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1.5 CE Test Hours

Original Research

Errors in Postoperative Administration of Intravenous Patient-Controlled Analgesia

A Retrospective Study

Contrada, Emily

AJN The American Journal of Nursing: April 2019 - Volume 119 - Issue 4 - p 28
doi: 10.1097/01.NAJ.0000554524.02127.72
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TEST INSTRUCTIONS

  • Read the article. Take the test for this CE activity online at www.nursingcenter.com/ce/ajn.
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  • Registration deadline is March 5, 2021.
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PROVIDER ACCREDITATION

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  • This activity is also provider approved by the California Board of Registered Nursing, Provider Number CEP 11749 for 1.5 contact hour. LPD is also an approved provider of CNE by the District of Columbia, Georgia, and Florida #50-1223. Your certificate is valid in all states.
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PAYMENT

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Errors in Postoperative Administration of Intravenous Patient-Controlled Analgesia: A Retrospective Study

GENERAL PURPOSE:

To present the details of a retrospective descriptive study conducted to describe and analyze the errors associated with postoperative IV patient-controlled analgesia (IV PCA).

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LEARNING OBJECTIVES/OUTCOMES:

After completing this continuing education activity, you should be able to

  • outline key components of IV PCA, as well as the types of errors associated with its use.
  • summarize the results of the authors' study of errors associated with postoperative IV PCA.
  1. With IV patient-controlled analgesia (IV PCA), the patient can self-administer pain medication by pressing a button to release
    1. a dose the patient selects according to pain severity.
    2. a dose the nurse selects according to a sliding scale.
    3. a preprogrammed dose.
  2. The amount of drug that can be given at set intervals to boost the level of anesthesia is termed the
    1. basal rate.
    2. bolus dose.
    3. dose limit.
  3. The amount of drug given per hour as a continuous infusion is termed the
    1. basal rate.
    2. bolus dose.
    3. dose limit.
  4. The maximum amount of drug to be delivered per a set number of hours is called the
    1. lockout interval.
    2. bolus dose.
    3. dose limit.
  5. The period of time between bolus doses during which the IV PCA device cannot deliver medication is called the
    1. lockout interval.
    2. dose limit.
    3. basal rate.
  6. The most common analgesics used in IV PCA are
    1. nonsteroidal antiinflammatory drugs.
    2. adjuvant analgesics.
    3. opioids.
  7. Hankin and colleagues examined reports of events involving IV PCA devices in a 2-year period and found the majority to be
    1. device safety problems.
    2. prescription errors.
    3. operator errors.
  8. According to Hankin and colleagues, of the reports of operator error, the majority involved
    1. an improperly installed IV PCA line.
    2. misprogramming of the device.
    3. a medication mixing error.
  9. Findings from a study by Hicks and colleagues suggested that PCA-related errors
    1. are less common than generally assumed.
    2. can be avoided with additional inservice training.
    3. tend to cause greater harm than non-PCA-related errors.
  10. According to Hicks and colleagues, the PCA process depends heavily on individuals’ ability to
    1. perform sequential tasks successfully.
    2. master the necessary gross motor skills.
    3. anticipate the need for troubleshooting.
  11. In the authors’ study, the most frequent type of IV PCA–associated error was
    1. device malfunction.
    2. operator error.
    3. patient error.
  12. In the authors’ study, the least frequent type of IV PCA–associated error was
    1. device malfunction.
    2. operator error.
    3. patient error.
  13. Of the cases of operator error that the authors examined, the largest percentage involved
    1. a disconnected bolus dose button.
    2. failure to start IV PCA drug administration.
    3. wrong infusion rates set by anesthesia providers.
  14. Of the cases of operator error that the authors examined, the smallest percentage involved
    1. a disconnected bolus dose button.
    2. an improperly installed IV PCA line.
    3. wrong infusion rates set by non-anesthesia providers.
  15. In this study, the largest percentage of cases of device malfunction involved
    1. a defective line.
    2. fast infusion.
    3. slow infusion.
  16. In this study, the smallest percentage of cases of device malfunction involved
    1. fast infusion.
    2. an irregular infusion rate.
    3. damage to the main body of the device.
  17. Of the cases of prescription error identified in this study, half involved
    1. mistakes in drug prescription records.
    2. omission of the patient's personal data.
    3. drug contraindications.
  18. Of the cases of prescription error identified in this study, only 1 involved
    1. mistakes in drug prescription records.
    2. omission of the patient's personal data.
    3. drug contraindications.
  19. Two of the 3 cases of patient error in this study involved
    1. manipulation of the device by the patient.
    2. manipulation of the device by the caregiver.
    3. a lack of understanding of how to use the device.
  20. The authors reported that the second most common type of error caused by device malfunction was
    1. a too-slow rate of infusion.
    2. a too-fast rate of infusion.
    3. damage to the main body of the device.
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