Janet is so happy to finally be home after a long day at work passing medication to 30 different clients. It had been a rough shift and it seemed like every client wanted something from her at the same time. Answering her phone, Janet is surprised to see that it is work calling. Work is calling because one of the clients, Joe, has been lethargic all day and the
Eszopiclone (Lunesta) during the day shift, but the medication was not due to be given till
9pm. With a sinking heart, Janet knows that she has
made a medication error by giving a 9pm sleeping medication at 9am.
What is the right time?
It is easy to see how 9pm could be confused with 9am on a MAR, especially if the MAR is hand-written or the print is small. WTMAE, or a wrong-time medication administration error, is a common medication error.
Use of abbreviations, such as TID, BID, QID, can create confusion as to how often a medication should be given. A common transcription error is to put down two times for a medication to be given – such as 8am and 5pm, when the doctor’s order actually calls for a medication to be given three or four times a day. Like Janet found out, another common error is to look at a MAR and see 9am instead of 9pm.
Triple check that Mar
Always check that you are administering the medication at the right time when you pull the medication, when you pour the medication and before you administer the medication. If your agency allows, consider using military time on the MARS.
If your healthcare provider uses abbreviations, such as TID, BID, or QID, keep a list handy of the definitions. Only use abbreviations that your agency has approved for use. Read the whole entry on the MAR, paying special attention for how many times the medication was ordered to be given in a day. For example if the entry says give QID or four times a day, check to see that there are 4 times listed in the administration column of the MAR.
Keep your eye on the clock
If a medication is ordered to be given at 8am, technically you have an hour before and an hour after that time to administer. Administering a medication at the right time means that the medication is not given too early or too late – watch that clock!
So, what happened to Joe?
Joe was lethargic during the day but the evening CRMA picked up the medication error and held the 9pm dose. Joe was back to his usual self the next day. Janet had to complete an incident report and review her error with the administrator.
Know the ordered times and administer the medication at the right time.
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