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ANECDOTAL RECORD

 INTRODUCTION:-

Anecdotal or progress notes are objective written descriptions of observed student

performance or behavior. They are the factual description of the meaningful incidents and
events that the teacher has observed while dealing with the students. It is also used for
describing a nurse's experience with a person or group especially in the clinical setting. Each
incident should be written down shortly after it happens.

Anecdotal records are factual description of the meaningful incidents and events which the
teacher has observed in the practice of pupils. They are prepared by teachers or supervisors
working with the students in the laboratory or clinical areas. The report may be negative or
positive incidents or outstanding performances or behaviors. It does not include teacher's
judgment or impression and personal interpretation.

 DEFINITION:-
It is a brief description of an observed behavior that appears significant for evaluation
purposes.
An objective description by the teacher of a significant occurrence or an episode in
the life of the pupil.
It is the written description of a specific incident for which a teacher has observed.

 TYPES OF ANECDOTAL RECORDS:-

 General
 Specific

General: This anecdote is maintained with no specific focus in mind.

Specific: Behavior: It includes cooperation, reasoning and social participation.

Event: It includes snack time, group time, arrival, departure, dramatic play.

 PURPOSE OF ANECDOTAL RECORDSPOTTINGLE:-

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Anecdotes capture the richness and complexity of the moment as students interact with one
another and with materials. These records of students' behavior and learning accumulated
over time enhance the teacher's understanding of the individual student as patterns or profiles
begin to emerge. Behavior change can be tracked and documented, and placed in the child's
portfolio resulting in suggestions for future observations, curriculum planning and student or
parent conferences.

 To substitute for vague generalizations about students specific exact description of

behavior.
 To stimulate the teacher to look for information, i.e., pertinent in helping each student
realize good self- adjustment.
 Useful in supplementing and validity observations made by other means. Od
 To understand the individual basic personality pattern and his reactions in different
situations.
 The teacher is able to understand her pupil in arealistic manner.
 It provides an opportunity for healthy pupil-teacher the relationship.
 Help the student to improve their behavior, as it is a direct feedback to an entire
observed incident. It can be used by students for self-appraisal andpeer assessment.
 Anecdotal record can be maintained in those areas of behavior that cannot be evaluated
by other more rigorous systematic methods.
 It can be used in helping students to understand and improve their behavior. Since it is a
direct feedback of an entire observed incident, the student I can analyze his/her behavior
better.

 CHARACTERISTICS OF ANECDOTAL RECORDING:-

 It is a factual recording of the actual event, incident or observation, uncolored by the
feelings, biases of the observer.
 It is a record of only one incident.
 It is a record of an incident which is considered important and significant in the
growth and development of the student.
 It should include:
 a description of a particular occasion
 a delineation of the behavior
noted, indicating who, what, why, when, where and how
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 the evaluator's opinion or estimate of the incident or behavior.

 To furnish the multiplicity of evidence needed for good cumulative record.
 To stimulate teachers to look for information ie pertinent in helping each student
realize good self-adjustment.
 To understand individual's basic personality pattern and his reactions in different
situations.
 The teacher is able to understand the pupil in a realistic manner.
 It provides an opportunity for healthy pupil teacher relationship.

 It can be maintained in the areas of behavior that cannot be evaluated by others

systematic methods.
 Useful in supplementing and validating observation by other means.
 Can be used by students for self-appraisal and peer assessment.

 BASIC ELEMENTS OF ANECDOTAL RECORDS:

* Students name, class and section
* Date of observation
* Name of observer
* Setting or background of the information
* Incident
* Signature of the observer
* Interpretation of behavior and recommendations concerning behavior.

 ADVANTAGES OF ANECDOTAL RECORDS:-

 These record help in clinical service practices.
 They stimulate teacher to use the records and contribute them.
 They provide teacher with objective description.
 They are very good for young children, who we unable to use paper-pencil test.
 They provide cumulative record of growth and development.
 They can be used by the counselor as a source of information for giving evidence.
 They can be used as a supplement to quantitative data.

 DISADVANTAGES OF ANECDOTAL RECORD:-

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 If carelessly recorded the purpose will not be fulfilled.

 Subjectivity.
 Lack of standardization.
 Difficulty in scoring.
 Time consuming.
 Limited application.
 It is a highly subjective measure to assess the behavior of the students.
 Interpretation of recordings is very difficult.
 Evaluation difficult.

 CONCLUSION:-
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Anecdotal records are a type of data collection in which informal reports of a

particular behaviour are recorded through observations. They are typically first-hand
accounts of something that someone observed or experienced. They are often used in
classrooms to document student behaviour as a way to help teachers improve their
teaching.

MEDICATION ERRORS
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 INTRODUCTION:-

A medication error is a failure in the treatment process that leads to, or has the
potential to lead to, harm to the patient. Medication errors can occur in deciding which
medicine and dosage regimen to use (prescribing faults—irrational, inappropriate, and
ineffective prescribing, under prescribing, overprescribing); writing the prescription
(prescription errors); manufacturing the formulation (wrong strength, contaminants or
adulterants, wrong or misleading packaging); dispensing the formulation (wrong drug, wrong
formulation, wrong label); administering or taking the medicine (wrong dose, wrong route,
wrong frequency, wrong duration); monitoring therapy (failing to alter therapy when
required, erroneous alteration). They can be classified, using a psychological classification of
errors, as knowledge-, rule-, action- and memory-based errors. Although medication errors
can occasionally be serious, they are not commonly so and are often trivial.

 DEFINITION:-

Medication Errors:

A medication error is any preventable event that may cause or lead to inappropriate
medication use or patient harm while the medication is in the control of the health care
professionals, patient or consumer. such events may be related to professionals, heath care
products, procedure and systems, including prescribing, order communication, product
labeling, dispensing, distribution, administration, education, monitoring and use.

Any preventable event that may cause or lead to inappropriate medication use or
patient harm while the medication is in the control of the health care professional, patient, or
consumer.

Medication Safety:

Medication safety is defined as the freedom from accidental injury due to medical care or
medical errors during the medication-use process, deserves the same prioritization, given the
scope of medication use in patient care and the frequency and severity of potential harm.

 TYPES OF MEDICATION ERROR:-

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According to ASHP (American society of hospital pharmacist) guidelines, medication

error can be categorized into 11 types

1. Prescribing error

2. Omission error

3. Improper dose error

4. Unauthorized drug error

5. Deteriorated drug error

6. Wrong time error

7. Wrong dosage form error

8. Wrong drug preparation error

9. Wrong administration technique error

10. Monitoring error

11. Compliance error

 INCIDENCE:-
 Prospective study in a Teaching Hospital in Ahmedabad Gujarat
 A total of 1109 patients (511 in Medicine and 598 in Pediatric ward)
 Total number of MES was 403 (36%) of which, 195 (38%) were in
Medicine and 208 (35%) were in Pediatric wards.
 The most common ME was Prescribing errors: 262 (65%) followed by
administration errors 126 (31%).
 Majority of prescriptions were semi rational 555 (53%) followed by
irrational 317 (30%), while 170 (17%) prescriptions were rational.

 MEDICATION ERROR REPORTING:-

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On identifying medication error the pharmacist reports to the physician

And further the medication error report form is filled and forwarded to MEDWATCH
website.

The reports are being reviewed by the staff of the department DMEPA(division of
medication error prevention and analysis) which is a part of CDER (center for drug
evaluation and research).

The DMEPA uses the NCCMERP (national coordination council for medication error
reporting and prevention) guidelines for the conformation of medication error.

They find the cause and solutions and inform them to.

FDA.

FDA publishes in journals.

 RISK FACTOR:-
 Child < 16Yrs
 Aged > 65Yrs
 Physically Challenged
 Patients receiving urgent, life-saving care
 Patients undergoing high-risk surgeries
 Patients on multiple medications
 Patients with multiple medication allergies
 Non-English speakers
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 Anyone being discharged from the hospital

 COMMON CAUSES OF MEDICATION ERRORS:-

A. Human factors

B. Systems

C. Abbreviations

D. Oral orders

E. Look-alike and sound-alike.drugs

F. Dosage calculation

G. At-risk population

H. At-risk drugs

 LOOK-ALIKE OR SOUND-ALIKE (LA/SA) DRUGS:-

Tens of thousands of drugs currently in the market, the potential for error due to
confusing drug names is significant
Look-alike or sound-alike (LA / S * A) health products refer to names of different
drugs that have orthographic similarities and/or similar phonetics (i.e. similar when
written or spoken).
These similarities may pose a risk to health by contributing to medical errors in
prescribing, documenting, dispensing or administering a product
The increasing potential for LASA medication is recognized by NABH and requires
each accredited organization to identify a list of look-alike or sound alike drugs.

Sound-alike drugs
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Avanza (Mirtazapine) Avandia (Rosiglitazone)

Diamox (Acetazolamide) Zimox (Amoxycillin)

Glynase (Glyburide) Zinase (Serratiopeptidase)

Incidal (Cetrizine) Inderal (Propanolol)

Look-alike drugs

Domstal (Domperidone) Alprax (Alprazolam)

Zyloric (Allopurinol) Buscopan (Hyoscine)

Lasix (Fursemide) Avil (Pheniramine )

Veltam (Tamsulosin) Pantium (Pantoprazole)

 MEDICATION ERRORSABBREVIATIONS
 Although widely used in prescription writing, abbreviations can kill!!
 Most of the time, prescribers invent their own.
 Secondly, different individuals/pharmacists may assume or interpret abbreviations
differently.
 Please stick to standard abbreviations

 TYPES OF MEDICATION ERRORS:-

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ROOT CAUSE ANALYSIS (RCA) OF MEDICATION ERROR:

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 STRATEGIES FOR PREVENTING MEDICATION ERRORS:-

Preventing Medication ErrorsAt Doctor level

 Ensuring prescription legibility through “Write in Capital Letters” policy.

 Medication orders and prescription to include both generic and brand name along with
dose, strength, directions for use.
 Implementation of “Verbal order policy” for oral orders
 Protocols for high risk Medication (e.g. Anticoagulant) usage.
 Usage of standardized abbreviations & acronyms throughout the organization.
 Introduction of Hospital Formulary.
 “Tall man” (mixed case) lettering to emphasize drug name differences (example
rabeprazole and aripiprazole).
 Regular Prescription audit followed by appropriate corrective and preventive actions.

Preventing Medication Errors AtNursing Level

 Labeling all medications before preparing.

 All medicines and labels to be verified by two qualified nursing professionals before
administration.
 Not more than one medication is labeled at one time.
 All medications found unlabeled should be discarded immediately.
 Continuous training and updation on LASA and High risk medication and Medication
Error reporting.
 Separate storing of LASA and High risk medication.

Preventing Medication Errors AtPharmacist level

 Ensuring dispensing in carried out by competent individuals.

 Separate storing of LASA and High risk medication.
 Implementation of Medication error reporting culture.
 Continuous training and updation on LASA and High risk medication.
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 Training on Hospital Formulary and Good Pharmacy Practices.

Preventing Medication Errors AtManagement level

 Development of a blame free & punishment free culture of medication error reporting.
 Punitive action is not an effective way to prevent recurrence.
 Medication error does not signify faulty personnel.
 It signifies faulty systems that need to be made safer.
 Establishment of a voluntary reporting system which does not lead to blaming and
shaming of the individual care provider.

 Dedicated personnel (Clinical Pharmacologist)/ Team to collect and analyze

Medication errors & device strategy for process improvement.

Role of IT in Reducing Errors

Computerized Physician Order Entry-

 Reduce errors / adverse drug events 55-80%.

 Produce legible and complete orders.
 Flag laboratory results that affect prescribing.
 Inform ordering Doctors of drug interactions, allergies, and duplication.
 Transmit orders to pharmacy when written.
 Minimize dosing errors; and
 Automatically calculate total doses.
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Hospital:

Patient Name:

Age/Sex:

C.R. No:

Ward:

Bed:

Date and Time of Incident:

Nature of Incident:

Cause of Incident:

Description of the Incident:

Condition of patient after the incident:

Doctor’s advise

Signature of the doctor:

Signature of the nurse:

Date of report:
INCIDENT REPORT FORM
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MEDICATION ERROR REPORT FORM

Reported by (circle): Dr Nurse Pharmacist
Location (circle): PCW PCICU

Please tick the category of medication error you wish to report.

SUPPLY ERROR
 Stock:- inadequate/expired
 Drug information problem
 Labelling error
 Dispensing error
 Other (Please specify)

ADMINISTRATION ERROR
 Dose omission/delay
 Incorrect dose given
 Incorrect administration: - technique/rate
 Other (please specify)

PRESCRIPTION ERROR
 Chart incomplete (e.g. name or weight missing/unsigned)
 Incorrect dose
 Incorrect frequency
 Illegible
 Drugs accidentally omitted
Was the error detected before the
 Drug interaction
 Transcription error drug was given? Y/N
 Other (please specify)

Details of the event (including any clinical consequences):

Date: Signature: Print name:

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 JOURNAL:-

An investigation of the effect of anecdotal information on the choice of a

healthcare facility

Kapil Chalil Madathil Et Al

Abstract

This article includes two studies investigating the impact of anecdotal healthcare information
from the Internet on healthcare decisions. The availability of anecdotal information on the
Internet through social media and peer support groups has increased the risk of the
dissemination of misleading information. The first study investigated the effect of
demographics, quality of life, health status and public reports usage on the use of anecdotal
healthcare information from the Internet. The second employed a 2 (anecdotal information
presented as videos supporting and contradicting public report information) * 2 (phase of
introduction of anecdotal information: early, late) between-subjects experimental design to
investigate the consumer's choice between two health facilities, the level of confidence in the
decision, the knowledge acquired and the workload experienced. The results from the first
study found that age, gender, educational level, health status and public report usage were
significant predictors of consumer use of anecdotal information on the Internet. The results
from the second suggest that the probability of making the optimal choice was reduced by
more than half when contradicting rather than supporting anecdotal information was
presented first. The data from anecdotal information became the anchor points for developing
an understanding of the healthcare situation, meaning initial perceptions did not change after
the presentation of the more reliable public reports. Because of comprehension issues related
to public reports, consumers may give more weight to anecdotal information found online.
Thus, new approaches are needed to ensure the former is engaging for a wide range of
healthcare consumers.

Keywords: Anecdotal information; Healthcare consumer decision making; Public reports.

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 CONCLUSION:-

Medication safety in healthcare is a very important patient safety challenge. Medication

errors are common entity in health care. It results from poorly designed health care systems
rather than negligence of healthcare providers. Safety improvement activities include
identification, reporting and analysis of the errors by dedicated team. Goal is to develop a
culture of patient safety and “fault tolerant” health care system. Health care professionals
should be encouraged to participate in blame free environment and initiate voluntary
reporting systems as a commitment to patient safety.

We must always remember that ‘‘there are no biologically safe drugs; there are only safe
physicians, nurses and pharmacists’’.
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 Bibliography: -
 Sudha R. “Nursing Education principal and Concepts”. 1st edition. New Delhi:
JAYPEE Publisher; 2013. P.
 Sodhi JK,Kaur S. “Comprehensive Textbook of Nursing Education”. 1 st edition.
London: JAYPEE Publisher; 2017. P.
 Basheer P Shabeer. “Text book of Nursing Education”. 1 st edition. Mahalakshipuram,
Bangalore; EMMESS Publisher; 2015. P.
 D Elakkuvana Bhaskara Raj. “Text Book of Nursing Education”. 2 nd edition. New
Delhi: EMMESS medical publisher; 2019. P.
 Journal: Author-Kapil Chalil Madathil. “An investigation of the effect of anecdotal
information on the choice of a healthcare facility”
https://pubmed.ncbi.nlm.nih.gov/29866319/


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Tripura institute of paramedical sciences

Nursing section

Subject: - NURSINGEDUCATION
ASSIGNMENT ON: -ANECDOTAL RECORD ON MEDICATION
ERROR

SUBMITTED BY- SUBMITTED BY-

MRS. RUPA GHOSH Ms. Joysree Bose.
PROFESSOR M.Sc. NURSING, 1ST SEMESTER.
DEPARTMENT OF OBS. & GYN. ROLL NO – 07
NURSING
TIPS, NURSING
TIPS, NURSING

DATE OF SUBMISSION: 04/11/2023

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DATE OF SUBMISSION: 04/11/2023