Cath Lab Digest - February 2008 - (Page 4)

4 CLINICAL EDITOR’S CORNER FEBRUARY 2008 EDITORIAL What’s in a Label? Avoiding Medication Mistakes MORTON KERN, MD Clinical Editor Clinical Professor of Medicine Associate Chief Cardiology University of California Irvine Orange, California LAURIE GUSTAFSON Executive Editor REBECCA KAPUR Managing Editor ELIZABETH MCTAMNEY Layout/Production Manager Y our patient requires heparin. The nurse picks up a brown heparin vial from the back counter, silently draws up the requested dose and gives it to the patient. The dose was supposed to be 1,000 units per kilogram, but 10,000 units per kilogram were given. Although there was no immediate injury, the hospitalization was prolonged, and no significant harm was done. After discharge from the hospital, the family brought legal action against the manufacture of the medication bottle for mislabeling but did not blame the nurse or the hospital. Whose problem is this? The Problem of Medications in the Cath Lab In the cath lab, multiple medications are always on the table in syringes and cups. The Joint Commission Accreditation on Health Care Organizations (now Joint Commission) requires that every syringe or container of any liquid or medication have a label, including the waste bowl, the bowl in which catheters are stored and any receptacles for other medications. Every cath lab physician, nurse and technologist has at one time or another has picked up a syringe, which they assumed to contain one medication and found it to have something else inside. Administration of the wrong medication is a critically important error which we seek to avoid at all costs. In order to do this, we have always employed a system of labeling, now formally mandated for all cath labs. PAUL MACKLER President/CEO PETER NORRIS Executive Vice President/General Manager JEFFREY MARTIN Vice President/Group Publisher Cardiology Division ALEX SLONIM Vice President/Associate Publisher of Cardiology CARSON MCGARRITY Senior Account Director NICK OTRANTO Account Manager BRENDA O’CONNOR Cardiology Sales Associate BILL NORTON Vice President, Meeting and Trade Shows LUCINDA BESKA Classified Advertising Sales Manager FRED KLUMPP Manager of Information Systems KATHY MURPHY Production Director STEFANIE TULEYA RENEE OLSZEWSKI Special Projects Editors PATRICIA LEVY Director of NACCME MORTON KERN, MD Clinical Editor Clinical Professor of Medicine Associate Chief Cardiology University of California Irvine Orange, California mortonkern005@hotmail.com Who is Responsible for Correct Medication Administration? This is the first and most important question. In this scenario above, who is responsible for medication administration and correct dosing? The answer is the physician and the nurse. The trained individual who draws up the medication, and the individual requesting that the medication be given, namely the physician, control what happens to the patient. It is mandatory that every person administering medication correctly identify the medication, calculate the dose and administer the medication via the appropriate route. Labels on medication bottles may be difficult to read, but this does not eliminate the need for accuracy. If there is a problem with reading the labeling on the bottle, many laboratories will take on the task of clarifying the contents of the bottle and its label for nursing usage. Regardless of whether medication bottles have clear labeling or not, it is still the responsibility of anyone handling medications to read the vial, double-check the contents, concentration and route of administration with the requesting physician. Part of the laboratory’s routine should be to repeat the order out loud so that all can hear and confirm. Remember, communication really does solve problems, and improves accuracy and performance. Administration of the wrong medication is a critically important error which we seek to avoid at all costs. CIRCULATION: Contact the Subscription Dept Tel: (800) 237-7285, ext 5 Or (610) 560-0500 ext. 5 E-mail: subscriptions@ hmpcommunications.com SUBSCRIPTION INFORMATION CATH LAB DIGEST IS FREE TO QUALIFIED CATH LAB PERSONNEL WORKING IN THE UNITED STATES. ALL OTHER SUBSCRIPTION RATES ARE AS FOLLOWS: UNITED STATES: $50.00, INTERNATIONAL: $100.00. SINGLE OR REPLACEMENT COPIES ARE SUBJECT TO AVAILABILITY-U.S. continued on next page Editorial Correspondence: Rebecca Kapur, Managing Editor, HMP COMMUNICATIONS Cardiology Editorial Offices, 7427 Winding Way, Brecksville, OH 44141 Tel. (800) 459-8657 Fax: (216) 393-0445 Email address: RKapur@hmpcommunications.com Circulation: Bonnie Shannon, BShannon@hmpcommunications.com, tel. (800) 237-7285, ext. 246 Advertising: Jeffrey Martin, Vice President/Group Publisher, tel. (800) 237-7285, ext. 238, Email: jmartin@hmpcommunications.com Alex Slonim, Vice President/Associate Publisher, tel. (800) 237-7285, ext. 245, Email aslonim@hmpcommunications.com Carson McBrayer, Senior Account Director, tel. (800) 237-7285, ext. 234, Email: cmcbrayer@hmpcommunications.com Nick Otranto, Account Manager, tel. (800) 237-7285, ext. 270, Email: notranto@hmpcommunications.com Brenda O’Connor, Sales Associate, tel. (800) 237-7285, ext. 259, Email: boconnor@hmpcommunications.com Advertising address: HMP COMMUNICATIONS, 83 General Warren Blvd., Suite 100 Malvern, PA 19355 Tel. (800) 237-7285. Cath Lab Digest (ISSN# 1073-2667) is issued 12 times per year by HMP COMMUNICATIONS, 83 General Warren Blvd., Suite 100, Malvern, PA 19355. Periodicals postage paid at Malvern, Pennsylvania and additional mailing offices. Printed in USA at Publisher’s Press, 100 Frank E. 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Table of Contents Feed for the Digital Edition of Cath Lab Digest - February 2008

Cath Lab Digest - February 2008 Bay Regional Medical Center ENDEAVOR IV: A Zotarolimus-Eluting Stent Versus a Paclitaxel-Eluting Stent in a Randomized Clinical Trial A 3D CT Vessel “Roadmap” Over Live Fluoroscopy for Chronic Total Occlusions Contents Clinical Editor’s Corner An Evaluation of Cath Lab Turnaround Time Commentary: An Evaluation of Cath Lab Turnaround Time Excerpts from Chapter 19. STEMI Interventions – Future Perspectives The Potential Clinical Utility of Intravascular Ultrasound Guidance in Patients Undergoing Percutaneous Coronary Intervention With Drug-Eluting Stents The Ten-Minute Interview with…Debbie Charlton, RN The Society of Invasive Cardiovascular Professionals (SICP) at Transcatheter Cardiovascular Therapeutics (TCT) 2007 The Cath Lab is a Business: Do You Have the Knowledge to Stay Afloat? Incidence and Predictors of Vascular Complications after Invasive Coronary Procedures: A Prospective Analysis Ask the Clinical Instructor: A Q&A Column for those New to the Cath Lab Volunteer Survey SICP* Section Meetings Calendar What Do You Think? CEU Education Center Clinical & Industry News Classifieds Advertisers Index

Cath Lab Digest - February 2008

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