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Hawaii Medication Data Form - Medication Error and Near Miss Classification

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US-02260BG
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This form is a generic example that may be referred to when preparing such a form for your particular state. It is for illustrative purposes only. Local laws should be consulted to determine any specific requirements for such a form in a particular jurisdiction.


Hawaii Medication Data Form — Medication Error and Near Miss Classification is a standardized reporting tool utilized in healthcare settings to identify and categorize medication errors and near misses. This form aims to improve patient safety and prevent future occurrences of medication-related incidents. The Hawaii Medication Data Form collects essential information about the incident, including the medication name, dosage, route of administration, date and time of occurrence, and the healthcare professional involved. It also contains sections to document details about the patient, such as age, sex, weight, and relevant medical history. There are different types of Hawaii Medication Data Forms — Medication Error and Near Miss Classification based on the categorization and severity of the incident. Some commonly used classifications include: 1. Medication Error: This form category is utilized when an error has occurred during the medication administration process, leading to the wrong drug, dose, route, or time of administration. It involves documenting the specific factors contributing to the error, such as communication breakdown, inadequate staff training, or misinterpretation of prescription orders. 2. Near Miss: This category is employed when an error is intercepted before reaching the patient, preventing harm. Near misses are considered valuable opportunities for learning and identifying potential system vulnerabilities. The form captures details about the near miss event, the steps taken to prevent harm, and recommendations for improvement. 3. Adverse Drug Reaction: This form category is used when a medication causes an unexpected, undesirable reaction in the patient. It involves documenting the drug(s) involved, the adverse effects experienced by the patient, and any necessary interventions or treatments provided. 4. Medication Dispensing Error: This specific form is used to classify errors that occur during the dispensing process, such as incorrect labeling or packaging, dispensing the wrong medication, or incorrect dosage instructions. It focuses on identifying the root causes of the error within the dispensing system to prevent future occurrences. By utilizing the Hawaii Medication Data Form — Medication Error and Near Miss Classification, healthcare professionals can contribute to a comprehensive database of medication-related incidents. This data can be analyzed to identify trends, implement targeted interventions, and enhance patient safety practices within healthcare organizations.

Hawaii Medication Data Form — Medication Error and Near Miss Classification is a standardized reporting tool utilized in healthcare settings to identify and categorize medication errors and near misses. This form aims to improve patient safety and prevent future occurrences of medication-related incidents. The Hawaii Medication Data Form collects essential information about the incident, including the medication name, dosage, route of administration, date and time of occurrence, and the healthcare professional involved. It also contains sections to document details about the patient, such as age, sex, weight, and relevant medical history. There are different types of Hawaii Medication Data Forms — Medication Error and Near Miss Classification based on the categorization and severity of the incident. Some commonly used classifications include: 1. Medication Error: This form category is utilized when an error has occurred during the medication administration process, leading to the wrong drug, dose, route, or time of administration. It involves documenting the specific factors contributing to the error, such as communication breakdown, inadequate staff training, or misinterpretation of prescription orders. 2. Near Miss: This category is employed when an error is intercepted before reaching the patient, preventing harm. Near misses are considered valuable opportunities for learning and identifying potential system vulnerabilities. The form captures details about the near miss event, the steps taken to prevent harm, and recommendations for improvement. 3. Adverse Drug Reaction: This form category is used when a medication causes an unexpected, undesirable reaction in the patient. It involves documenting the drug(s) involved, the adverse effects experienced by the patient, and any necessary interventions or treatments provided. 4. Medication Dispensing Error: This specific form is used to classify errors that occur during the dispensing process, such as incorrect labeling or packaging, dispensing the wrong medication, or incorrect dosage instructions. It focuses on identifying the root causes of the error within the dispensing system to prevent future occurrences. By utilizing the Hawaii Medication Data Form — Medication Error and Near Miss Classification, healthcare professionals can contribute to a comprehensive database of medication-related incidents. This data can be analyzed to identify trends, implement targeted interventions, and enhance patient safety practices within healthcare organizations.

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The ASHP classifies errors as prescribing error, dispensing error, omission error, wrong time error, unauthorized drug error, improper dose error, wrong dosage-form error, wrong drug-preparation error, wrong administration-technique error, deteriorated drug error, monitoring error, compliance error, and other ...

Write a note in the medical record documenting what happened, the impact on the patient, treatment provided, and results. You can include who was told about it, what they were told, and when. The clinical record is the wrong place to guess what happened or to blame others.

Near-misses can be classified as belonging to category B of the NCC MERP classification. Near-misses do not reach the patient, but can still potentially cause harm. In 1 emergency department, the rate of an error occurring but not reaching the patient was 11.8%.

Date(s) of error(s) (month, day, year) Time(s) of error(s) Describe the medication error. (Include name of medication, dose, and route; attach an extra sheet of paper if necessary.) CAUSE(S) OF MEDICATION ERROR(S) (Check all that apply.)

Draw a single line through the erroneous entry and write the time, date, and your name. Identify the reason for the correction. Include the rationale in your notation; for example, ?mistaken entry, wrong medication name written.? Follow facility policy when adding late information.

When an error is made in a medical record entry, proper error correction procedures must be followed. Draw line through entry (thin pen line). ... Initial and date the entry. State the reason for the error (i.e. in the margin or above the note if room). Document the correct information.

Adopt a reporting system. The only way to reduce medication errors is to develop a reporting system and then make changes to prevent similar errors from reoccurring. Even a near miss should be reported. The staff should be encouraged to report without any repercussions.

Reporting Medication Errors Examples include the Institute of Safe Medication Practices (ISMP) and the Food and Drug Administration (FDA). These organizations collectively review error submissions. Case reports are published to educate health care professionals regarding errors and near errors.

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Check all that apply for medication error. For medication errors involving wrong medication, Section. B: Discovery must include the medication that was given ... All errors and near misses shall be reported in a non-punitive, supportive environment. Data is used to evaluate for trends, review current practice.This is a near miss classification form for an adverse drug event study. Dispensing: the pharmacist must check for drug–drug interactions and allergies, then release the appropriate quantity of the medication in the correct form. by ZR Wolf · 2008 · Cited by 231 — Background. This chapter examines reporting of health care errors (e.g., verbal, written, or other form of communication and/or recording of near miss and ... by RA Nosek Jr · 2005 · Cited by 34 — The user then can select a single error from the spreadsheet and view all the pertinent details from the incident in report form. Go to: Centralized reporting. Oct 23, 2015 — ... the term 'near miss' is used as synonym for describing what is classified 'intercepted error' for pharmacovigilance purposes. A near miss from a. Medication reconciliation is the formal process in which health care professionals partner with patients to ensure accurate and complete medication information ... May 24, 2023 — When a prescriber is required to write “Medical Necessity” on the prescription, then the dispenser must submit a code to the TN data collection. • In addition there is a “Near Miss” category. • The ... • Note: Medication errors have a separate form for completion – only complete the Medication Error.

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Hawaii Medication Data Form - Medication Error and Near Miss Classification