CFPN Medication Error Investigation and Patient Safety 3

Question 1

A healthcare facility's medication error rate suddenly increases after a new electronic health record (EHR) is implemented. This exemplifies which patient safety concept?

Accepted Answer

Automation bias and unintended consequences of health information technology

Answer

EHR implementation can introduce new error types through alert fatigue, interface changes, and unintended workflow disruptions.

Question 2

In a wrongful death lawsuit involving a medication error, the plaintiff must demonstrate causation. What does this specifically require?

Accepted Answer

That the medication error more likely than not caused or contributed to the patient's death

Answer

Causation in civil negligence requires showing a preponderance of evidence that the error was a substantial contributing factor to the harm.

Question 3

What is the significance of the 'five rights' of medication administration in a forensic investigation of a medication error?

Accepted Answer

They serve as a framework to identify which specific check failed and contributed to the error

Answer

The five rights (right patient, drug, dose, route, time) provide a structured checklist; deviation from any right identifies a specific failure point.

Question 4

When a medication error results in patient harm, which document should be completed to report the event internally within the healthcare system?

Accepted Answer

Incident/variance report (not part of the medical record)

Answer

Incident reports capture details for quality improvement and risk management and are kept separate from the medical record to maintain their protected status.

Question 5

Which medication safety concept does the phrase 'design for failure' reflect in healthcare system engineering?

Accepted Answer

Building systems that make errors difficult to commit and easy to catch

Answer

'Design for failure' or error-proofing (poka-yoke) involves engineering systems so human errors are prevented or intercepted before causing harm.

CFPN - Certified Forensic Pharmacy Nurse Practice Test

CFPN - Certified Forensic Pharmacy Nurse Practice Test

CFPN Medication Error Investigation and Patient Safety 3