What do “tall man” letters represent?

What organization is the authority on high-alert medications across different healthcare settings?

Institute for Safe Medication Practices

The Institute for Safe Medication Practices identifies high-alert medications and strategies to reduce errors and minimize harm. They are also responsible for maintaining lists of common look-alike/sound-alike drugs, error-prone abbreviations, and medications to avoid crushing.

Which of the following potential hazards are addressed by OSHA regulations?

All of these potential hazards are addressed by OSHA regulations.

OSHA regulations address the following potential hazards in a pharmacy: Exposure to blood borne pathogens (HIV, Hepatitis B & C), exposure to hazardous chemicals or drugs, exposure of eyes or bodies to corrosive materials, exposure to latex allergy, exposure to wet surfaces that could cause slip and falls, and availability of personal protective equipment.

Which of the following organizations implemented the error-prone abbreviation list?

ISMP

The Institute of Safe Medication Practices (ISMP) implemented the “error-prone abbrevia- tion” list; The Joint Commission (TJC) implemented the “do-not use” list.

Tall man lettering may be most appropriate for which pair of look-alike/sound-alike drugs?

hydralazine/hydroxyzine

Tall man lettering is used to highlight areas of similar-sounding or -looking words. In the case of hydralazine and hydroxyzine, the letters that differ between the two would be appropriate to capitalize so as to further differentiate them, i.e., hydrALAzine and hydrOXYzine.

Which of the following medications has not been involved in a high incidence of medication errors?

Amoxicillin

MEDMARX has identified the following medications that have been associated with a high incidence of medication errors: insulin, morphine, potassium chloride, albuterol, heparin, vancomycin, cefazolin, acetaminophen, warfarin, and furosemide.

Which of these scenarios represents a potential hospital pharmacy error?

transcription error

When transcribing a prescription over the phone, it is possible for pharmacy employees to misinterpret or write down incorrect information. All other scenarios presented are errors that may be caused by patients and/or family members in the hospital setting.

What should countertops in I.V. rooms be cleaned with?

70% Isopropyl Alcohol

Isopropyl Alcohol should be used to clean countertops, as well as the laminar flood hood, and gloves in between I.V. admixtures.

Which of the following strategies may result in a reduction in medication errors?

Spell out drug names.

Spelling the drug’s name out instead of using an abbreviation will eliminate any confusion caused by a prescriber.

What do “tall man” letters indicate?

Tall man letters are used to indicate differences in the spelling of drug names.

“Tall man” letters are used to indicate differences in the spelling of similar drug names. Using tall man (mixed case) letters helps draw attention to the dissimilarities in their names. Several studies have shown that highlighting sections of drug names using tall man letters can help distinguish similar drug names, making them less prone to mix-ups.

Which of the following defines a solvent?

The larger part of a solution

The larger part of a solution is called the “solvent.” A solvent is a substance, usually a liquid, that dissolves another substance to make a solution.

The hospital Pharmacy and Therapeutics Committee determines that Drug X and Drug Y are equally effective, but Drug X is preferred because of cost. If a patient is admitted to the hospital on Drug Y and switched to Drug X, what is this an example of?

therapeutic interchange

Therapeutic interchanges allow for the substitution of one medication to an alternative, more preferred medication. Patients should be informed if their medications are interchanged or substituted in this way.

Within how much time does a scheduled medica- tion need to be administered to a patient?

30 minutes

The ISMP developed guidelines for the administering of medications in an acute care facility where medications are to be administered either 30 minutes before or 30 minutes after the scheduled time for the drug to be administered to the patient. The guidelines only apply to scheduled medications, which are all maintenance doses that are administered in a standard, repeated cycle of frequency, such as q4h, QID, TID, BID, daily, and so on.

Which MERP error category is defined as an error that may have contributed or resulted in a patient’s death?

Category I

A category I error is an error that may have contributed or resulted in patient’s death.

Which of these is an example of unintentional medication misuse?

The patient uses his rescue asthma inhaler multiple times per day when the drug is only indicated for emergent shortness of breath.

In the case of an asthma inhaler, perhaps the patient's asthma is undertreated and he is therefore experiencing shortness of breath more than expected. He is not necessarily dependent on the medication, but a referral to a prescriber would be appropriate so the necessary control medications can be ordered. On the other hand, when a patient intentionally continues drug therapy following discontinuation, uses another person's medications, or takes a medication with addiction potential more often than prescribed, it may indicate that the patient is dependent on the medication and/or requires a larger dose than prescribed; this is considered intentional misuse.

Which of the following prescribing methods will reduce the number of prescription errors?

Electronic

Electronic prescribing reduces the number of prescription errors by eliminating illegible prescriptions, using clinical decision support to reduce preventable errors, and improving communication between the clinician and patient.

What do “tall man” letters represent?

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