Pharmacy and Medication Services Flashcards

A surveyor finds that a facility administers medications from multi-dose vials to multiple residents and reuses needles between draws from the same vial. What is the primary concern?

Answer: Risk of cross-contamination and transmission of bloodborne pathogens

Reusing needles with multi-dose vials can introduce contaminants into the vial and transmit bloodborne pathogens between patients, a serious infection control and pharmaceutical services deficiency.

Under SMQT survey protocols, what is the significance of a 'look-alike/sound-alike' (LASA) medication error during a review?

Answer: It indicates a potential system failure in drug storage or labeling that requires facility policy review

LASA errors signal systemic vulnerabilities in labeling, storage, or verification processes; surveyors examine whether the facility has policies to reduce LASA confusion.

A facility's pharmacist recommends discontinuing a medication, but the attending physician disagrees and documents a clinical rationale for continuing. How should the surveyor view this?

Answer: Compliant, provided the physician's reasoning is clinically documented and the resident is monitored

Physicians may override pharmacist recommendations when they document a valid clinical rationale; the key survey criterion is that the recommendation was received, considered, and a documented response was made.

Which practice best demonstrates compliance with safe medication pass observation during an SMQT survey?

Answer: Nurse prepares each resident's medication immediately before administration and verifies identity using two identifiers

Safe medication administration requires preparation at the time of administration and positive patient identification using at least two identifiers to prevent errors.

A surveyor is reviewing a nursing home's medication error reporting data and notices that near-misses are never reported. What does this suggest?

Answer: There may be a culture of underreporting that prevents identification of systemic medication safety risks

Zero near-miss reports typically indicate a culture of fear or lack of a non-punitive reporting system, which hides systemic risks rather than resolving them.

During a survey, a resident's care plan lists a documented allergy to penicillin, but the surveyor observes amoxicillin ordered and administered. What is the most likely deficiency?

Answer: Failure to screen for cross-reactive allergies before prescribing a related beta-lactam antibiotic

Amoxicillin is a penicillin-class beta-lactam; prescribing it to a penicillin-allergic patient without allergy reassessment or clinical justification is a medication safety deficiency.

What does the term 'medication reconciliation' specifically require at care transitions in a surveyed facility?

Answer: Comparing a patient's medication orders across transitions to identify discrepancies such as omissions, duplications, or interactions

Medication reconciliation is the process of comparing a patient's medication orders to all medications the patient was taking to avoid errors at admission, transfer, or discharge.