Question 1

What is the primary purpose of the ISMP high-alert medications list?

Accepted Answer

The ISMP high-alert medications list identifies drugs that bear a heightened risk of causing significant patient harm when used in error. These medications require special safeguards such as warning labels, double-checks, and restricted access to minimize errors.

Question 2

What is tall man lettering and how does it help prevent medication errors?

Accepted Answer

Tall man lettering is a safety technique that uses mixed-case capitalization to highlight the differing portions of look-alike or sound-alike drug names, such as buPROPion versus busPIRone. By visually emphasizing the distinguishing letters, tall man lettering helps prescribers, pharmacists, and nurses differentiate between similarly named medications and reduce selection errors.

Question 3

What is a wrong-dose medication error, and what are common contributing factors?

Accepted Answer

A wrong-dose error occurs when a patient receives an amount of medication that differs from the prescribed dose, whether too much or too little. Common contributing factors include calculation errors, misreading decimal points (e.g., 1.0 mg read as 10 mg), weight-based dosing miscalculations, and failure to adjust doses for renal or hepatic impairment.

Question 4

What is MedWatch and what types of medication problems should be reported to it?

Accepted Answer

MedWatch is the FDA's Safety Information and Adverse Event Reporting Program, where healthcare professionals and consumers can voluntarily report serious adverse drug reactions, product quality problems, and medication errors. Reports help the FDA identify safety signals that may prompt label changes, drug recalls, or new Risk Evaluation and Mitigation Strategies (REMS).

Question 5

How does barcode medication administration (BCMA) improve patient safety at the bedside?

Accepted Answer

BCMA systems scan the barcodes on both the patient's wristband and the medication package to electronically verify the five rights—right patient, right drug, right dose, right route, and right time—before administration. This technology significantly reduces wrong-patient and wrong-drug errors by triggering alerts when a mismatch is detected, and it creates a time-stamped electronic record of every medication administered.

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