1. List common classifications of medication errors including limitations of incident Medication use process General type of error National Coordinating Council for Medication Error Reporting and Prevention (NCC-MERP) 2. Define root-cause analysis (RCA) and failure mode and effects analysis (FMEA a. FMEA • Tool that can be applied to any process (not just medication safety) • Considers Murphy’s Law (anything can go wrong) • Looks at cause effect, likelihood statistics, and actions that can be taken to reduce the failure rate • Can be used to detect and track changes • Unlike general incident reporting • Can be done for each step in a process and viewed cumulatively b. RCA • A problem solving method for identifying the primary/underlying cause of an issue • Can be used in other areas beyond medication safety • Root cause: removal of the identified “cause” results in prevention of the event occurring • An associated factor may affect, but not remove with certainty, outcome recurrence 3. One of the pharmacy interns at your community pharm refuses to call a certain physician to get an order clarification because he claims that “it doesn’t matter anyway, that physician won’t fix it.” which of the hazardous attitudes is this intern displaying? Resignation 4. One of your coworkers recently had a loss in her family, very close to her. She came into work, despite having vacation time, to get away from drama. You notice throughout the day that she is not focusing on her work and seems distracted. Which principle of CRM is potential being violated in this example? Situational awareness