresforsaferpatientcaretrubscn\/wp-json\/wp\/v2\/users\/397"}],"version-history":[{"count":19,"href":"https:\/\/pressbooks.bccampus.ca\/clinicalproceduresforsaferpatientcaretrubscn\/wp-json\/pressbooks\/v2\/chapters\/910\/revisions"}],"predecessor-version":[{"id":5064,"href":"https:\/\/pressbooks.bccampus.ca\/clinicalproceduresforsaferpatientcaretrubscn\/wp-json\/pressbooks\/v2\/chapters\/910\/revisions\/5064"}],"part":[{"href":"https:\/\/pressbooks.bccampus.ca\/clinicalproceduresforsaferpatientcaretrubscn\/wp-json\/pressbooks\/v2\/parts\/809"}],"metadata":[{"href":"https:\/\/pressbooks.bccampus.ca\/clinicalproceduresforsaferpatientcaretrubscn\/wp-json\/pressbooks\/v2\/chapters\/910\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.bccampus.ca\/clinicalproceduresforsaferpatientcaretrubscn\/wp-json\/wp\/v2\/media?parent=910"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/clinicalproceduresforsaferpatientcaretrubscn\/wp-json\/pressbooks\/v2\/chapter-type?post=910"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/clinicalproceduresforsaferpatientcaretrubscn\/wp-json\/wp\/v2\/contributor?post=910"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/clinicalproceduresforsaferpatientcaretrubscn\/wp-json\/wp\/v2\/license?post=910"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}