3 8 S U P P L E M E N T T O O U T P A T I E N T S U R G E R Y M A G A Z I N E O C T O B E R 2 0 1 5
drug names. Clearly write information on labels using a ballpoint pen or felt-tip
marker that won't smudge or run. To eliminate risk of misreading handwritten
labels, consider using pre-printed labels color-coded by drug classifications:
induction agents in yellow, benzodiazepines in orange, muscle relaxants in fluo-
rescent red, narcotics in blue, vasopressors and hypotensive agents in violet,
and local anesthetics in gray. Peel-off labels on vials can be applied to single-use
syringes when the vials' contents are drawn. Drug names should still be visible
on the vials after the peel-off labels have been removed.
Whenever possible, leave drugs in their already correctly labeled ampoules
until it's time to administer them. Prepare a lineup of empty syringe-needle com-
binations, and use one each time you need to open an ampoule and administer a
drug. Whenever possible, transfer the dose from the ampoule to the patient's IV
immediately, and skip the step of labeling a syringe. When less than a full
ampoule is administered, leave the remainder of the drug inside the already
labeled ampoule. Save all used ampoules until the end of the case in case confu-
sion arises about which drugs were administered.
Organized, secured storage
The "big three" medications at risk for safety errors are opioids, insulin and anti-
coagulants, according to Darryl S. Rich, PharmD, MBA, FASHP, a medication safe-
ty specialist at the Institute for Safe Medication Practices. Insulin is almost never
used at facilities that host ambulatory cases, because if a patient has hyper-
glycemia significant enough to require
insulin, the case is often postponed until
the diabetes is better controlled.
Likewise, anticoagulants are almost
never needed in an outpatient setting.
Narcotics, however, pose a serious risk.
Patients with significant comorbidities,
extremes of age or high body mass
Pamela
Bevelhymer,
RN,
BSN
z DRUG STORE Automated storage
solutions direct staff to intended medications.
