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.
Tennessee Medication Data Form - Medication Error and Near Miss Classification
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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.
34.1 Category I An error occurred that may have contributed to or resulted in the patient's death. [ Classify each medication involved in a medication error. Include the intended product for use, as well as the actual product used, if these are different.
Table of Contents CategoryDescriptionANo error, capacity to cause errorBError that did not reach the patientCError that reached patient but unlikely to cause harm (omissions considered to reach patient)DError that reached the patient and could have necessitated monitoring and/or intervention to preclude harm5 more rows
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.
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%.
Medication error procedures: Immediately notify the supervisor and physician. Follow agency policy to notify appropriate professionals. Know and follow your facility's policy for medication errors. Complete a medication error report in ance with regulations and agency policies.
Health care professionals and consumers have the opportunity to report the occurrence of medication errors to a variety of organizations. Examples include the Institute of Safe Medication Practices (ISMP) and the Food and Drug Administration (FDA). These organizations collectively review error submissions.
A medication error is defined as "any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the healthcare professional, patient, or consumer,? ing to the National Coordinating Council for Medication Error Reporting and Prevention.