PEBC Patient Safety Protocols 5 — Questions and Answers
Question 1: Which strategy is MOST effective at preventing errors when verbal or telephone orders must be accepted?
- Accepting the order and filing it immediately
- Read-back verification: the receiver repeats the order aloud for the prescriber to confirm (Correct answer)
- Asking the prescriber to spell each drug name
- Recording the call and transcribing it later
Correct answer: Read-back verification: the receiver repeats the order aloud for the prescriber to confirm
Read-back verification closes the communication loop and confirms that the order was heard correctly before it is acted upon.
Question 2: A patient with a documented penicillin allergy is prescribed amoxicillin-clavulanate. What is the pharmacist's primary responsibility?
- Dispense since cross-reactivity rates are low
- Alert the prescriber to the allergy documentation and clarify the clinical decision before dispensing (Correct answer)
- Substitute with a cephalosporin without consulting the prescriber
- Dispense and add an allergy warning sticker only
Correct answer: Alert the prescriber to the allergy documentation and clarify the clinical decision before dispensing
The pharmacist must contact the prescriber to confirm the allergy history was considered before dispensing a drug that shares a beta-lactam structure.
Question 3: Which technology has the strongest evidence for reducing medication administration errors in hospital pharmacies?
- Colour-coded prescription pads
- Barcode medication administration (BCMA) systems (Correct answer)
- Alphabetical drug storage
- Fax-based prescription transmission
Correct answer: Barcode medication administration (BCMA) systems
BCMA systems verify the 'five rights' electronically at the point of administration, significantly reducing wrong-drug, wrong-dose, and wrong-patient errors.
Question 4: A caregiver brings in a 2-year-old who accidentally ingested an unknown quantity of iron tablets. What is the pharmacist's first action?
- Advise the caregiver to induce vomiting at home
- Direct the caregiver to call Poison Control (1-800-268-9017) and proceed to the emergency department immediately (Correct answer)
- Recommend activated charcoal from the pharmacy shelf
- Observe the child in the pharmacy for 30 minutes
Correct answer: Direct the caregiver to call Poison Control (1-800-268-9017) and proceed to the emergency department immediately
Iron ingestion in young children is a medical emergency; the pharmacist must direct the family to Poison Control and emergency services immediately.
Question 5: Which of the following best describes a 'near-miss' event in pharmacy practice?
- An error that reached the patient and caused minor harm
- An error that was caught and corrected before it reached the patient (Correct answer)
- A patient complaint about wait time
- A drug shortage that required therapeutic substitution
Correct answer: An error that was caught and corrected before it reached the patient
A near-miss is an error that was intercepted before reaching the patient, providing a critical learning opportunity without patient harm.
Question 6: A patient on carbamazepine is prescribed erythromycin for a respiratory infection. What patient safety concern must the pharmacist address?
- Erythromycin reduces carbamazepine absorption
- Erythromycin inhibits CYP3A4, potentially causing carbamazepine toxicity (Correct answer)
- Carbamazepine accelerates erythromycin clearance, reducing antibiotic effect only
- There is no clinically significant interaction
Correct answer: Erythromycin inhibits CYP3A4, potentially causing carbamazepine toxicity
Erythromycin is a CYP3A4 inhibitor; co-administration with carbamazepine (a CYP3A4 substrate) can cause carbamazepine accumulation and signs of toxicity.
Question 7: Which label information is most critical for preventing a controlled substance dispensing error related to patient identity?
- The prescriber's DEA number printed on the label
- The patient's full name and date of birth on both the vial and the bag (Correct answer)
- The drug's lot number for recall traceability
- The pharmacy's license number
Correct answer: The patient's full name and date of birth on both the vial and the bag
Printing the patient's full name and date of birth on both outer and inner packaging allows final verification at point of dispensing and pickup, reducing wrong-patient errors.
PEBC Patient Safety Protocols 5
Which strategy is MOST effective at preventing errors when verbal or telephone orders must be accepted?