MEDICATION ERRORS(Mistakes, Slips and/or Lapses)
MistakesError in planning and/or taking action.
Knowledge based: Unfamiliar with policies and
procedures Operating out of scope of
practice
Rule based: Not implementing Five Rights of
Medication Administration Operating outside agency Policies
and Procedures
Slips & LapsesError in executing correctly planned
actions.
Action based: Failure to maintain/stock/secure
prescribed medications. Not performing Five Rights of
Medication Administration.
Memory based: Adequate & Timely documentation. Following up on
physician/client/pharmacy requests
Identified Mistakes Unaware of agency policies and
procedures for med administration Unaware of indicators for post
administration observationo Allergic Reaction o Contraindications
Identified Slips & Lapses Missed Dose Wrong administration
technique/time Administering discontinued
medication Administering expired medication Transcribing verbal order in wrong
patient’s chart Documenting on wrong patient Meds administered based on
invalid lab results
ERRORWhen intended action is not performed.